Summary
Definition
History and exam
Key diagnostic factors
- abdominal discomfort
- alteration of bowel habits associated with pain
- abdominal bloating or distention
- normal exam of abdomen
Risk factors
- physical and sexual abuse
- PTSD
- age <50 years
- female sex
- previous enteric infection
- family history
- family and job stress
Diagnostic investigations
Investigations to consider
- fecal occult blood test
- serologic tests for celiac disease
- fecal calprotectin
- fecal lactoferrin
- serum CRP
- 48-hour stool collection for total bile acids
- serum fibroblast growth factor 19
- 23‐seleno‐25‐homotaurocholic acid (SeHCAT) test
- empiric trial of bile acid binder
- hydrogen breath test
- stool tests for Giardia lamblia
- plain abdominal radiograph
- flexible sigmoidoscopy
- colonoscopy
Treatment algorithm
Contributors
Authors
Chief of Gastroenterology and Hepatology
Kelsey-Seybold Clinic
Clinical Professor of Medicine
Baylor College of Medicine
Houston
Adjunct Professor of Medicine
University of Texas Medical Branch
Galveston
TX
Disclosures
NS declares that he has no competing interests.
Peer reviewers
Professor of Medicine and Psychiatry
School of Medicine
Co-Director
UNC Center for Functional GI and Motility Disorders
Chapel Hill
NC
Disclosures
DD declares that he has no competing interests.
Research Fellow
Department of Gastroenterology
St Mark's Hospital
Northwick Park
Harrow
UK
Disclosures
SM declares that he has no competing interests.
Clinical Research Fellow
Division of Medicine
Imperial College
London
UK
Disclosures
HW declares that he has no competing interests.
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