Development of Irritable Bowel Syndrome Features Over a 5-year Period

Clevers, Egbert; Tack, Jan; Törnblom, Hans; Ringström, Gisela; Luyckx, Koen; Simrén, Magnus; Oudenhove, Lukas Van

doi:10.1016/j.cgh.2018.02.043

Cited by 20 publications

(29 citation statements)

References 35 publications

(31 reference statements)

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“…Rather unexpectedly, we found that a decrease in GI symptom severity did not lead to an improved quality of life in our study. Clevers et al recently evaluated longitudinal symptom changes over time and, in contrast to our results, found that patients with lower GI symptom severity had significantly higher quality of life scores . They also demonstrated that GI‐specific anxiety is associated with an increase in GI symptom severity, which is in agreement with our results as GI‐specific anxiety was significantly lower in the group that did not fulfill the Rome III criteria.…”

Section: Discussionsupporting

confidence: 90%

“…time and, in contrast to our results, found that patients with lower GI symptom severity had significantly higher quality of life scores. 37 They also demonstrated that GI-specific anxiety is associated with an increase in GI symptom severity, which is in agreement with our results as GI-specific anxiety was significantly lower in the group that did not fulfill the Rome III criteria. The inconsistency between our data in terms of quality of life might be explained in part by the different questionnaires used.…”

Section: Clevers Et Al Recently Evaluated Longitudinal Symptom Changesupporting

confidence: 92%

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Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Weerts

Vork

Mujagic

et al. 2019

Neurogastroenterology Motil

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Background Irritable bowel syndrome (IBS) is a brain‐gut disorder, of which the natural course varies between patients and is difficult to predict. This study aimed to evaluate symptom evolution over a 5‐year follow‐up period and to identify baseline predictors for symptom severity and quality of life (QoL) at follow‐up. Methods Maastricht IBS cohort participants completed questionnaires upon inclusion regarding demographics and lifestyle, gastrointestinal (GI) symptoms, anxiety and depression, and QoL. The same questionnaires, in addition to others, were completed after 5 years. Rome criteria were confirmed face‐to‐face at initial enrollment and through telephonic interviews at follow‐up. Key Results At a mean follow‐up of 4.7 years, 379 patients were approached of whom 203 (53.7%) responded. Of these, 161 were reached by telephone and analyzed; 49 (30.4%) did not fulfill the Rome III criteria at follow‐up and had lower levels of GI symptoms and GI‐specific anxiety compared to those remaining Rome III‐positive (P < 0.001). However, Rome III‐negative patients had comparable levels of QoL and life satisfaction, comorbid anxiety and depression, work absenteeism, and impaired productivity. No baseline predictors were found for being Rome III‐positive or Rome III‐negative. However, greater age and lower baseline physical QoL predicted lower physical QoL at follow‐up (P < 0.005 and P < 0.01, respectively), while lower baseline mental QoL predicted lower mental QoL at follow‐up (P = 0.005). Additionally, higher anxiety and depression scores at follow‐up were associated with lower QoL and life satisfaction at follow‐up (P < 0.001). Conclusions and Inferences Long‐term QoL and general well‐being might depend on concurrent psychological symptoms, rather than GI symptom improvement.

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Section: Discussionsupporting

confidence: 90%

Section: Clevers Et Al Recently Evaluated Longitudinal Symptom Changesupporting

confidence: 92%

Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Weerts

Vork

Mujagic

et al. 2019

Neurogastroenterology Motil

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“…48 From the data presented here, anxiety and depression appear to be risk factors in all age groups. They may reflect different patterns of treatment-seeking, health service provision or diagnostic practices compared to Western countries but it is also possible that there are two distinct patterns of IBS onset-one occurs in older people of either sex with pre-existing medical comorbidities and one that occurs generally in younger women.…”

Section: Breadth and Strength Of Risk Factorsmentioning

confidence: 65%

Review article: the incidence and risk factors for irritable bowel syndrome in population‐based studies

Creed

2019

Aliment Pharmacol Ther

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Background:In the absence of prior gastrointestinal infection, the risk factors for irritable bowel syndrome (IBS) are not well established.Aim: To identify the incidence and risk factors for IBS in general population samples Methods: Narrative review of population-based studies. Electronic databases were searched using the keywords "incidence," "onset," "epidemiology," "population," "risk factors" with "irritable bowel syndrome" with subsequent hand searching. Inclusion criteria were: population-based, adults, prospective design (including retrospective case cohorts), clinical or research diagnosis of IBS and exclusion of individuals who had IBS prior to recruitment. Results:Of 1963 papers, 38 were included; all provided data on risk factors, 27 reported incidence. The median incidence of physician-diagnosed IBS in 19 general population cohorts was 38.5 per 10 000 person-years (interquartile range = 20-45.3).In 14 cohorts with specific medical disorders, median incidence was 92 per 10 000 person-years (IQR: 73.9-119). Apart from gastroenteritis, the most common risk factors were other medical disorders, female sex, age (both young and old), anxiety and depression, life events/stress, frequent healthcare use, pain and sleep disorders. The results were conflicting for alcohol consumption, smoking and BMI. Incidence rates were similar in different countries but risk factors differed.Conclusions: Incidence rates were generally lower than previous estimates reflecting physician-diagnosed IBS. The results highlight the importance of other medical and psychosocial problems in the onset of IBS in addition to prior gastrointestinal infections. Aetiological research could be enhanced by studying the underlying mechanisms relating to all of these risk factors.

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“…In two recent studies researchers used LCA to analyze data on Europeans with IBS (Clevers et al, ; Polster et al, ). Using retrospective measures of symptoms, Polster et al () identified the following six latent classes based on the severity of patient‐reported GI, psychological, and somatic symptoms: Constipation with low comorbidity, constipation with high comorbidity, diarrhea with low comorbidity, diarrhea with high comorbidity, mixed GI symptoms with high comorbidity, and a mix of symptoms with overall mild severity.…”

Section: Introductionmentioning

confidence: 99%

“…Using retrospective measures of symptoms, Polster et al () identified the following six latent classes based on the severity of patient‐reported GI, psychological, and somatic symptoms: Constipation with low comorbidity, constipation with high comorbidity, diarrhea with low comorbidity, diarrhea with high comorbidity, mixed GI symptoms with high comorbidity, and a mix of symptoms with overall mild severity. In the Clevers et al () study, persons with IBS were categorized using three latent classes (high, intermediate, and low‐GI symptom severity) based on retrospective measures of six GI symptoms (diarrhea, constipation, abdominal pain, satiety, indigestion, and reflux); non‐GI symptoms were not included in identification of the latent classes.…”

Section: Introductionmentioning

confidence: 99%

Symptom‐based latent classes of persons with irritable bowel syndrome

Han

Pike

Jarrett

et al. 2019

Research in Nursing & Health

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A large amount of interindividual variability exists in symptom experiences of persons with irritable bowel syndrome (IBS). Thus, consideration of multiple symptoms to identify distinct symptom subgroups may be useful in directing personalized health strategies for symptom management. We aimed to identify latent classes (i.e., subgroups) of persons with IBS who share similar patterns of symptoms using symptom‐related variables (six groups of daily diary symptoms, cognitive beliefs about IBS, and IBS quality of life [QOL]); and to examine how subgroups differed in patient characteristics. Data were derived from a baseline assessment of men and women enrolled in two cognitively‐focused intervention trials (N = 332). Using latent class analysis, four latent classes were identified: Class 1 (low symptoms and good QOL, n = 153), Class 2 (low symptoms and moderate QOL, n = 106), Class 3 (high symptoms with diarrhea and poor QOL, n = 38), and Class 4 (high symptoms with low diarrhea and moderate QOL, n = 35). Diarrhea, being female, less formal education, unemployment, and previous history of major depressive disorder were associated with membership in Class 3. Using these distinct symptom profiles, the next step is to explore underlying mechanisms accounting for symptom burden with the goal of designing tailored interventions to reduce that burden.

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Development of Irritable Bowel Syndrome Features Over a 5-year Period

Cited by 20 publications

References 35 publications

Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Review article: the incidence and risk factors for irritable bowel syndrome in population‐based studies

Symptom‐based latent classes of persons with irritable bowel syndrome

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