Making a Confident Diagnosis of Irritable Bowel Syndrome

Gastroenterol Clin North Am. 2021 Sep;50(3):547-563. doi: 10.1016/j.gtc.2021.03.004. Epub 2021 Jun 25.


Irritable bowel syndrome (IBS) is among the most common diagnoses made by medical providers and its symptoms are common causes for health care consultation. IBS is characterized by abdominal pain associated with abnormal stool consistency and/or frequency and is widely considered a diagnosis of exclusion, despite abundant evidence contradicting such an approach. A positive diagnosis is achieved through application of symptom-based clinical criteria, careful history and physical examination, evaluation for alarm sign/symptoms, and judicious use of diagnostic testing. This article reviews the symptom-based criteria for IBS and utility of diagnostic tests commonly included in the evaluation of IBS symptoms.

Keywords: Alarm symptoms; Diagnosis; Irritable bowel syndrome; Rome criteria.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Diagnosis, Differential
  • Humans
  • Irritable Bowel Syndrome* / diagnosis
  • Referral and Consultation