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===Differential Diagnosis of Irritable Bowel Syndrome on the basis of Constipation:===
===Differential Diagnosis of Irritable Bowel Syndrome on the basis of Constipation:===
The differential diagnosis of Irritable bowel Syndrome based on predominant symptoms is as follows:<ref name="pmid26913568">{{cite journal |vauthors=Guagnozzi D, Arias Á, Lucendo AJ |title=Systematic review with meta-analysis: diagnostic overlap of microscopic colitis and functional bowel disorders |journal=Aliment. Pharmacol. Ther. |volume=43 |issue=8 |pages=851–862 |year=2016 |pmid=26913568 |doi=10.1111/apt.13573 |url=}}</ref><ref name="pmid27796144">{{cite journal |vauthors=Hilpüsch F, Johnsen PH, Goll R, Valle PC, Sørbye SW, Abelsen B |title=Microscopic colitis: a missed diagnosis among patients with moderate to severe irritable bowel syndrome |journal=Scand. J. Gastroenterol. |volume=52 |issue=2 |pages=173–177 |year=2017 |pmid=27796144 |doi=10.1080/00365521.2016.1242025 |url=}}</ref><ref name="pmid14201408">{{cite journal| author=SCOBIE BA, MCGILL DB, PRIESTLEY JT, ROVELSTAD RA| title=EXCLUDED GASTRIC ANTRUM SIMULATING THE ZOLLINGER-ELLISON SYNDROME. | journal=Gastroenterology | year= 1964 | volume= 47 | issue=  | pages= 184-7 | pmid=14201408 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14201408  }} </ref><ref name="pmid16678566">{{cite journal |vauthors=Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS |title=Childhood functional gastrointestinal disorders: child/adolescent |journal=Gastroenterology |volume=130 |issue=5 |pages=1527–37 |year=2006 |pmid=16678566 |doi=10.1053/j.gastro.2005.08.063 |url=}}</ref><ref name="pmid12425553">{{cite journal |vauthors=Cash BD, Schoenfeld P, Chey WD |title=The utility of diagnostic tests in irritable bowel syndrome patients: a systematic review |journal=Am. J. Gastroenterol. |volume=97 |issue=11 |pages=2812–9 |year=2002 |pmid=12425553 |doi=10.1111/j.1572-0241.2002.07027.x |url=}}</ref><ref name="pmid15188167">{{cite journal |vauthors=Spiegel BM, DeRosa VP, Gralnek IM, Wang V, Dulai GS |title=Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysis |journal=Gastroenterology |volume=126 |issue=7 |pages=1721–32 |year=2004 |pmid=15188167 |doi= |url=}}</ref><ref name="pmid10235207">{{cite journal |vauthors=Hamm LR, Sorrells SC, Harding JP, Northcutt AR, Heath AT, Kapke GF, Hunt CM, Mangel AW |title=Additional investigations fail to alter the diagnosis of irritable bowel syndrome in subjects fulfilling the Rome criteria |journal=Am. J. Gastroenterol. |volume=94 |issue=5 |pages=1279–82 |year=1999 |pmid=10235207 |doi=10.1111/j.1572-0241.1999.01077.x |url=}}</ref><ref name="pmid20456760">{{cite journal |vauthors=Prott G, Shim L, Hansen R, Kellow J, Malcolm A |title=Relationships between pelvic floor symptoms and function in irritable bowel syndrome |journal=Neurogastroenterol. Motil. |volume=22 |issue=7 |pages=764–9 |year=2010 |pmid=20456760 |doi=10.1111/j.1365-2982.2010.01503.x |url=}}</ref><ref name="pmid8995945">{{cite journal |vauthors=Voderholzer WA, Schatke W, Mühldorfer BE, Klauser AG, Birkner B, Müller-Lissner SA |title=Clinical response to dietary fiber treatment of chronic constipation |journal=Am. J. Gastroenterol. |volume=92 |issue=1 |pages=95–8 |year=1997 |pmid=8995945 |doi= |url=}}</ref><ref name="pmid20152787">{{cite journal |vauthors=Spiller R, Camilleri M, Longstreth GF |title=Do the symptom-based, Rome criteria of irritable bowel syndrome lead to better diagnosis and treatment outcomes? |journal=Clin. Gastroenterol. Hepatol. |volume=8 |issue=2 |pages=125–9; discussion 129–36 |year=2010 |pmid=20152787 |doi=10.1016/j.cgh.2009.12.018 |url=}}</ref><ref name="pmid20179692">{{cite journal |vauthors=Rao SS, Valestin J, Brown CK, Zimmerman B, Schulze K |title=Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial |journal=Am. J. Gastroenterol. |volume=105 |issue=4 |pages=890–6 |year=2010 |pmid=20179692 |pmc=3910270 |doi=10.1038/ajg.2010.53 |url=}}</ref><ref name="pmid27753436">{{cite journal |vauthors=Irvine AJ, Chey WD, Ford AC |title=Screening for Celiac Disease in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-analysis |journal=Am. J. Gastroenterol. |volume=112 |issue=1 |pages=65–76 |year=2017 |pmid=27753436 |doi=10.1038/ajg.2016.466 |url=}}</ref><ref name="pmid20634346">{{cite journal |vauthors=van Rheenen PF, Van de Vijver E, Fidler V |title=Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis |journal=BMJ |volume=341 |issue= |pages=c3369 |year=2010 |pmid=20634346 |pmc=2904879 |doi= |url=}}</ref><ref name="pmid20179696">{{cite journal |vauthors=Chey WD, Nojkov B, Rubenstein JH, Dobhan RR, Greenson JK, Cash BD |title=The yield of colonoscopy in patients with non-constipated irritable bowel syndrome: results from a prospective, controlled US trial |journal=Am. J. Gastroenterol. |volume=105 |issue=4 |pages=859–65 |year=2010 |pmid=20179696 |pmc=2887227 |doi=10.1038/ajg.2010.55 |url=}}</ref><ref name="pmid25913530">{{cite journal |vauthors=Slattery SA, Niaz O, Aziz Q, Ford AC, Farmer AD |title=Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea |journal=Aliment. Pharmacol. Ther. |volume=42 |issue=1 |pages=3–11 |year=2015 |pmid=25913530 |doi=10.1111/apt.13227 |url=}}</ref><ref name="pmid25238408">{{cite journal |vauthors=Canavan C, Card T, West J |title=The incidence of other gastroenterological disease following diagnosis of irritable bowel syndrome in the UK: a cohort study |journal=PLoS ONE |volume=9 |issue=9 |pages=e106478 |year=2014 |pmid=25238408 |pmc=4169512 |doi=10.1371/journal.pone.0106478 |url=}}</ref><ref name="pmid23357491">{{cite journal |vauthors=Begtrup LM, Engsbro AL, Kjeldsen J, Larsen PV, Schaffalitzky de Muckadell O, Bytzer P, Jarbøl DE |title=A positive diagnostic strategy is noninferior to a strategy of exclusion for patients with irritable bowel syndrome |journal=Clin. Gastroenterol. Hepatol. |volume=11 |issue=8 |pages=956–62.e1 |year=2013 |pmid=23357491 |doi=10.1016/j.cgh.2012.12.038 |url=}}</ref><ref name="pmid19364994">{{cite journal |vauthors=Ford AC, Chey WD, Talley NJ, Malhotra A, Spiegel BM, Moayyedi P |title=Yield of diagnostic tests for celiac disease in individuals with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis |journal=Arch. Intern. Med. |volume=169 |issue=7 |pages=651–8 |year=2009 |pmid=19364994 |doi=10.1001/archinternmed.2009.22 |url=}}</ref><ref name="pmid23826010">{{cite journal |vauthors=Mehdi Z, Sakineh E, Mohammad F, Mansour R, Alireza A |title=Celiac disease: Serologic prevalence in patients with irritable bowel syndrome |journal=J Res Med Sci |volume=17 |issue=9 |pages=839–42 |year=2012 |pmid=23826010 |pmc=3697208 |doi= |url=}}</ref><ref name="pmid19602448">{{cite journal |vauthors=Ford AC, Spiegel BM, Talley NJ, Moayyedi P |title=Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis |journal=Clin. Gastroenterol. Hepatol. |volume=7 |issue=12 |pages=1279–86 |year=2009 |pmid=19602448 |doi=10.1016/j.cgh.2009.06.031 |url=}}</ref>
The differential diagnosis of Irritable bowel Syndrome based on constipation is as follows:<ref name="pmid26913568">{{cite journal |vauthors=Guagnozzi D, Arias Á, Lucendo AJ |title=Systematic review with meta-analysis: diagnostic overlap of microscopic colitis and functional bowel disorders |journal=Aliment. Pharmacol. Ther. |volume=43 |issue=8 |pages=851–862 |year=2016 |pmid=26913568 |doi=10.1111/apt.13573 |url=}}</ref><ref name="pmid27796144">{{cite journal |vauthors=Hilpüsch F, Johnsen PH, Goll R, Valle PC, Sørbye SW, Abelsen B |title=Microscopic colitis: a missed diagnosis among patients with moderate to severe irritable bowel syndrome |journal=Scand. J. Gastroenterol. |volume=52 |issue=2 |pages=173–177 |year=2017 |pmid=27796144 |doi=10.1080/00365521.2016.1242025 |url=}}</ref><ref name="pmid14201408">{{cite journal| author=SCOBIE BA, MCGILL DB, PRIESTLEY JT, ROVELSTAD RA| title=EXCLUDED GASTRIC ANTRUM SIMULATING THE ZOLLINGER-ELLISON SYNDROME. | journal=Gastroenterology | year= 1964 | volume= 47 | issue=  | pages= 184-7 | pmid=14201408 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14201408  }} </ref><ref name="pmid16678566">{{cite journal |vauthors=Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS |title=Childhood functional gastrointestinal disorders: child/adolescent |journal=Gastroenterology |volume=130 |issue=5 |pages=1527–37 |year=2006 |pmid=16678566 |doi=10.1053/j.gastro.2005.08.063 |url=}}</ref><ref name="pmid12425553">{{cite journal |vauthors=Cash BD, Schoenfeld P, Chey WD |title=The utility of diagnostic tests in irritable bowel syndrome patients: a systematic review |journal=Am. J. Gastroenterol. |volume=97 |issue=11 |pages=2812–9 |year=2002 |pmid=12425553 |doi=10.1111/j.1572-0241.2002.07027.x |url=}}</ref><ref name="pmid15188167">{{cite journal |vauthors=Spiegel BM, DeRosa VP, Gralnek IM, Wang V, Dulai GS |title=Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysis |journal=Gastroenterology |volume=126 |issue=7 |pages=1721–32 |year=2004 |pmid=15188167 |doi= |url=}}</ref><ref name="pmid10235207">{{cite journal |vauthors=Hamm LR, Sorrells SC, Harding JP, Northcutt AR, Heath AT, Kapke GF, Hunt CM, Mangel AW |title=Additional investigations fail to alter the diagnosis of irritable bowel syndrome in subjects fulfilling the Rome criteria |journal=Am. J. Gastroenterol. |volume=94 |issue=5 |pages=1279–82 |year=1999 |pmid=10235207 |doi=10.1111/j.1572-0241.1999.01077.x |url=}}</ref><ref name="pmid20456760">{{cite journal |vauthors=Prott G, Shim L, Hansen R, Kellow J, Malcolm A |title=Relationships between pelvic floor symptoms and function in irritable bowel syndrome |journal=Neurogastroenterol. Motil. |volume=22 |issue=7 |pages=764–9 |year=2010 |pmid=20456760 |doi=10.1111/j.1365-2982.2010.01503.x |url=}}</ref><ref name="pmid8995945">{{cite journal |vauthors=Voderholzer WA, Schatke W, Mühldorfer BE, Klauser AG, Birkner B, Müller-Lissner SA |title=Clinical response to dietary fiber treatment of chronic constipation |journal=Am. J. Gastroenterol. |volume=92 |issue=1 |pages=95–8 |year=1997 |pmid=8995945 |doi= |url=}}</ref><ref name="pmid20152787">{{cite journal |vauthors=Spiller R, Camilleri M, Longstreth GF |title=Do the symptom-based, Rome criteria of irritable bowel syndrome lead to better diagnosis and treatment outcomes? |journal=Clin. Gastroenterol. Hepatol. |volume=8 |issue=2 |pages=125–9; discussion 129–36 |year=2010 |pmid=20152787 |doi=10.1016/j.cgh.2009.12.018 |url=}}</ref><ref name="pmid20179692">{{cite journal |vauthors=Rao SS, Valestin J, Brown CK, Zimmerman B, Schulze K |title=Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial |journal=Am. J. Gastroenterol. |volume=105 |issue=4 |pages=890–6 |year=2010 |pmid=20179692 |pmc=3910270 |doi=10.1038/ajg.2010.53 |url=}}</ref><ref name="pmid27753436">{{cite journal |vauthors=Irvine AJ, Chey WD, Ford AC |title=Screening for Celiac Disease in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-analysis |journal=Am. J. Gastroenterol. |volume=112 |issue=1 |pages=65–76 |year=2017 |pmid=27753436 |doi=10.1038/ajg.2016.466 |url=}}</ref><ref name="pmid20634346">{{cite journal |vauthors=van Rheenen PF, Van de Vijver E, Fidler V |title=Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis |journal=BMJ |volume=341 |issue= |pages=c3369 |year=2010 |pmid=20634346 |pmc=2904879 |doi= |url=}}</ref><ref name="pmid20179696">{{cite journal |vauthors=Chey WD, Nojkov B, Rubenstein JH, Dobhan RR, Greenson JK, Cash BD |title=The yield of colonoscopy in patients with non-constipated irritable bowel syndrome: results from a prospective, controlled US trial |journal=Am. J. Gastroenterol. |volume=105 |issue=4 |pages=859–65 |year=2010 |pmid=20179696 |pmc=2887227 |doi=10.1038/ajg.2010.55 |url=}}</ref><ref name="pmid25913530">{{cite journal |vauthors=Slattery SA, Niaz O, Aziz Q, Ford AC, Farmer AD |title=Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea |journal=Aliment. Pharmacol. Ther. |volume=42 |issue=1 |pages=3–11 |year=2015 |pmid=25913530 |doi=10.1111/apt.13227 |url=}}</ref><ref name="pmid25238408">{{cite journal |vauthors=Canavan C, Card T, West J |title=The incidence of other gastroenterological disease following diagnosis of irritable bowel syndrome in the UK: a cohort study |journal=PLoS ONE |volume=9 |issue=9 |pages=e106478 |year=2014 |pmid=25238408 |pmc=4169512 |doi=10.1371/journal.pone.0106478 |url=}}</ref><ref name="pmid23357491">{{cite journal |vauthors=Begtrup LM, Engsbro AL, Kjeldsen J, Larsen PV, Schaffalitzky de Muckadell O, Bytzer P, Jarbøl DE |title=A positive diagnostic strategy is noninferior to a strategy of exclusion for patients with irritable bowel syndrome |journal=Clin. Gastroenterol. Hepatol. |volume=11 |issue=8 |pages=956–62.e1 |year=2013 |pmid=23357491 |doi=10.1016/j.cgh.2012.12.038 |url=}}</ref><ref name="pmid19364994">{{cite journal |vauthors=Ford AC, Chey WD, Talley NJ, Malhotra A, Spiegel BM, Moayyedi P |title=Yield of diagnostic tests for celiac disease in individuals with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis |journal=Arch. Intern. Med. |volume=169 |issue=7 |pages=651–8 |year=2009 |pmid=19364994 |doi=10.1001/archinternmed.2009.22 |url=}}</ref><ref name="pmid23826010">{{cite journal |vauthors=Mehdi Z, Sakineh E, Mohammad F, Mansour R, Alireza A |title=Celiac disease: Serologic prevalence in patients with irritable bowel syndrome |journal=J Res Med Sci |volume=17 |issue=9 |pages=839–42 |year=2012 |pmid=23826010 |pmc=3697208 |doi= |url=}}</ref><ref name="pmid19602448">{{cite journal |vauthors=Ford AC, Spiegel BM, Talley NJ, Moayyedi P |title=Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis |journal=Clin. Gastroenterol. Hepatol. |volume=7 |issue=12 |pages=1279–86 |year=2009 |pmid=19602448 |doi=10.1016/j.cgh.2009.06.031 |url=}}</ref>
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=== '''Differential Diagnosis of Irritable Bowel Syndrome on the basis of Diarrhea:''' ===
=== '''Differential Diagnosis of Irritable Bowel Syndrome on the basis of Diarrhea:''' ===
The differential diagnosis of Irritable Bowel Syndrome based on diarrhea is as follows:<ref name="pmid26913568" /><ref name="pmid27796144" />
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=== '''Differential Diagnosis of Irritable Bowel Syndrome on the basis of Abdominal Pain:''' ===
=== '''Differential Diagnosis of Irritable Bowel Syndrome on the basis of Abdominal Pain:''' ===
The differential diagnosis of Irritable Bowel syndrome based on abdominal pain is as follows:
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Revision as of 16:38, 1 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Irritable bowel syndrome must be differentiated from other diseases that cause diarrhea, constipation, and abdominal pain, such as Celiac disease, Inflammatory bowel disease(Crohn's disease and Ulcerative colitis) Thyroid disease (Hyper or Hypothyroidism), strictures due to ischemia, diverticulitis or ischemia, among others.

The differential diagnosis for Irritable bowel syndrome can be listed based on predominant symptoms, such as constipation predominant, diarrhea predominant and pain predominant diseases.

Differentiating Irritable Bowel Syndrome from other Diseases

Diseases with similar symptoms

Differential Diagnosis of Irritable Bowel Syndrome on the basis of Constipation:

The differential diagnosis of Irritable bowel Syndrome based on constipation is as follows:[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]

Differential Diagnosis for Constipation predominant symptoms Clinical features Diagnosis
Strictures due to diverticultis,inflammatory bowel disease, ischemia or cancer
Hypothyroidism
  • Fatigue, increased sensitivity to cold, dry skin, constipation, weight gain, puffy face, muscle weakness, hoarseness
Medication
  • Medication history.
Neurologic disease
  • History and neurologic examination
Pelvic floor dysfunction
  • Straining, self digitation
Colonic inertia

Differential Diagnosis of Irritable Bowel Syndrome on the basis of Diarrhea:

The differential diagnosis of Irritable Bowel Syndrome based on diarrhea is as follows:[1][2]

Differential Diagnosis for Diarrhea predominant symptoms Clinical features Diagnosis
Crohn's disease
Ulcerative colitis
Microscopic colitis
Celiac disease
Neuroendocrine tumor
Hyperthyroidism
  • Serum TSH levels
Lactose intolerance
Infectious causes
  • Abdominal discomfort, diarrhea especially in the setting of recent travel
Small bowel bacterial overgrowth
Clostridium difficile infection(Psuedomembranous colitis)

Differential Diagnosis of Irritable Bowel Syndrome on the basis of Abdominal Pain:

The differential diagnosis of Irritable Bowel syndrome based on abdominal pain is as follows:

Differential Diagnosis for Pain predominant symptoms Clinical Features Diagnosis
Aerophagia, bloating
Intermittent small bowel obstruction
  • More likely with a history of previous abdominal surgeries
Ischemia
Chronic pancreatitis
Endometriosis
  • Menstrual associated symptoms, pelvic symptoms
Acute Intermittent Porphyria

The table below summarizes the findings that differentiate watery causes of chronic diarrhea[21][22][23][24]

Cause Osmotic gap History Physical exam Gold standard Treatment
< 50 mOsm per kg > 50 mOsm per kg*
Watery Secretory Crohns + -
Zollinger-Ellison syndrome + -
  • Gastrin levels
  • Proton pump inhibitors
  • Octreotide
Hyperthyroidism + -
VIPoma + -
  • Elevated VIPlevels
  • Followed by imaging
Osmotic Lactose intolerance - +
Celiac disease - +
Functional Irritable bowel syndrome - - Abdominal pain or discomfort recurring at least 3 days per month in the past 3 months and associated with 2 or more of the following:
  • Onset associated with change in frequency of stool
  • Onset associated with change in appearance of stool

History of straining is also common

Clinical diagnosis

References

  1. ↑ 1.0 1.1 Guagnozzi D, Arias Á, Lucendo AJ (2016). "Systematic review with meta-analysis: diagnostic overlap of microscopic colitis and functional bowel disorders". Aliment. Pharmacol. Ther. 43 (8): 851–862. doi:10.1111/apt.13573. PMID 26913568.
  2. ↑ 2.0 2.1 Hilpüsch F, Johnsen PH, Goll R, Valle PC, Sørbye SW, Abelsen B (2017). "Microscopic colitis: a missed diagnosis among patients with moderate to severe irritable bowel syndrome". Scand. J. Gastroenterol. 52 (2): 173–177. doi:10.1080/00365521.2016.1242025. PMID 27796144.
  3. ↑ SCOBIE BA, MCGILL DB, PRIESTLEY JT, ROVELSTAD RA (1964). "EXCLUDED GASTRIC ANTRUM SIMULATING THE ZOLLINGER-ELLISON SYNDROME". Gastroenterology. 47: 184–7. PMID 14201408.
  4. ↑ Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS (2006). "Childhood functional gastrointestinal disorders: child/adolescent". Gastroenterology. 130 (5): 1527–37. doi:10.1053/j.gastro.2005.08.063. PMID 16678566.
  5. ↑ Cash BD, Schoenfeld P, Chey WD (2002). "The utility of diagnostic tests in irritable bowel syndrome patients: a systematic review". Am. J. Gastroenterol. 97 (11): 2812–9. doi:10.1111/j.1572-0241.2002.07027.x. PMID 12425553.
  6. ↑ Spiegel BM, DeRosa VP, Gralnek IM, Wang V, Dulai GS (2004). "Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysis". Gastroenterology. 126 (7): 1721–32. PMID 15188167.
  7. ↑ Hamm LR, Sorrells SC, Harding JP, Northcutt AR, Heath AT, Kapke GF, Hunt CM, Mangel AW (1999). "Additional investigations fail to alter the diagnosis of irritable bowel syndrome in subjects fulfilling the Rome criteria". Am. J. Gastroenterol. 94 (5): 1279–82. doi:10.1111/j.1572-0241.1999.01077.x. PMID 10235207.
  8. ↑ Prott G, Shim L, Hansen R, Kellow J, Malcolm A (2010). "Relationships between pelvic floor symptoms and function in irritable bowel syndrome". Neurogastroenterol. Motil. 22 (7): 764–9. doi:10.1111/j.1365-2982.2010.01503.x. PMID 20456760.
  9. ↑ Voderholzer WA, Schatke W, Mühldorfer BE, Klauser AG, Birkner B, Müller-Lissner SA (1997). "Clinical response to dietary fiber treatment of chronic constipation". Am. J. Gastroenterol. 92 (1): 95–8. PMID 8995945.
  10. ↑ Spiller R, Camilleri M, Longstreth GF (2010). "Do the symptom-based, Rome criteria of irritable bowel syndrome lead to better diagnosis and treatment outcomes?". Clin. Gastroenterol. Hepatol. 8 (2): 125–9, discussion 129–36. doi:10.1016/j.cgh.2009.12.018. PMID 20152787.
  11. ↑ Rao SS, Valestin J, Brown CK, Zimmerman B, Schulze K (2010). "Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial". Am. J. Gastroenterol. 105 (4): 890–6. doi:10.1038/ajg.2010.53. PMC 3910270. PMID 20179692.
  12. ↑ Irvine AJ, Chey WD, Ford AC (2017). "Screening for Celiac Disease in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-analysis". Am. J. Gastroenterol. 112 (1): 65–76. doi:10.1038/ajg.2016.466. PMID 27753436.
  13. ↑ van Rheenen PF, Van de Vijver E, Fidler V (2010). "Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis". BMJ. 341: c3369. PMC 2904879. PMID 20634346.
  14. ↑ Chey WD, Nojkov B, Rubenstein JH, Dobhan RR, Greenson JK, Cash BD (2010). "The yield of colonoscopy in patients with non-constipated irritable bowel syndrome: results from a prospective, controlled US trial". Am. J. Gastroenterol. 105 (4): 859–65. doi:10.1038/ajg.2010.55. PMC 2887227. PMID 20179696.
  15. ↑ Slattery SA, Niaz O, Aziz Q, Ford AC, Farmer AD (2015). "Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea". Aliment. Pharmacol. Ther. 42 (1): 3–11. doi:10.1111/apt.13227. PMID 25913530.
  16. ↑ Canavan C, Card T, West J (2014). "The incidence of other gastroenterological disease following diagnosis of irritable bowel syndrome in the UK: a cohort study". PLoS ONE. 9 (9): e106478. doi:10.1371/journal.pone.0106478. PMC 4169512. PMID 25238408.
  17. ↑ Begtrup LM, Engsbro AL, Kjeldsen J, Larsen PV, Schaffalitzky de Muckadell O, Bytzer P, Jarbøl DE (2013). "A positive diagnostic strategy is noninferior to a strategy of exclusion for patients with irritable bowel syndrome". Clin. Gastroenterol. Hepatol. 11 (8): 956–62.e1. doi:10.1016/j.cgh.2012.12.038. PMID 23357491.
  18. ↑ Ford AC, Chey WD, Talley NJ, Malhotra A, Spiegel BM, Moayyedi P (2009). "Yield of diagnostic tests for celiac disease in individuals with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis". Arch. Intern. Med. 169 (7): 651–8. doi:10.1001/archinternmed.2009.22. PMID 19364994.
  19. ↑ Mehdi Z, Sakineh E, Mohammad F, Mansour R, Alireza A (2012). "Celiac disease: Serologic prevalence in patients with irritable bowel syndrome". J Res Med Sci. 17 (9): 839–42. PMC 3697208. PMID 23826010.
  20. ↑ Ford AC, Spiegel BM, Talley NJ, Moayyedi P (2009). "Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis". Clin. Gastroenterol. Hepatol. 7 (12): 1279–86. doi:10.1016/j.cgh.2009.06.031. PMID 19602448.
  21. ↑ Silverberg MS, Satsangi J, Ahmad T, Arnott ID, Bernstein CN, Brant SR; et al. (2005). "Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology". Can J Gastroenterol. 19 Suppl A: 5A–36A. PMID 16151544.
  22. ↑ Sauter GH, Moussavian AC, Meyer G, Steitz HO, Parhofer KG, Jüngst D (2002). "Bowel habits and bile acid malabsorption in the months after cholecystectomy". Am J Gastroenterol. 97 (7): 1732–5. doi:10.1111/j.1572-0241.2002.05779.x. PMID 12135027.
  23. ↑ Maiuri L, Raia V, Potter J, Swallow D, Ho MW, Fiocca R; et al. (1991). "Mosaic pattern of lactase expression by villous enterocytes in human adult-type hypolactasia". Gastroenterology. 100 (2): 359–69. PMID 1702075.
  24. ↑ RUBIN CE, BRANDBORG LL, PHELPS PC, TAYLOR HC (1960). "Studies of celiac disease. I. The apparent identical and specific nature of the duodenal and proximal jejunal lesion in celiac disease and idiopathic sprue". Gastroenterology. 38: 28–49. PMID 14439871.

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