Irritable bowel syndrome (IBS) affects approximately 10 to 15% of the general adult population in the US, yet the condition remains undiagnosed in at least 75% of patients.2
Diagnosis is based on clinical history, symptoms, physical examination, and exclusion of alarm features.1 In fact, the American College of Gastroenterology does not recommend routine diagnostic testing in patients when symptom-based criteria are fulfilled and alarm features are not present.3*
Diagnosis should include:
1. History based on Rome IV Criteria1
-
Abdominal pain at least 1 day per week for the past 3 months† associated with 2 or more:
- - defecation
- - change in stool frequency
- - change in stool form
2. Exclusion of alarm features1,5,6
- Symptom onset after age 50
- Severe or worsening symptoms
- Unexplained weight loss
- Nocturnal diarrhea
- Rectal bleeding
- Iron-deficiency anemia
- Family history of: colon cancer, celiac disease, IBD
- Fever
3. Physical exam1
Use the “25% Rule” to determine IBS-D subtype1
On days with at least one abnormal bowel movement1:
- <25% of bowel movements with hard, lumpy stool (type 1 or 2 on the Bristol Stool Form Scale)
- >25% of bowel movements with loose, watery stool (type 6 or 7 on the Bristol Stool Form Scale)
The Bristol Stool Form Scale has been shown to be a reliable surrogate marker for colonic transit.
Copyright Rome Foundation, Bristol Stool Form Scale developed by Dr. Ken Heaton, University of Bristol, UK
See how XIFAXAN may work for IBS-D