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19) The small number of older patients who were found to have esophageal cancer had no higher prevalence of alarm symptoms than other subjects in this study.
Under the ACG approach, a patient who gives a history consistent with IBS and has no alarm symptoms or signs--weight loss, fever, rectal bleeding, malnutrition, anemia, a low albumin level, or an elevated WBC--can reasonably be assumed to have IBS and can move straight to a therapeutic trial.