Bob Badgett, MD
To the Editors: The two recent reviews of the irritable bowel syndrome (1, 2) are very helpful. However, both state that sigmoidoscopy is necessary in all patients to rule out organic disorders. As noted by Dr. Drossman, 15% to 20% of the population has the irritable bowel syndrome (2). Does sufficient evidence exist to warrant that many sigmoidoscopies? We could limit sigmoidoscopies to the one third of patients who seek medical care, but this limitation has no pathophysiologic basis.
Kruis and colleagues (3) compared "gold standard" upper and lower endoscopies with a noninvasive diagnostic score derived from weighted clinical variables.
Badgett B. Diagnosing the Irritable Bowel Syndrome. Ann Intern Med. ;117:1056–1057. doi: 10.7326/0003-4819-117-12-1056
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Published: Ann Intern Med. 1992;117(12):1056-1057.
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