Irritable bowel syndrome other diagnostic studies: Difference between revisions
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* Gastrointestinal endoscopy is done in difficult cases of IBS where history is unclear but physical examination is suggestive of the diagnosis. | |||
* All IBS patients with alarm features must undergo '''endoscopic evaluation.''' | |||
* Colonoscopy must be considered in patients aged more than 50 years as part of routine colon cancer screening. | |||
* In IBS patients with persistent diarrhea of age >40 years, a colonoscopy should also be performed to rule out organic causes like IBD and perform sigmoid colon biopsies for microscopic colitis. | |||
* IBS patients with dyspepsia, should undergo esophagogastroduodenoscopy. | |||
* Sigmoidoscopy is performed in patients in order to exclude melanosis coli due to laxative abuse and inflammation. | |||
Sigmoidoscopy | |||
The difficult clinical decision is when to proceed to | The difficult clinical decision is when to proceed to | ||
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(eg, rectal bleeding, weight loss, anorexia). | (eg, rectal bleeding, weight loss, anorexia). | ||
Melanosis coli indicating | Melanosis coli indicating | ||
Revision as of 22:10, 7 November 2017
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Irritable bowel syndrome Microchapters |
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Differentiating Irritable bowel syndrome from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
There are no other diagnostic studies associated with [disease name].
OR
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- There are no other diagnostic studies associated with [disease name].
- [Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include:
- [Finding 1]
- [Finding 2]
- [Finding 3]
- Other diagnostic studies for [disease name] include:
- [Diagnostic study 1], which demonstrates:
- [Finding 1]
- [Finding 2]
- [Finding 3]
- [Diagnostic study 2], which demonstrates:
- [Finding 1]
- [Finding 2]
- [Finding 3]
- [Diagnostic study 1], which demonstrates:
- Gastrointestinal endoscopy is done in difficult cases of IBS where history is unclear but physical examination is suggestive of the diagnosis.
- All IBS patients with alarm features must undergo endoscopic evaluation.
- Colonoscopy must be considered in patients aged more than 50 years as part of routine colon cancer screening.
- In IBS patients with persistent diarrhea of age >40 years, a colonoscopy should also be performed to rule out organic causes like IBD and perform sigmoid colon biopsies for microscopic colitis.
- IBS patients with dyspepsia, should undergo esophagogastroduodenoscopy.
- Sigmoidoscopy is performed in patients in order to exclude melanosis coli due to laxative abuse and inflammation.
The difficult clinical decision is when to proceed to
colonoscopy or barium enema. This decision should be
made by a specialist, and depends mainly on the
individual patient’s risk. Risk is influenced by age (young
patients are very unlikely to have malignant pathology),
family history, duration of symptoms (IBS symptoms are
long-lived), and the presence of any sinister symptoms
(eg, rectal bleeding, weight loss, anorexia).
Melanosis coli indicating
laxative use and microinflammatory disease can be identified
during colonoscopy. Endoscopy is unnecessary in
young patients with classic irritable bowel syndrome
symptoms.69
Endoscopy is an expensive and limited resource, thus
we should probably reserve use of it for patients with
persistent diarrhoeal symptoms in whom duodenal and
colonoscopic biopsy specimens might be needed to
exclude coeliac disease and microscopic colitis,
respectively. However, the diagnostic yield of colonic
biopsy is very low.109,113 A high proportion of patients do
improve during follow-up, so a staged approach, though
lengthy, could save resources and avoid unnecessary
procedures.
coeliac disease.110
crohns, diagnosis of this disorder generally
cannot be made without radiological analysis of the
small bowel,
flexible sigmoidoscopy with biopsies.
Diagnosis
obstructive defecation (pelvic-floor dyssynergia) should be considered,
anorectal manometry can confirm the diagnosis.
.