Diagnostic decision-making in the irritable bowel syndrome

Diagnostic classification problems and work towards a positive diagnosis of the irritable bowel syndrome are reviewed. The absence of a biochemical or morphological marker for this syndrome has led several authors to apply multivariate statistical models in the search for a combination of symptoms that could help in distinguishing the irritable bowel syndrome from other causes of dyspepsia. Despite some limited success in experimental studies the clinical value of porported combinations remains to be proved. Diagnosis of the irritable bowel still rests upon the recognition of key symptoms, rules of thumb, and the exclusion of organic disease.