Use of surrogate markers of inflammation and Rome criteria to distinguish organic from nonorganic intestinal disease

Validation of the Rome III Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care

“…26 The Manning criteria performed best in the original validation study, 19 and when this study was excluded from the analysis the positive and negative LRs fell to 2.7 and 0.33. The Rome I criteria, which were validated in only one study containing 602 patients, 30 yielded a positive LR of 4.8 and a negative LR of 0.34. 26 Several of the studies included in this meta-analysis classified subjects with diverticular disease, colorectal adenomas, or both, as having organic disease.…”

“…26 Of the available criteria, only those of Manning et al had been subject to more than one validation. 19,[27][28][29] There was only one eligible study examining the accuracy of the Rome I criteria, 30 despite the fact that they had been published 18 years previously, and no studies of either the Rome II or Rome III criteria.…”

Enhancing Diagnostic Performance of Symptom-Based Criteria for Irritable Bowel Syndrome by Additional History and Limited Diagnostic Evaluation

“…Interestingly, studies using combinations of symptoms with biomarkers and/or measures of psychological wellbeing reported improved diagnostic accuracy. 17,21 Other investigators have reported that the absence of "red flag" features, such as nocturnal symptoms, 22,23 or incorporating the results of simple laboratory tests, including hemoglobin and erythrocyte sedimentation rate, 24 may increase the ability to distinguish between functional and organic lower GI diseases.…”

“…12 Tibble et al also demonstrated a high diagnostic accuracy of the Rome I criteria in combination with both a fecal calprotectin and a small intestinal permeability ratio. 21 However, the Kruis model may be limited by its complexity, and the approach of Tibble et al…”

Faecal calprotectin: a new marker for Crohn's disease?

“…1 Calprotectin is now emerging as a new faecal marker that may solve this problem. 1^5 It is an acute phase protein and is the major protein of the neutrophil cytosol.…”