Table 3Colonic evaluation

StudyPopulation testedTests usedGold standardAbnormal testsAlternative diagnosis
Hamm (1999)Rome criteria met for at least 6 months, and no colonic endoscopic exam in previous 2 years. i.e. not all recent diagnosisAge <50: Flexible sigmoidoscopy
Age >50: Colonoscopy or flexible sigmoidoscopy plus barium enema
None7/306 (2%)

1146 patients not tested
1 colonic obstruction
3 colonic polyps without malignancy
Tolliver (1994)International Congress of Gastroenterology Symptom Criteria for IBS. Referred to secondary care without prior diagnosisAir contrast barium enema, flexible sigmoidoscopy and / or colonoscopy.None43 abnormalities in 23 patients (all 196 tested)2 which could be cause of IBS symptoms
1 cancer
MacIntosh (1992)IBS patients referred to secondary care, (89% fulfilled Manning 3 or more and 84% fulfilled Rome criteria)Sigmoidoscopy, colonoscopy, phosphate enema, rectal biopsyNone0/89 (all patients tested)None
Francis (1996)Patients evaluated within 6 months of diagnosis, met Rome criteria and normal stool exam, haematological and biochemical indices including ESR.Sigmoidoscopy in all, plus barium enema or colonoscopy in over 45 year olds.None0/125 (all patients tested)None except diverticular disease

From: 6, Diagnosis

Cover of Irritable Bowel Syndrome in Adults
Irritable Bowel Syndrome in Adults: Diagnosis and Management of Irritable Bowel Syndrome in Primary Care [Internet].
NICE Clinical Guidelines, No. 61.
National Collaborating Centre for Nursing and Supportive Care (UK).
Copyright © 2008, Royal College of Nursing.

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