Symptoms Alone Differentiate Between IBS,Organic Disease, And Food Allergy WESTPORT, CT (Reuters Health) Oct 2 - Specific symptoms can distinguishpatients with irritable bowel syndrome (IBS) from those with an organic disease orfood allergy, according to an Italian study. These findings confirm that IBS andallergy are distinct conditions, the investigators write. Dr. Matteo Neri, of the Universita G. D'Annunzio in Chieti, and colleaguesdiagnosed 99 patients with IBS and 79 with organic disease based on clinical andlaboratory evaluation. Another 22 patients with bowel symptoms were diagnosedwith food allergy based on immunological testing. Eighty-eight patients withextraintestinal allergies and no gastrointestinal symptoms served as controls. Patients completed the Bowel Disease Questionnaire, the results of which werecompared to patient diagnoses and subjected to stepwise logistic regression. Thefindings are reported in the September issue of the European Journal ofGastroenterology and Hepatology. Compared with control subjects, patients with IBS were significantly more likelyto report pain relieved by bowel movements, pain in the lower abdomen, pain inboth the lower and upper abdomen, frequent pain, and abdominal bloating. When the researchers compared IBS patients to those with organic GI disease,IBS was significantly associated with straining on defecation, diarrhea andabdominal bloating, while patients with organic disease were significantly morelikely to report pain in the upper abdomen, reflux, and appetite loss. Theinvestigators report that this model "provided near perfect discrimination betweengroups." IBS also differed significantly from food allergy. A diagnosis of IBS wassignificantly associated with pain in the lower abdomen, pain relieved by bowelmovements, pain occurring at least once per week, and abdominal bloating. "I think that doctors in the clinical practice might apply symptoms-based criteria todiagnose IBS," Dr. Neri told Reuters Health. If patients presented with symptomsspecific to IBS, patients would not need to undergo endoscopy, he pointed out. "It will be interesting to apply the same design to see whether food intolerance canbe differentiated based on symptoms," Dr. Neri said. "Will the discriminatingcapability of symptoms resist the confrontation with food intolerance? That wouldbe another story." Eur J Gastroenterol Hepatol 2000;12:981-988.