COMMENTARY

Gastrointestinal symptoms

Bringing science to the art of diagnosis

P Moayyedi

Correspondence to:
Correspondence to:
Professor P Moayyedi
Gastroenterology Division, McMaster University-HSC 4W8, 1200 Main St West, Hamilton, Ontario, Canada L8N 3Z5; evansl{at}mcmaster.ca

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Which gastrointestinal symptoms are useful in distinguishing organic from functional disease?

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Keywords: colorectal cancer; diagnosis; dyspepsia; functional bowel disorders; organic disease

The first 150 words of the full text of this article appear below.

Patients and clinicians are becoming increasingly intolerant of diagnostic uncertainty. This is reflected in the rising demand for endoscopic procedures¹ implicitly suggesting that gastrointestinal symptoms are an unreliable indicator of serious pathology. Unfortunately, the growing array of tests that are being demanded for patients are placing further pressures on already stretched health care budgets. The natural reaction to this is to evaluate whether we can improve on the value of the history to diagnose gastrointestinal disease. This process was started over 30 years ago when researchers such as Card and colleagues^2,3 and de Dombal and colleagues^4,5 evaluated the use of computers to aid the clinician in making diagnoses in patients with upper gastrointestinal symptoms. The enthusiasm for this approach faded when data suggested that computer improved diagnostic accuracy of computers was not sufficient to prevent investigations.⁶ The paucity of subsequent research in this field is disappointing as it . . . [Full text of this article]

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