Manning Criteria in Irritable Bowel Syndrome: Its Diagnostic Significance

Abstract

Background:Irritable bowel syndrome is one of the most commonly encountered gastrointestinal disorders, for which there are no established diagnostic criteria. Thus, a diagnosis of IBS is made by exclusion of any organic diseases. Recently, important attempts for the positive diagnosis of irritable bowel syndrome by questionnaire surveys of physical symptoms have been made. We performed a questionnaire survey to evaluate the diagnostic value of the Manning criteria and to observe the major symptoms in irritable bowel syndrome.Methods:A symptom questionnaire which consisted of 22 items, including 6 cardinal symptoms of the Manning criteria, were answered by 172 outpatients who had gastrointestinal complaints. According to a final diagnosis based on independent clinical evaluation, all patients were categorized in three groups: irritable bowel syndrome group, nonulcer dyspepsia group and organic gastrointestinal disease group. The results of the questionnaire were analyzed for each group.Results:The sensitivity and specificity of the Manning criteria for the diagnosis of irritable bowel syndrome were 67% and 70% if three or more items were regarded as positive. The mean score and overall frequency of the Manning criteria were significantly higher in irritable bowel syndrome group than in nonulcer dyspepsia (p<0.01) or organic gastointestinal disease group (p<0.05) Among subgroups of the irritable bowel syndrome group, the pain-predominant subgroup showed a significantly higher score and overall frequency than the painless subgroup(p<0.05).Conclusions:The Manning criteria would be useful as a simple and reliable backup tool for the diagnosis of irritable bowel syndrome and seem to be more useful in pain-predominant subgroup. More detailed history-taking should prevent unnecessary extensive investigations for the diagnosis of irritable bowel syndrome.

Systematic review of diagnostic criteria for IBS demonstrates poor validity and utilization of Rome III

“…Of the 41 articles identified, 14 met the full inclusion criteria and were included in the systematic review (Table 1). 9,10,20,22–32 Three articles provided validation for more than one criteria 25,27,28 …”

Validation of the Rome III Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care

“…26 Of the available criteria, only those of Manning et al had been subject to more than one validation. 19,[27][28][29] There was only one eligible study examining the accuracy of the Rome I criteria, 30 despite the fact that they had been published 18 years previously, and no studies of either the Rome II or Rome III criteria.…”

Irritable bowel syndrome: A single gastrointestinal disease or a general somatoform disorder?

“…According to our own investigations, the criteria were unable to distinguish between IBS and lactose malabsorption [31]. Their sensitivity and specificity were 67% and 70%, respectively, in one study [32] and 58% and 74% in another [33], and it varied substantially between genders [34]. The population prevalence of IBS varied between 5% and 25%, depending on the different Rome IBS definitions used [19,35].…”