This Irritable Bowel Syndrome (IBS) symptoms Manning criteria calculator helps diagnose IBS based on symptoms such as pain or stool consistency. Below the form you can read more on the diagnosis criteria and on this gastrointestinal disorder.
How does the Irritable Bowel Syndrome (IBS) symptoms Manning criteria calculator work?
This health tool provides symptom criteria to aid the screening of patients with relevant symptoms and help the formulation of diagnosis in the case of irritable bowel syndrome.
The Manning criteria is considered a diagnostic algorithm. It is usually applied through questions related to symptoms and signs of IBS addressed to the patient, which are in turn interpreted by the physician, who chooses how many of the specific criteria the patient meets.
The criteria used in the Irritable Bowel Syndrome (IBS) Manning criteria calculator is the following:
■ Pain onset associated with frequent bowel movements;
■ Looser stools associated with onset of pain;
■ Pain relieved by defecation;
■ Noticeable abdominal bloating;
■ Sensation of incomplete evacuation more than 25% of the time;
■ Diarrhea with mucus more than 25% of the time.
Although the criteria can be used efficiently to correlate functional symptoms, further testing is required to establish a positive diagnosis after this stage.
One of the criticisms received by the model refers to the fact that it doesn’t provide high sensitivity in differential diagnosis with other gastrointestinal conditions such as non-ulcer dyspepsia or organic gastrointestinal disease.
The table below evidences the gender difference in the occurrence frequency of Manning criteria in IBS:
|Manning criteria||Male||Female||P value|
|Pain onset associated with frequent bowel movements||60||55||0.82|
|Looser Stools at pain onset||68||52||0.52|
|Pain relieved by defecation||64||55||0.02|
|Noticeable abdominal bloating||16||58||0.02|
|Sensation of incomplete evacuation||80||76||0.89|
|Diarrhea with mucus||24||15||0.48|
There are other diagnostic tools available such as the Rome Criteria I and II or the Kruis criteria. Comparison of the Manning and Rome criteria through a validation study has revealed that the first has less sensitivity but more specificity in diagnosis.
Irritable Bowel Syndrome (IBS) guidelines
This is a functional gastrointestinal disorder characterized by altered bowel habits and unspecific abdominal pain and distension. There are four patters on dysfunction:
■ IBS-D: where diarrhea is predominant;
■ IBS-C: that is constipation predominant;
■ IBS-M: where diarrhea and constipation are mixed;
■ IBS-A: that alternates diarrhea and constipation.
It is considered that changes of pattern, i.e. from C to D, occur in 75% of patients.
The term altered bowel habit defines a series of symptoms such as constipation, diarrhea or postprandial urgency.
Pain is usually located in the lower abdomen, in the left lower quadrant without radiation to other abdominal areas. Meals may precipitate it and it is often partially relieved by defecation.
Other symptoms include:
■ Comorbid fibromyalgia;
■ Urinary frequency;
■ Sexual dysfunction;
■ Weight loss;
■ Gluten intolerance.
Diagnosis involves physical examinations, personal history, radiographic evidence and individual laboratory testing i.e. blood count to screen for anemia, metabolic panel or stool examination.
In the Rome III criteria positive diagnosis is set in patients with recurrent abdominal pain for at least 3 days in each of the previous three months that is associated with other criteria such as defecation relief, changes in stool consistency and frequency or abdominal bloating.
1) Manning AP, Thompson WG, Heaton KW, Morris AF. (1978) Towards positive diagnosis of the irritable bowel. Br Med J; 2(6138):653-4.
2) Talley NJ, Phillips SF, Melton LJ, Mulvihill C, Wiltgen C, Zinsmeister AR. (1990) Diagnostic value of the Manning criteria in irritable bowel syndrome. Gut; 31(1):77-81.
3) Drossman DA, Funch-Jensen P, Janssens J, et al. (1990) Identification of subgroups of functional bowel disorders. Gastroenterol International; 3:15.
4) Fass R, Longstreth GF, Pimentel M, Fullerton S, Russak SM, Chiou CF, Reyes E, Crane P, Eisen G, McCarberg B, Ofman J. (2001) Evidence- and consensus-based practice guidelines for the diagnosis of irritable bowel syndrome. Arch Intern Med; 161(17):2081-8.
5) Ford AC, Bercik P, Morgan DG, Bolino C, Pintos-Sanchez MI, Moayyedi P. (2013) Validation of the Rome III criteria for the diagnosis of irritable bowel syndrome in secondary care. Gastroenterology; 145(6):1262-70.e1.11 Jun, 2016