Enterotachogram analysis to distinguish irritable bowel syndrome from Crohn's disease

Crohn's disease is often initially misdiagnosed as irritable bowel syndrome. The goal of this research was to determine if computerized auscultation (fasting enterotachogram analysis) could have a role in distinguishing between these diagnoses. Patients with irritable bowel syndrome, Crohn's disease, and a control group were enrolled in the study. The fasting sound-to-sound interval, standard deviation of the interval, sounds per minute, and percentage time involved with bowel sounds was determined by computerized enterotachogram analysis. The mean sound-to-sound interval for the Crohn's group (1232 msecs) and the controls (1706 msecs) was significantly higher than the irritable bowel group (511 msecs, P < 0.0001). We conclude that Crohn's is not characterized by a shortened interval. The high negative predictive value of the fasting enterotachogram for irritable bowel syndrome suggests that an interval greater than 740 msecs should trigger a search for an alternative diagnosis to irritable bowel. Crohn's disease should be included in that differential.