Diagnostic strategy of irritable bowel syndrome: a low- and middle-income country perspective

• Published in: Intestinal research Vol. 22; no. 3; pp. 286 - 296
• Main Authors: Hidayat, Amal Arifi, Waskito, Langgeng Agung, Sugihartono, Titong, Aftab, Hafeza, Rezkitha, Yudith Annisa Ayu, Vilaichone, Ratha-Korn, Miftahussurur, Muhammad
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Association for the Study of Intestinal Diseases 01.07.2024; 대한장연구학회
• Subjects: developing countries; diagnosis; human and disease; irritable bowel syndrome; Review; 내과학; Developing countries; Diagnosis; Irritable bowel syndrome; Human and disease
• ISSN: 1598-9100; 2288-1956
• DOI: 10.5217/ir.2023.00199

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder associated with substantial impairment which considerably burdens healthcare systems worldwide. Research on IBS has largely been conducted in high-income countries posing barriers to the application of diagnostic strategies in low- and middle-income countries (LMICs) due to differences in disease characteristics, healthcare resources, and socioeconomic factors. This review discusses the diagnostic issues associated with LMICs. We present a concise overview of the relevant approaches and propose a diagnostic strategy based on the latest evidence. A positive diagnostic strategy that relies on appropriate symptom-based criteria is crucial within the diagnostic framework. A combination of complete blood count, fecal occult blood test, and complete stool test may reliably identify individuals with suspected IBS who are more likely to have organic diseases, thus justifying the necessity for a colonoscopy. Eventually, we developed a diagnostic algorithm based on a limited setting perspective that summarizes the available evidence and may be applied in LMICs.