Identifying dyspepsia and irritable bowel syndrome:: The value of pain or discomfort, and bowel habit descriptors

Background: The utility of current diagnostic criteria for dyspepsia anti irritable bowel syndrome (IBS) in clinical practice is largely unknown. We aimed to compare the diagnostic value of different definitions and questionnaires in a population. Methods: The Abdominal Symptom Questionnaire (ASQ) was mailed to a representative sample (n = 1506, 20-87 years old), and every fifth person (n = 302) concomitantly received the Bowel Disease Questionnaire (BDQ). The diagnostic agreement for dyspepsia and fur IBS, defined in accordance with the Manning and the modified Pome criteria and a new simple definition. was analysed. Results: In the ASQ the agreement on the IBS status for the three IBS definitions was greater than or equal to 88%, and in the BDQ greater than or equal to 93%. Agreement for the three definitions on thc two questionnaires was greater than or equal to 88% regardless of which definition of IBS was applied. Agreement between questionnaires was similar (88%) for dyspepsia. For both IBS and dyspepsia the kappa coefficient indicated moderate to substantial concordance. Pain or discomfort did not cover all linguistic aspects of dyspepsia. Prevalence rates of dyspepsia were comparable in the ASQ and BSQ, whereas higher prevalences of IBS with the ASQ was related to the cutoff levels for reporting abdominal pain or discomfort. Conclusion: It is possible to identify IBS more simply by self-report questionnaires.