Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome in Adults

Publication Date: September 2, 2019
Last Updated: December 15, 2022

Treatment

Table 1. Summary of Recommendations of AGA Clinical Guideline on the Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome in Adults (IBS-D)

1. In patients presenting with chronic diarrhea, AGA suggests the use of stool tests, either fecal calprotectin or fecal lactoferrin to screen for inflammatory bowel disease. ( Low , Conditional (weak) )
612
2. In patients presenting with chronic diarrhea, AGA suggests against the use of blood tests erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) to screen for inflammatory bowel disease. ( Low , Conditional (weak) )
612
3. In patients presenting with chronic diarrhea, AGA recommends stool testing for Giardia. ( High , Strong )
612
4. In patients presenting with chronic diarrhea with no travel history to or recent immigration from high risk areas, AGA suggests against testing stools for ova and parasites (other than Giardia). ( Low , Conditional (weak) )
612
5. In patients presenting with chronic diarrhea, AGA recommends testing for celiac disease with IgA tTG and a second test to detect celiac disease in the setting of IgA deficiency. ( Moderate , Strong )
612
6. In patients presenting with chronic diarrhea, AGA suggests testing for bile acid diarrhea. ( Low , Conditional (weak) )
612
7. In patients presenting with chronic diarrhea, AGA makes no recommendation for the use of currently available serologic tests for diagnosis of IBS. ( Evidence Gap , No recommendation )
612

Recommendation Grading

Overview

Title

Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome in Adults

Authoring Organization

American Gastroenterological Association

Publication Month/Year

September 2, 2019

Last Updated Month/Year

November 5, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

This document presents the official recommendations of the American Gastroenterological Association (AGA) on the Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D) in Adults.

Target Patient Population

Adults with Diarrhea-Predominant Irritable Bowel Syndrome

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Laboratory services

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Assessment and screening

Diseases/Conditions (MeSH)

D003967 - Diarrhea

Keywords

functional diarrhea, irritable bowel syndrome (IBS), IBS-D

Source Citation

Smalley W, Falck-Ytter C, Carrasco-Labra A, Wani S, Lytvyn L, Falck-Ytter Y. AGA Guideline on the Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome in Adults (IBS-D). Gastroenterology 2019 Jul 11. pii: S0016-5085(19)41083-4. doi: 10.1053/j.gastro.2019.07.004. [Epub ahead of print]

Supplemental Methodology Resources

Technical Review

Methodology

Number of Source Documents
112
Literature Search Start Date
March 30, 2017
Literature Search End Date
September 1, 2018