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Kruis Score for Diagnosis of Irritable Bowel Syndrome (IBS)
Combines symptom pattern with exam and basic labs to support an IBS diagnosis.
Kruis Score for Diagnosis of Irritable Bowel Syndrome (IBS)
Abdominal pain, flatulence, or bowel irregularity reported by patient
Symptoms present for more than 2 years
Pain described as burning, cutting, very strong, terrible, pressure, dull, or boring
Alternating constipation and diarrhea
Abnormal physical findings or history pathognomonic of a diagnosis other than IBS
ESR >20 mm/hr
Leukocytosis (WBC >10,000/uL)
Hemoglobin low (<12 g/dL women, <14 g/dL men)
History of, or observed, blood in the stool
Result0 points
Score <=44 does not support an IBS diagnosis — consider further work-up for organic disease.
When to use
- Supporting a positive diagnosis of IBS using symptom pattern plus simple exam/laboratory findings, rather than diagnosis by exclusion.
Formula
Weighted sum of symptom, exam and laboratory items; score >44 supports IBS.
Pearls and pitfalls
- Any single 'red flag' item (abnormal exam, anemia, leukocytosis, elevated ESR, blood in stool) carries a large negative weight and can override a high symptom score.