Irritable Bowel Syndrome (IBS) & Diarrhea

Manning Criteria for IBS — 2 or more of the following 6 parameters:

• Pain relieved with defecation
• ↑ Stool frequency at time of pain
• Diarrheal stools at time of pain
• Mucus in stool
• Sensation of incomplete defecation
• Abdominal distention on PE

Accuracy for IBS depends on sex, age, & number of criteria.  For example:

• 20 y.o. women: 2/6 (50%) to 6/6 (>90%)
• 60 y.o. man:  2/6 (25%) to 6/6 (70%)

Accuracy for men is always less than for women, and accuracy for everyone decreases after 40 y.o.

• Don’t Dx new-onset IBS in pt. ≥50 y.o. without a decent work-up (incl. colonoscopy)

See also “IBS & Abdominal Pain”