Diagnosis of irritable bowel syndrome People with irritable bowel syndrome (IBS) typically report that they suffer with abdominal cramps and constipation. In some patients, chronic constipation is interspersed with brief episodes of diarrhoea; while a minority of patients with IBS have only diarrhoea. The presentation of symptoms is usually months or years and commonly patients consult different doctors, without great success, and doing various specialized investigations. It notices a strong correlation of the reported symptoms with stress; indeed diarrhoeal discharges are associated with emotional phenomena. IBS blood is present only if the disease is associated with haemorrhoids. Research conducted on irritable bowel syndrome in the 2000s, faecal incontinence and the gastrointestinal complications of HIV have used the<unk><unk>  as a diagnostic<unk>  easy to use, even in research which lasted for 77 months. Historically, this<unk>  of assessment of the faeces has been recommended by the consensus group of Kaiser Permanente Medical Care Program (San Diego, California, US) for the collection of data on functional bowel disease (FBD). More recently, according to the latest revision of the Rome III Criteria, six clinical manifestations of IBS can be identified: Subtypes prevalent presentation of<unk>  in IBS according to the Rome III Criteria 1. IBS with constipation (IBS-C) – lumpy or hard<unk> s * ≥ 25% and loose (soft) or watery<unk> s † *<unk>  type 1–2 (Separate hard lumps like nuts or sausage-shaped); †<unk>  type 6–7 (fluffy pieces with ragged edges, soft or watery, no solid or completely liquid pieces);‡ In the absence of the use of antidiarrhoeal or laxative. These four identified subtypes correlate with the consistency of the<unk> , which can be determined by the<unk> . In 2007, the Mayo Clinic College of Medicine in Rochester, Minnesota, United States, reported a piece of epidemiological research conducted on a population of 4,196 people living in Olmsted County Minnesota, in which participants were asked to complete a questionnaire based on the<unk> . + Distribution of risk factors in three groups classified according to the colonic transit and subgroups classified according to the type of feces model century Normal colonic transit (BSS 3–4) (n=1662) Slow colonic transit (BSS 1–2) (n=411) Fast colonic transit (BSS 5–7) (n=197) Age (mean ± s.d.; years) 62 ± 12 63 ± 13 61 ± 12 Male (%) 50 38 43 BMI (mean ± s.d.) 29.6 ± 7.5 28.2 ± 6.8 32.5 ± 9.9 SSC score (mean ± s.d.) (Somatic Symptom Checklist) 1.6 ± 0,50 1.7 ± 0.53 1.8 ± 0.57 Smoking (%) 8 7 12 Alcohol (%) 45 48 41 Cholecystectomy (%) 11 12 19 Appendectomy (%) 28 31 35 Birth control pills (% women) 3 5 3 Marital status Married (%) 80 77 76 School level Compulsory education (%) 5 5 7 High school/some years (%) 53 52 58 Diploma or university (%) 41 42 36 Family history Gastric cancer (%) 16 14 15 Bowel cancer (%) 12 11 15 The research results (see table) indicate that about 1 in 5 people have a slow transit (type 1 and 2<unk> s), while 1 in 12 has an accelerated transit (type 5 and 6<unk> s). Moreover, the nature of the<unk>  is affected by age, sex, body mass index, whether or not they had cholecystectomy and possible psychosomatic components (somatisation); there were no effects from factors such as smoking, alcohol, the level of education, a history of appendectomy or familiarity with gastrointestinal diseases, civil state, or the use of oral contraceptives. Therapeutic evaluation Several investigations correlate the<unk>  in response to medications or therapies, in fact, in one study was also used to titrate the dose more finely than one drug (colestyramine) in subjects with diarrhoea and faecal incontinence. In a randomised controlled study, the<unk>  is used to study the response to two laxatives: Macrogol (polyethylene glycol) and psyllium (Plantago psyllium and other species of the same genus) of 126 male and female patients for a period of 2 weeks of treatment; failing to show the most rapid response and increased efficiency of the former over the latter. In the study, they were measured as primary outcomes: the number weekly bowel movements,<unk>  consistency according to the types of the<unk> , time to defecation, the overall effectiveness, the difficulty in defecating and<unk>  consistency. From 2010, several studies have used the<unk>  as a diagnostic<unk>  validated for recognition and evaluation of response to various treatments, such as probiotics, moxicombustion, laxatives in the elderly, preparing Ayurvedic poly-phytotherapy filed TLPL/AY, psyllium, mesalazine, methylnaltrexone, and oxycodone/naloxone, or to assess the response to physical activity in athletes.
Bristol stool scale
Stool osmotic gap
Tecumseh step test
Stool test
Beutler test
Prausnitz–Küstner test
Fecal occult blood
Sweat test