Evolution of the Diagnosis of Functional Gut Disorders: Is an Objective Positive Diagnostic Approach Within Reach?

Irritable bowel syndrome (IBS) is a chronic painful condition that often seriously impairs life, work, and relationships.1 Accurate diagnosis is important to save patients from unnecessary and costly investigations. Tests including colonoscopy even if negative have been documented to fail to reassure patients with IBS.2 The Rome criteria were developed by consensus to provide diagnostic criteria for research and help clinicians make a positive diagnosis of IBS in practice rather than test and then make a diagnosis of exclusion.3 How did these criteria come about? Are the criteria useful and used in practice? Does a positive diagnosis based on symptom assessment reassure patients? In the future, will objective testing become available to positively diagnose IBS? Let us see what the literature can tell us.