الفهرس 
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Abstract
Irritable bowel syndrome is the most commonly diagnosed gastrointestinal disorder. It is a symptom-based condition defined by the presence of abdominal pain or discomfort, with altered bowel habits, in the absence of any other disease to cause these sorts of symptoms (William C. et al , 2015).
IBS is a public health problem since it is widely seen and does not have a cure ( Kamil et al, 2011). Because of the lack of pathognomonic clinical features and of specific diagnostic methods IBS may be easily misdiagnosed (Stoicescu et al., 2012).
Interest in the potential for a missed organic GI diagnosis in patients with suspected IBS has increased over the last decade ( Patel et al, 2015). Many patients with organic GI diseases such as inflammatory bowel disease and microscopic colitis report symptoms that are compatible with IBS (Halpin et al , 2012).
The issue is further complicated by the fact that there were few validation studies of the gold-standard for reaching a diagnosis of IBS, the Rome III criteria (Longstreth et al , 2006), and in a large validation study they performed only modestly in predicting the presence of true IBS (Ford et al , 2013).
The validity of the diagnostic criteria of IBS ( Rome III ) has been studied; however, this has not been done using conventional measurement of sensitivity and specificity in general population samples because there is no gold standard to allow independent confirmation of diagnosis, such as a biomarker.Instead estimations of specificity have been made among those with organic gastrointestinal disease, and sensitivity amongst cases who have already presented and been diagnosed. All of these criteria have modest specificity to diagnose IBS in those with organic gastrointestinal disease of about 0.7. This reflects the fact that the symptoms experienced in IBS are common to other gastrointestinal conditions (Whitehead & Drossman , 2010 ).
Evidence for whether organic GI disease detected at colonoscopy, such as inflammatory bowel disease or colorectal cancer, is likely in patients with IBS is conflicting, with few studies conducted to date (Patel et al, 2015).
Our concern in this study was to prove whether or not organic colonic disease could be detected in patients diagnosed as IBS by Rome III criteria, thus we have examined the yield of colonoscopy in patients with symptoms meeting Rome III criteria for diagnosis of IBS, aiming to estimate the prevalence of organic colonic diseases among Egyptian patients meeting Rome III criteria for diagnosis of IBS at time of diagnosis, identify the most common organic colonic disease/diseases among these patients and identify IBS subtype wich is associated with the highest prevalence of organic colonic disease at time of diagnosis.