Diagnosing IBS

The correct diagnosis and appropriate treatment regime present doctors with two major challenges. There are unfortunately no specific tests that can help to make the diagnosis. Although doctors rely heavily on the symptoms discussed above, the diagnosis is often made by exclusion, especially by less experienced doctors. This implies that a lot of expensive tests are requested. 

Over the years, symptom criteria moved from the Manning Criteria, Kruis score to the Rome I, Rome II and now Rome III criteria for a symptom-based diagnosis. Nowadays, the Rome III criteria is used to diagnose IBS.

The Rome III criteria are the following:

1. Recurrent abdominal pain or discomfort, at least three days per month for the last three months, associated with two or more of the following: 

- Improvement with defecation, and/or
- Onset associated with a change in frequency of stool, and/or
- Associated with a change in form (appearance) of stool

Criteria need to be fulfilled for the last three months, with symptom having started six months prior to diagnosis.

Reviewed by Dr Ismail Moola MBCHB (UCT) FCP (SA) Cert Gastro Phys (SA)
Specialist Physician / Gastroenterologist Netcare Sunninghill Hospital and part time Lecturer Department of Internal Medicine, Division of Gastroenterology, Wits University February 2015.

Previously reviewed by Dr E. Wilken (MBChB) Mmed (Int), gastroenterologist, May 2011