Irritable Bowel Syndrome: Toward an Understanding of Severity (original) (raw)
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Gastroentérologie Clinique et Biologique, 2004
Aims-Heath-related quality of life (QoL) is decreased in patients with irritable bowel syndrome (IBS) but the relationship between symptom intensity of IBS and QoL remains largely unknown. The aim of this prospective survey was to investigate the relationship between intensity of IBS and changes in QoL. Methods-Eight hundred and fifty-eight patients with IBS, according to Rome II criteria, completed a symptom questionnaire to measure intensity of IBS, and the gastrointestinal quality of life (GIQLI) questionnaire, which is a general QoL measure in patients with gastrointestinal disorders. Results-37.2% of the patients had constipation-predominant type IBS, 37.3% had diarrhea-predominant IBS and 25.4% had alternating diarrhea and constipation type symptoms. IBS was considered to be in remission or mild in 8.3% of patients; 41.3% had moderate IBS and 50.4% had severe IBS. The mean GIQLI score was 88 ± 20. There was a significant correlation between symptom intensity and changes in QoL. Other significantly related factors were the type of bowel abnormality and gender. Conclusion-In IBS patients, symptom intensity and type of IBS have a negative impact on health-related QoL. RÉSUMÉ Relations entre la sévérité et la qualité de vie chez 858 malades ayant un syndrome de l'intestin irritable
Clinical Gastroenterology and Hepatology, 2011
Background & Aims-Patient-reported outcomes (PROs) are used to gauge the benefit of treatments for functional gastrointestinal disorders, including irritable bowel syndrome (IBS). Commonly used endpoints derived from scales of symptom severity differ in their structure, format, and the extent to which they are based on established, psychometric fundamentals. We evaluated the overlap between 2 measures of IBS symptom severity, documented their association with different symptoms (pain, bloating, defecation), and identified psychological factors that might bias PRO ratings, by affecting how patients interpret IBS symptom severity. Methods-Ninety-eight patients diagnosed with IBS, based on Rome III criteria, completed the multi-component IBS symptom severity scale and the single-item, UCLA symptom severity scale. Data were collected on pain, bloating, and bowel habits, as well as somatization, sensitivity to arousal symptoms (anxiety sensitivity), and a negative thinking style called pain catastrophizing. Results-The 2 global scales were correlated with one another (r=0.56); each scale was most strongly associated with variation in abdominal pain. Data were consistent with a model in which pain catastrophizing and somatization influenced 1 or more of patients' judgments of pain, bloating, and/or bowel habits, which then affected the PROs. Conclusions-Depending on their structure and format, PROs can have different levels of sensitivity to core IBS symptoms and be influenced by psychological and somatic complaints that
Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact
Alimentary Pharmacology & Therapeutics, 2005
Background : The impact of irritable bowel syndrome, a gastrointestinal motility disorder, is underestimated and poorly quantified, as clinicians may see only a minority of sufferers.Aim : To determine the prevalence, symptom patterns and impact of irritable bowel syndrome in the US.Methods : This two-phase community survey used quota sampling and random-digit telephone dialling (screening interview) to identify individuals with medically diagnosed irritable bowel syndrome or individuals not formally diagnosed, but fulfilling irritable bowel syndrome diagnostic criteria (Manning, Rome I or II). Information on irritable bowel syndrome symptoms, general health status, lifestyle and impact of symptoms on individuals’ lives was collected using in-depth follow-up interviews. Data were also collected for healthy controls identified in the screening interviews.Results : The total prevalence of irritable bowel syndrome in 5009 screening interviews was 14.1% (medically diagnosed: 3.3%; undiagnosed, but meeting irritable bowel syndrome criteria: 10.8%). Abdominal pain/discomfort was the most common symptom prompting consultation. Most sufferers (74% medically diagnosed; 63% undiagnosed) reported alternating constipation and diarrhoea. Previously diagnosed gastrointestinal disorders occurred more often in sufferers than non-sufferers. Irritable bowel syndrome sufferers had more days off work (6.4 vs. 3.0) and days in bed, and reduced activities to a greater extent than non-sufferers.Conclusions : Most (76.6%) irritable bowel syndrome sufferers in the US are undiagnosed. Irritable bowel syndrome has a substantial impact on sufferers’ well-being and health, with considerable socioeconomic consequences.
Validation of symptom-based diagnostic criteria for irritable bowel syndrome: a critical review
The American journal of gastroenterology, 2010
This article reviews the evidence for validity of symptom-based criteria (Manning, Rome I, Rome II, and Rome III) for irritable bowel syndrome (IBS). Two kinds of validations are reported: (i) studies testing whether symptom criteria discriminate patients with structural disease at colonoscopy from patients without structural disease; and (ii) studies testing whether symptom criteria discriminate patients presumed to have IBS by positive diagnosis from healthy subjects or patients with other functional and structural disorders. The first study type addresses an important clinical management question but cannot provide meaningful information on the sensitivity or positive predictive value because IBS is defined only by exclusion of structural disease. Specificity is modest (about 0.7) but can be improved to 0.9 by the addition of red flag signs and symptoms. The second type of study judges validity by whether the symptom criteria consistently perform as predicted by theory. Here, fac...
An Update on Irritable Bowel Syndrome
TAJ: Journal of Teachers Association, 2009
Irritable bowel syndrome (IBS) is the most common disorder diagnosed by gastroenterologists and one of the more common ones encountered in general practice. The illness has a large economic impact on health care use and indirect costs, chiefly through absenteeism. IBS is a bio-psychosocial disorder in which three major mechanisms interact: Psychosocial factors, altered motility, and/or heightened sensory function of the intestine. Treatment of patients is based on positive diagnosis of the symptom complex, limited exclusion of underlying organic disease and institution of a therapeutic trial. doi: 10.3329/taj.v18i1.3310 TAJ 2005; 18(1): 66-71
Review Article An Update on Irritable Bowel Syndrome
2014
Irritable bowel syndrome (IBS) is the most common disorder diagnosed by gastroenterologists and one of the more common ones encountered in general practice. The illness has a large economic impact on health care use and indirect costs, chiefly through absenteeism. IBS is a bio-psychosocial disorder in which three major mechanisms interact: Psychosocial factors, altered motility, and/or heightened sensory function of the intestine. Treatment of patients is based on positive diagnosis of the symptom complex, limited exclusion of underlying organic disease and institution of a therapeutic trial. TAJ 2005; 18(1): 66-71
A long-term profile of patients with irritable bowel syndrome
Objective: To evaluate the symptom profile, course and prognosis of patients with irritable bowel syndrome (IBS) over a 15 years period. Study Design: An observational study. Place and Duration of Study: Shifa International Hospital, Islamabad, Pakistan, from 1996 to 2011. Methodology: Patients diagnosed with IBS at the study centre were followed for their clinical features, course over the period of time, management and its results. Only those patients were included in the study who completed the follow-up period. Results: A total of 292 patients with mean age of 40.44 ± 13.69 years were inducted. There were 156 (53.4%) males and 136 (46.6%) females. Nearly all male and female patients had abdominal pain and bloating. However, constipation was seen in 79.4% females and 71.6 males. Diarrhea was seen in 46.5% females and 42.7% males. Both constipation and diarrhea were seen in 27.3% female and 15.6% males. A high number of patients had concomitant illnesses and a large proportion of ...