Kruis Score for Diagnosis of Irritable Bowel Syndrome (IBS)

Why Use

The Kruis Score can help objectify and validate clinician suspicion of a patient with IBS .

When to Use

Patients with highly suspected IBS as a possible confirmatory test. Patients with equivocal symptoms but with an initial negative workup to suggest if further workup should be pursued prior to diagnosing IBS.

Formula

Pearls / Pitfalls

The Kruis Score helps to different IBS from organic bowel disease. It uses symptoms and lab testing to suggest which patients likely have IBS (high specificity). It is intentionally not a highly “sensitive” test, since IBS is often a diagnosis of exclusion. Points to keep in mind: As IBS is often a diagnosis of exclusion, often it is appropriate to begin with route lab and/or imaging testing in patients where clinicians have some possible suspicion of organic ideas.

Management

Refer to ACG guidelines for management of acute diarrheal infections in adults.

Advice

If IBS is confirmed, a trial of IBS-related medications (antispasmodics, fiber) may be appropriate. If IBS is not confirmed, further evaluation may be indicated, like CT or ultrasound imaging, HIDA scan, endoscopy, or further blood testing.

More Information

If score <44, negative for IBS. If score >44, positive for IBS. If any “red flags” present, consider further assessment for other pathology.