Table 2 Summary of the recommendations for investigating irritable bowel syndrome
InterventionQuality ofBenefit/Strength of
evidenceharmrecommendation
• Take a symptom historyLowNet benefitDefinitive
• Assess psychosocial factorsLowNet benefitDefinitive
• Physical examinationLowNet benefitDefinitive
• Check for alarm symptomsModerateNet benefitDefinitive
• Investigations
    FBCModerateNet benefitDefinitive
    EMAModerateTrade-offsQualified
    Lactose breath hydrogenModerateNet benefitQualified
    test
    ColonoscopyModerateTrade-offsQualified
    Abdominal ultrasoundLowTrade-offsQualified
  • EMA, endomysial antibodies; FBC, full blood count.