Table 3 Recommendations for diagnosing irritable bowel syndrome in primary care

Intervention	Quality of	Benefit/	Strength of
Intervention	evidence	harm	recommendation
• Take a symptom history	Moderate	Net benefit	Definitive
• Assess previous consultations	Low	Net benefit	Definitive
• Screening questions for	Good	Net benefit	Definitive
depression	Good	Net benefit	Definitive
• Assess psychosocial	Moderate	Net benefit	Definitive
factors	Moderate	Net benefit	Definitive
• Check for alarm	Moderate	Net benefit	Definitive
symptoms	Moderate	Net benefit	Definitive
• Investigations
FBC	Moderate	Net benefit	Definitive
EMA/TTG	Good	Trade-offs	Qualified

EMA, endomysial antibodies; FBC, full blood count; TTG, tissue transglutaminase.