The incidence of initial diagnosis of BE in a stable white population did not change significantly over a 7-yr period, despite an increase in EGD rates.

Irr itable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterized by recurrent episodes of abdominal pain or discomfort along with changes in frequency or consistency of the stool in the absence of an organic etiology. The condition is heterogeneous, exhibiting variability in the frequency of symptoms reported within and between males and females. 1 The pathophysiological mechanisms of IBS are not completely understood. Alterations in gut motility, visceral perception, and central processing of pain and motor function due to abnormalities in the enteric and central nervous system are believed to account for symptoms of IBS. 2 The brain-gut axis and biopsychosocial model have been used to explain how intrinsic and extrinsic stimuli modulate disease expression. 3,4 It is unknown whether IBS is primarily a disorder of abnormal perception to a normal stimulus, or a disorder of normal perception to an abnormal physiologic sensory stimulus. Since no structural abnormalities or biochemical markers characterize IBS, diagnosis is based on the presence of clinical symptoms. 2 Symptom-based diagnostic criteria have been established to create uniformity in reporting and enhance diagnostic accuracy. Objective: The quality of documentation of signs and symptoms and validation of the diagnosis of irritable bowel syndrome (IBS) according to case definition criteria of Manning, Rome I and Rome II in an office setting has not been previously described.We sought to identify and validate cases of IBS based on the Manning, Rome I and Rome II diagnostic criteria in a rural practice setting. Original Research Conclusions:Only a small percentage of IBS cases with assigned diagnostic codes met case definition criteria for IBS.There were low concordance rates among the three diagnostic criteria applied.

Pharmacogenetics represents a rapidly advancing, competitive field of investigation. Due to the potential for clinically recognizable interactions between a set of old polymorphic genes and a relatively new environmental insult (drugs), many human geneticists believe that variability in the drug-metabolizing enzyme systems will soon translate into clinical practice across entire populations. Despite this, the field has not yet received widespread clinical acceptance. This article will review the common cytochrome P450 gene polymorphisms and discuss the factors that may facilitate (or attenuate) their translation into clinical practice.

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