Value of different diagnostic criteria for the irritable bowel syndrome among men and women.J Clin Gastroenterol 2008; 42(2):160-6JC
Whether the diagnostic value of various criteria used to diagnose irritable bowel syndrome (IBS) differ by sex is controversial.
To evaluate the sex-specific value of varying IBS criteria and sex-specific symptoms in patients with IBS and organic disease.
Outpatients of a gastroenterology practice (64% female) completed a validated questionnaire and received a complete diagnostic work-up as required. Questionnaire data were collected prospectively and audited retrospectively.
Overall 233 (male 21%) had a final diagnosis of IBS; 305 (male 47%) received a diagnosis of organic disease. Constipation and bloating were more frequent in females independent whether they had IBS or organic disease. The sensitivity of the diagnostic criteria in male patients was between 82% and 88%, when Manning (3 or more), Rome I or Rome II criteria were applied, whereas the specificity was 65% to 71%. In females, sensitivity was 62% to 64% and specificity was between 66% and 70%. Although all the diagnostic IBS criteria had higher positive predictive values in females versus males, the negative predictive values were lower in females.
Current criteria for IBS differ modestly between sexes, probably reflecting variable prevalence of the disease rather than a sex-specific presentation of IBS.