Bellentani et al developed a simple score for determining if a patient with abdominal symptoms has irritable bowel syndrome or an organic disease of the colon. This can help to identify patients who may benefit from additional diagnostic procedures. The authors are from Universita' degli Studi di Modena in Italy.
Parameters:
(1) age in years
(2) history in a first order relative of colon cancer or colon polyps
(3) history in a first order relative with colitis
(4) chronic low grade fever (temperature > 37.5°C)
(5) visible abdominal distention
(6) complaining of abdominal distention
(7) bowel movements
(8) flatulence
(9) frank blood in the stool
(10) erythrocyte sedimentation rate (ESR)
(11) white blood cell count
|
Parameter |
Finding |
Points |
|
age in years |
<= 45 years of age |
0 |
|
|
> 45 years of age |
95 |
|
family history of colon cancer or colon polyps |
absent |
0 |
|
|
present |
33 |
|
family history of colitis |
absent |
0 |
|
|
present |
-35 |
|
chronic low grade fever |
none |
0 |
|
|
<= 6 months |
0 |
|
|
> 6 months |
74 |
|
visible abdominal distention |
absent |
0 |
|
|
present |
-39 |
|
complaints of abdominal distention |
absent |
0 |
|
|
present |
-34 |
|
bowel sounds |
normal |
0 |
|
|
abnormal |
-33 |
|
flatulence |
absent |
0 |
|
|
present |
-33 |
|
frank blood in the stool |
absent |
0 |
|
|
present |
112 |
|
ESR |
<= 17 mm in first hour |
0 |
|
|
> 17 mm in first hour |
134 |
|
WBC count |
<= 10,000 per µL |
0 |
|
|
> 10,000 per µL |
85 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: -174
• maximum score: 533
• The higher the score the more likely that the patient has an organic disease of the colon. The lower the score the more likely that the patient has irritable bowel disease.
|
Total Score |
Diagnosis |
|
< -50 |
irritable bowel disease |
|
-50 to 50 |
indeterminate |
|
> 50 |
organic disease |
Specialty: Gastroenterology
