Checklist for Irritable Bowel Syndrome - Healthyinfo
[Pages:1]Checklist for Irritable Bowel Syndrome
Symptoms
Symptoms listed are based on the Rome Diagnostic Criteria. Please note that the Rome Diagnostic Criteria were created for the purpose of
including patients into a clinical trial. Even though some patients might not fit the Criteria, a diagnosis of IBS might still be appropriate.
Recurrent abdominal pain or discomfort at least 3 days per month for past 3 months
Yes
No
Associated with two or more of the following:
Improvement with defecation
Yes
No
Onset associated with a change in frequency of stool
Yes
No
Onset associated with a change in form (appearance) of stool
Yes
No
Assessment
Careful history taken
Yes
No
Asked about bowel habits and stool characteristics
Yes
No
Asked about food intake
Yes
No
Asked about triggers (i.e., gastrointestinal infection or marked stressors)
Yes
No
Asked about supplements
Yes
No
Asked about any psychological stressors
Yes
No
Physical Exam completed (including rectal exam)
Yes
No
Assess for depression
Yes
No
Assess previous consultation
Yes
No
Lab studies completed
Yes
No
Warning Signs / Alarm Symptoms
Rectal bleeding Anemia Weight loss Fever Family history of colon cancer Onset of symptoms after 50 years of age Short history of symptoms Nocturnal symptoms Male Sex Recent antibiotic use
Major change in symptoms
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Testing
If no warning signs:
Serologic testing for celiac sprue (celiac disease)
Yes
No
If serologic testing positives: Full evaluation for celiac sprue (celiac disease): Upper endoscopy for duodenal biopsy
Yes
No
If warning signs, consider the following:
Complete cell count Blood chemical studies Measurement of thyroid levels Stool testing for occult blood, ova, parasites and culture Colonoscopy Other symptom-guided diagnostic testing, specific:
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Diagnosis Established subclassification of the disorder (constipation, diarrhea, or mixed) Counseling to explain diagnosis Patient education and resource material distributed Treatment prescribed
Management
Follow-up visit within two months after initiating therapy Set reasonable goals for next visit Adjust treatment as necessary Regular follow-up with patient as necessary Notes:
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
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