Comparison of Kruis, Manning and Rome IV Criteria in Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a functional disorder of the gastrointestinal tract characterized by chronic abdominal pain, cramping, constipation, and diarrhea. Manning criteria, Kruis criteria and Rome IV criteria have shown that certain symptoms derived from a 15-items questionnaire differentiated patients with Irritable Bowel Syndrome (IBS) from patients with organic diseases. The purpose of the study is to find out the reliability and discriminatory value of the Manning criteria, Kruis criteria and Rome IV criteria in the differentiation of Irritable Bowel Syndrome (IBS) from organic diseases and to find out if the three criteria could be combined. The study is a prospective cross-sectional analytical study of one hundred and thirty patients who presented with Diarrhea or Constipation to the Department of Medicine, Department of Surgery, Department of Medical Gastroenterology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore between September- February, 2019-2020. After taking informed consent, patients were subjected to preformed questionnaire in the language best understood by them. Patient underwent diagnostic investigations like Complete blood count (CBC), Erythrocyte Sedimentation Rate (ESR), C- reactive protein, Serum albumin and Colonoscopy. A total of 130 patients were interviewed for the study. Manning criteria had the highest sensitivity (88%) compared to Kruis criteria (81%) and Rome IV criteria (80%). Kruis criteria had the highest specificity (91%) compared to Manning criteria (87%) and Rome IV criteria (86%). On combining the three criteria, while the sensitivity is 94.4%, the specificity fell drastically to 58%. Hence everything considered it is best to ply with the individual criteria for the diagnosis of irritable bowel syndrome.