When is a colonoscopy necessary in diagnosing IBS?
- A colonoscopy is routinely recommended only in patients older than 50 years of age as per the colon cancer screening guidelines.
- A colonoscopy for those younger than 50 years of age may be appropriate in patients with significant diarrhea or refractory symptoms or if other alarm features are present.
- It should be noted that if a colonoscopy is performed on a patient with suspected IBS with diarrhea, random biopsies should be obtained to exclude microscopic colitis, as a recent study found microscopic colitis present in 2.5% of patients older than the age of 35.
