Obligatory medical device diagnostics.
- H2 breath tests (lactose H2 breath test, fructose H2 breath test, and sorbitol H2 breath test, if applicable) – to rule out lactose, fructose, or sorbitol tolerance. In this test procedure, a baseline determination of the hydrogen concentration in the exhaled air is made before the examination begins; then the affected person is asked to ingest the test sugar (either a lactose, fructose or sorbitol solution) and subsequently the hydrogen concentration in the exhaled air is measured every ten minutes for three to four hours; if the measured values deviate from the baseline value by more than 20 ppm (parts per million), the findings are to be regarded as pathological. [obligatory for the main symptom meteorism (flatulence)]
- Abdominal ultrasonography (ultrasound examination of the abdominal organs) – if gallbladder disease is suspected.
- Vaginal sonography (ultrasound examination by means of an ultrasound probe inserted into the vagina (vagina)) – to exclude ovarian cancer (ovarian cancer); in about 85% of ovarian cancer patients, typical irritable bowel syndrome complaints occur before the cancer diagnosis new and as the first symptom! (About 6 months before diagnosis).
- Sigmoidoscopy (rectosigmoidoscopy, i.e., reflection of the lower approx. 30-40 cm of the rectum (rectum) and the sigmoid colon (sigmoid loop, sigmoid colon)) – as a basic diagnostic; depending on the predominant symptoms.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Ileocolonoscopy/colonoscopy* (colonoscopy) – >50 years of age or >45 years of age if there is a positive family history of colon cancer (colorectal cancer) or, regardless of age, if there is elevated calprotectin/lactoferrin in the stool, chronic diarrhea (diarrhea), or other symptoms (see Indications for colonoscopy)
- Step biopsies (tissue samples from several sections of the intestine) obligatory in diarrhea.
- Esophagogastroduodenoscopy (ÖGD) * (endoscopy of the esophagus, stomach and upper part of the duodenum (duodenum)) with duodenal biopsies (tissue samples from the duodenum).
- Colon transit time determination* (examination can be determined the passage time in the colon) [for the main symptom severe constipation (constipation)].
- Gastrointestinal passage* (X-ray or magnetic resonance imaging/MRI) – stenosis? [for the main symptom meteorism]
- Abdominal CT*
* Generally, invasive further examinations should be performed only when warning signs are present (see “Symptoms – Complaints” under “Warning Signs of Somatic Causes of Illness” for more information).
