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Diagnosis of exclusion

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 1 minute read
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In medicine, we describe a condition as a diagnosis of exclusion when there’s no definitive test to prove it exists or that a particular person has it. Instead, we diagnose it as a collection of particular symptoms, while we’ve done tests to rule out other conditions that can cause a similar presentation.

Irritable bowel syndrome is a good example – gut symptoms are very real to patients, but (as yet) we have no specific test. Instead, we rule out Crohn’s disease, ulcerative colitis, and celiac disease, which also cause gut symptoms.

It’s also useful for conditions such as Alzheimer’s, where the clinical suspicion fits with what we know of the disease. A test is available, but it’s so invasive – requiring a sample of brain tissue – that it’s not an acceptable risk. So, we rule out other causes for memory loss, such as an infection or an electrolyte problem, and then diagnose Alzheimer’s based on the symptoms.

Next steps

A doctor will make a diagnosis of exclusion based on a discussion of the symptoms, a thorough examination, and considering a patient’s medical history. They may do further tests to rule out other conditions before settling on a diagnosis.

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Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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