Abdominal pain and bowel dysfunction: diagnostic role of intestinal ultrasound

Background Abdominal pain and irregular bowel habits are common among young people. Irritable bowel syndrome is frequent in the general population and has important economic and social costs. Inflammatory bowel diseases are c hronic processes with an acute or indolent onset in young people. Different ial clinical diagnosis between irritable bowel syndrome and inflammatory bo wel disease can be difficult since symptoms and signs are often non-specifi c. Objective To evaluate the role of intestinal ultrasound, a non-invasive, si mple and cheap diagnostic tool, in the differentiation between organic and functional bowel diseases. Methods Abdominal and intestinal ultrasound examinations were performed on 313 consecutive outpatients presenting with abdominal pain and irregular bo wel habits lasting more than 3 months. These patients had no symptoms or si gns indicative of organic disorders and no previous diagnosis of organic di sease. An intestinal wall thickness of more than 7 mm was considered diagno stic for inflammatory bowel disease. Subsequently, we compared the ultrasou nd results with diagnoses obtained following the traditional criteria (radi ological and endoscopic examinations). Results Intestinal ultrasound for the diagnosis of inflammatory bowel disea se showed 74% sensitivity, 98% specificity, a positive predictive value of 92% and a negative predictive value of 92%. Conclusions In our experience, intestinal ultrasound seems important as a f irst diagnostic tool in young patients without clear symptoms or signs of o rganic diseases, and can be used as an indication that subsequent invasive tests are required. Eur J Gastroenterol Hepatol 13:927-931 (C) 2001 Lippinc ott Williams & Wilkins.