Irritable Bowel Syndrome (IBS) Differential Diagnoses

Updated: Feb 15, 2022
  • Author: Jenifer K Lehrer, MD; Chief Editor: BS Anand, MD  more...
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Diagnostic Considerations

Manning and associates established 6 criteria to distinguish irritable bowel syndrome from organic bowel disease. [29] Although historically important, these criteria are insensitive (58%), nonspecific (74%), and less reliable in men. The Manning criteria are as follows:

  • Onset of pain associated with more frequent bowel movements

  • Onset of pain associated with looser bowel movements

  • Pain relieved by defecation

  • Visible abdominal bloating

  • Subjective sensation of incomplete evacuation more than 25% of the time

  • Mucorrhea more than 25% of the time

Other problems to consider include the following:

  • Fructose intolerance

  • Gastrinoma

  • Infectious colitis

  • Medication adverse effects

  • Secretory diarrhea

  • VIPoma

  • Food intolerances, including lactose, fructose, and FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols)

Differential Diagnoses