Disease-specific outcomes assessment for irritable bowel syndrome

IBS is a common, costly condition. The major issue for endoscopists is to decide whether colonoscopy is needed to exclude organic disease. In most cases flexible sigmoidoscopy or barium enema is sufficient. Endoscopy does not have much of a role once the diagnosis is made other than to perform colon cancer screening or to evaluate new symptoms. As evidenced by the data in this article, no formal economic evaluation has been performed for IBS. This deficiency is quite noticeable, especially when compared with the work done in dyspepsia. In addition, it is difficult to measure outcomes in IBS. Mortality is not an issue. Fortunately, disease-specific quality-of-life instruments are now available for use and it is hoped new treatments will soon be at hand. Perhaps in the near future a true diagnostic test for IBS will be available. The threshold for pain with balloon distention is abnormal in many IBS patients. Central nervous system imaging may be a guide. Once these pieces fall into place, more efficient management guidelines may be possible. At present, IBS remains a diagnosis of exclusion and therapy is designed for symptom amelioration. The goal is to accomplish this with as little health care resources as possible.