CT (Reuters Health) - Specific symptoms can distinguish patients with irritable bowel syndrome (IBS) from those with an organic disease or food allergy, according to an Italian study. These findings confirm that IBS and allergy are distinct conditions, the investigators write.

Dr. Matteo Neri, of the Universita G. D'Annunzio in Chieti, and colleagues diagnosed 99 patients with IBS and 79 with organic disease based on clinical and laboratory evaluation. Another 22 patients with bowel symptoms were diagnosed with food allergy based on immunological testing. Eighty-eight patients with extraintestinal allergies and no gastrointestinal symptoms served as controls.

Patients completed the Bowel Disease Questionnaire, the results of which were compared to patient diagnoses and subjected to stepwise logistic regression. The findings are reported in the September issue of the European Journal of Gastroenterology & Hepatology.

Compared with control subjects, patients with IBS were significantly more likely to report pain relieved by bowel movements, pain in the lower abdomen, pain in both the lower and upper abdomen, frequent pain, and abdominal bloating.

When the researchers compared IBS patients to those with organic GI disease, IBS was significantly associated with straining on defecation, diarrhea and abdominal bloating, while patients with organic disease were significantly more likely to report pain in the upper abdomen, reflux, and appetite loss. The investigators report that this model "provided near perfect discrimination between groups."

IBS also differed significantly from food allergy. A diagnosis of IBS was significantly associated with pain in the lower abdomen, pain relieved by bowel movements, pain occurring at least once per week, and abdominal bloating.

"I think that doctors in the clinical practice might apply symptoms-based criteria to diagnose IBS," Dr. Neri told Reuters Health. If patients presented with symptoms specific to IBS, patients would not need to undergo endoscopy, he pointed out.

"It will be interesting to apply the same design to see whether food intolerance can be differentiated based on symptoms," Dr. Neri said. "Will the discriminating capability of symptoms resist the confrontation with food intolerance? That would be another story."

(From Reuters Health)