More accurate diagnosis of irritable bowel syndrome by the use of 'non-colonic' symptomatology.
Open accessAbstract
The criteria now used in an attempt to distinguish irritable bowel syndrome from organic gastrointestinal disease rely almost entirely on symptoms of colonic origin. 'Non-colonic' symptoms, however, arising either from elsewhere in the gut or of a more general nature, are common in irritable bowel syndrome and may have even better diagnostic potential. The prevalence of these non-colonic features was assessed in 107 patients with the irritable bowel syndrome and 295 subjects with other gut disorders. Gastrointestinal type non-colonic symptoms are useful in differentiating irritable bowel syndrome from inflammatory bowel disease but, with the exception of early satiety, are not helpful when there is gastro-oesophageal or biliary disease. More general 'non-colonic' features, such as lethargy and backache, are much commoner in irritable bowel syndrome than in all the organic gastrointestinal diseases studied and have good discriminant function. Multiple logistic regression analysis identified certain features that had a particularly significant independent risk for irritable bowel syndrome. Those were lethargy (relative risk 6.7), incomplete evacuation (RR 5.2), age under 40 (RR 2.1), backache (RR 2.0), early satiety (RR 1.8), and frequency of micturition (RR 1.8). These relative risks can be multiplied together to give an overall risk when more than one of these features is present in a patient. Until a diagnostic test is available more confident diagnosis of irritable bowel syndrome can be achieved by identifying symptoms that have good discriminant function. The results of this study indicate that the non-colonic features of irritable bowel syndrome may be especially valuable in this respect.
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Other studies have observed an excess somatization tendency in outpatients with IBS.
“Other studies (21–23) have also observed an excess somatization tendency in outpatients with IBS.”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [22]
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- Authors
- Maxton, D. G., Morris, J., & Whorwell, P. J.
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1991-07
- Volume
- 32
- Issue
- 7
- Pages
- 784-786
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1378996
- OpenAlex
- W1977675126
- Cited by
- 121
- References
- 12
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 7 · 2012: 3
- FWCI
- 8.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- irritable bowel syndrome, differential diagnosis, lethargy, back pain, early satiety, incomplete evacuation, micturition frequency, inflammatory bowel disease, organic gastrointestinal disease, diagnostic criteria, risk factors
- MeSH terms
- Adult, Aged, Cholelithiasis, Colitis, Ulcerative, Colonic Diseases, Functional, Crohn Disease, Diagnosis, Differential, Esophagitis, Peptic, Female, Humans, Male, Middle Aged, Peptic Ulcer
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