Alternative investigations for irritable bowel syndrome

Area of Science:

• Gastroenterology
• Diagnostic Test Evaluation
• Complementary and Alternative Medicine

Background:

• Alternative and complementary medicine practitioners often recommend alternative treatments for irritable bowel syndrome.
• The use of alternative investigations for gastrointestinal disease is increasing, driven by practitioners and direct-to-consumer advertising.
• Mainstream laboratories in Australia offer various alternative investigations for gastrointestinal conditions.

Purpose of the Study:

• To examine alternative investigations advocated for gastrointestinal disease assessment.
• To determine the availability of these tests through mainstream laboratories in Australia.
• To evaluate these investigations based on established diagnostic criteria.

Main Methods:

• A comprehensive literature review was conducted for each identified investigation.
• Investigations were evaluated using the ACCE criteria: analytical validity, clinical validity, clinical utility, and ethical implications.
• Focus on tests readily available through mainstream laboratories.

Main Results:

• Identified readily available tests include serum immunoglobulin G (IgG) to food antigens, salivary IgA, intestinal permeability, fecal short-chain fatty acids, and fecal microbial analysis.
• None of the investigated alternative methods met the ACCE criteria for diagnostic tests.
• Deficiencies were noted in analytical validity, clinical application, validity, and ethical usage standards.

Conclusions:

• Alternative investigations for gastrointestinal symptoms lack reliability and direct clinical applications.
• These tests should not be recommended for investigating digestive complaints.
• Further validation is needed to establish the clinical utility and reliability of alternative diagnostic methods.