Center for Digestive Disorders, Boston University School of Medicine, Boston, MA 02118, USA.
Postgrad Med. 2010 Mar;122(2):102-11. doi: 10.3810/pgm.2010.03.2127.
Patients with irritable bowel syndrome (IBS) account for >$20 billion in direct and indirect costs annually, a large portion of which relates to making the diagnosis. The diagnosis of IBS is challenging because symptoms can vary between patients and overlap with those of other disorders. This review examines the current diagnostic approach in IBS and discusses new tools that may improve diagnostic confidence earlier in the process. The prevalence of organic disease among patients who meet symptom-based criteria for IBS (eg, Rome III) is generally low; therefore, in the absence of "alarm features," the probability for organic disease is very low. Increased public awareness of IBS symptoms and physician awareness of symptom-based criteria for IBS are needed to facilitate earlier diagnosis. Accumulating evidence suggests that fecal and/or serum biomarkers may be helpful in differentiating IBS from non-IBS disorders. These tools may help minimize unnecessary testing and diagnostic delays. As biomarkers are further studied and developed, they are likely to become an integral part of the diagnosis of IBS and reduce the potential for incorrect diagnosis and treatment delays.
肠易激综合征 (IBS) 患者每年的直接和间接医疗费用超过 200 亿美元，其中很大一部分与诊断有关。IBS 的诊断具有挑战性，因为症状在患者之间存在差异，并且与其他疾病的症状重叠。本文综述了 IBS 的当前诊断方法，并讨论了可能在早期提高诊断信心的新工具。符合 IBS 症状（如罗马 III 标准）的患者中，器质性疾病的患病率通常较低；因此，在没有“报警特征”的情况下，器质性疾病的可能性非常低。需要提高公众对 IBS 症状的认识和医生对 IBS 基于症状的标准的认识，以促进早期诊断。越来越多的证据表明，粪便和/或血清生物标志物可能有助于区分 IBS 与非 IBS 疾病。这些工具可能有助于减少不必要的检查和诊断延误。随着生物标志物的进一步研究和开发，它们很可能成为 IBS 诊断的一个组成部分，并减少错误诊断和治疗延误的可能性。
