International Journal of Gastroenterology

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

Received: 18 May 2020    Accepted: 20 June 2020    Published: 06 July 2020
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Abstract

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.

DOI 10.11648/j.ijg.20200402.12
Published in International Journal of Gastroenterology (Volume 4, Issue 2, December 2020)
Page(s) 34-40
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Irritable Bowel Syndrome (IBS), Kruis Criteria, Manning’s Criteria, Rome’s IV Criteria

References
[1] Brandt LJ, Chey WD, Foxx-Orenstein AE, et al. An evidence-based systematic review on the management of irritable bowel syndrome. American Journal of Gastroenterology. 2009; 104 (Suppl 1): S1-S35.
[2] Boyce PM, Koloski NA, Talley NJ. Irritable bowel syndrome according to varying diagnostic criteria: are the new Rome II criteria unnecessarily restrictive for research and practice. Am J Gastroenterol. 2000 Nov; 95 (11): 3176-83.
[3] Occhipinti K, Smith JW. Irritable bowel syndrome: a review and update. Clin Colon Rectal Surg. 2012; 25: 46–52.
[4] Talley NJ. Serotoninergic neuroenteric modulators. Lancet. 2001; 358: 2061–2068.
[5] Dunlop SP, Coleman NS, Blackshaw E, Perkins AC, Singh G, Marsden CA, Spiller RC. Abnormalities of 5-hydroxytryptamine metabolism in irritable bowel syndrome. Clin Gastroenterol Hepatol. 2005; 3: 349–357.
[6] Coates MD, Mahoney CR, Linden DR, Sampson JE, Chen J, Blaszyk H, Crowell MD, Sharkey KA, Gershon MD, Mawe GM, et al. Molecular defects in mucosal serotonin content and decreased serotonin reuptake transporter in ulcerative colitis and irritable bowel syndrome. Gastroenterology. 2004; 126: 1657–1664.
[7] Drossman DA, Camilleri M, Mayer EA, Whitehead WE. AGA technical review on irritable bowel syndrome. Gastroenterology. 2002; 123: 2108–2131.
[8] Drossman DA, Corrazziari E, Delvaux M, Spiller R, Talley NJ, Thompson WG. Rome III: The Functional Gastrointestinal Disorders. Gastroenterology 2006; 130: 1377–1390.
[9] Talley NJ, Spiller R. Irritable bowel syndrome: a little understood organic bowel disease? Lancet. 2002; 360: 555–564.
[10] Manning A. P., Thompson W. G., Heaton K. W., Morris A. F. Towards positive diagnosis of the irritable bowel. Br. Med. J. 1978; 2: 653–654.
[11] Kruis W., Thieme C., Weinzierl M., Schüssler P., Holl J., Paulus W. A diagnostic score for the irritable bowel syndrome. Its value in the exclusion of organic disease. Gastroenterology August 1984; 87 (1): 1-7.
[12] Homes KM, Salter RH. Irritable bowel syndrome-a safe diagnosis? Br Med J. Manning Criteria in Irritable Bowel Syndrome: Its Diagnostic Significance. Korean J Intern Med. 1993 Jan; 8 (1): 34–39.
[13] Doğan UB, Unal S. Kruis scoring system and Manning's criteria in diagnosis of irritable bowel syndrome: is it better to use combined? Acta Gastroenterol Belg. 1996 Oct-Dec; 59 (4): 225-8.
[14] Ford A. C., Bercik P., Morgan D. G., Bolino C., Pintos-Sanchez M. I., Moayyedi P. Validation of the Rome III criteria for the diagnosis of irritable bowel syndrome in secondarycare. Gastroenterology. 2013; 145: 1262-1270.
[15] Andrew seng boon chua. Prevalence of irritable bowel syndrome in northern india. J neurogastroenterol motil. 2011 Jan; 17 (1): 6-8.
[16] P. Jellema, D. A. W. M. Van Der Windt, F. G. Schellevis, H. E. Van Der Horst. Systematic review: accuracy of symptom-based criteria for diagnosis of irritable bowel syndrome in primary care. 2009 September; 30 (7): 695-706.
Author Information
  • Department of Medical Gastroenterology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

  • Department of Medical Gastroenterology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

  • Department of Medical Gastroenterology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

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    Farah Naaz Kazi, Anurag Agarwal, Prashant Kanni. (2020). Comparison of Kruis, Manning and Rome IV Criteria in Irritable Bowel Syndrome. International Journal of Gastroenterology, 4(2), 34-40. https://doi.org/10.11648/j.ijg.20200402.12

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    ACS Style

    Farah Naaz Kazi; Anurag Agarwal; Prashant Kanni. Comparison of Kruis, Manning and Rome IV Criteria in Irritable Bowel Syndrome. Int. J. Gastroenterol. 2020, 4(2), 34-40. doi: 10.11648/j.ijg.20200402.12

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    AMA Style

    Farah Naaz Kazi, Anurag Agarwal, Prashant Kanni. Comparison of Kruis, Manning and Rome IV Criteria in Irritable Bowel Syndrome. Int J Gastroenterol. 2020;4(2):34-40. doi: 10.11648/j.ijg.20200402.12

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  • @article{10.11648/j.ijg.20200402.12,
      author = {Farah Naaz Kazi and Anurag Agarwal and Prashant Kanni},
      title = {Comparison of Kruis, Manning and Rome IV Criteria in Irritable Bowel Syndrome},
      journal = {International Journal of Gastroenterology},
      volume = {4},
      number = {2},
      pages = {34-40},
      doi = {10.11648/j.ijg.20200402.12},
      url = {https://doi.org/10.11648/j.ijg.20200402.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijg.20200402.12},
      abstract = {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.},
     year = {2020}
    }
    

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    T1  - Comparison of Kruis, Manning and Rome IV Criteria in Irritable Bowel Syndrome
    AU  - Farah Naaz Kazi
    AU  - Anurag Agarwal
    AU  - Prashant Kanni
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    JO  - International Journal of Gastroenterology
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    PB  - Science Publishing Group
    SN  - 2640-169X
    UR  - https://doi.org/10.11648/j.ijg.20200402.12
    AB  - 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.
    VL  - 4
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