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    • Calcs that help predict probability of a diseaseDiagnosis
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    • Numerical inputs and outputsFormula
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    Patent Pending

    Manning Criteria for Diagnosis of Irritable Bowel Syndrome (IBS)

    Determines likelihood of irritable bowel syndrome diagnosis based on clinically significant criteria.
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    When to Use
    Pearls/Pitfalls
    Why Use

    Patients being evaluated for possible IBS.

    • The Manning Criteria were developed through patient survey and follow-up.
    • They differentiate patients with organic and non-IBS conditions.

    Points to keep in mind:

    • Studies have found highly variable diagnostic performance of the criteria.

    The symptoms that define IBS are subjective and self-reported, making a diagnostic classification system helpful. Moreover, there is evidence to support the notion that patients meeting criteria may be more likely to respond to some therapies.

    Red Flag Signs

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The Manning Criteria were developed to help predict which patients will de diagnosed with IBS, i.e. will not have any organic disease identified after complete work-up. In a setting where work-up resources are limited, or take undue time, these may be particularly useful.

    Management

    We are unaware of validated management algorithms using the Manning Criteria.

    Critical Actions

    IBS is a ‘rule-out’ diagnosis, which is to say all other possibilities must be ruled out first.

    Formula

    Addition of positive criterion.

    • Onset of pain linked to more frequent bowel movements
    • Looser stools associated with onset of pain
    • Pain relieved by passage of stool
    • Noticeable abdominal bloating
    • Sensation of incomplete evacuation more than 25% of the time
    • Diarrhea with mucus more than 25% of the time

    Facts & Figures

    If no red flag signs are present, a patient likely has IBS when at least 3 of the 6 criteria are met with 63-90% sensitivity and 70-93% specificity.

    Dr. A. P. Manning

    About the Creator

    A. P. Manning, MD, is a physician at the Bristol Royal Infirmary in the United Kingdom. He published the derivation study for the Manning Criteria on IBS diagnosis during his time as a research fellow at Duke University.

    To view Dr. A. P. Manning's publications, visit PubMed