Clinical Patterns Over Time in Irritable Bowel Syndrome: Symptom Instability and Severity Variability

Abstract

IBS symptoms are instable over time and variables in intensity. Many patients with D-IBS or C-IBS move to A-IBS; however, shift from D-IBS to C-IBS, or vice versa, is very infrequent.

Insights Into Normal and Disordered Bowel Habits From Bowel Diaries

“…However, currently available bowel questionnaires do not ascertain the relationship between bowel symptoms (e.g., straining) and stool form. This is a significant lacuna, particularly in patients who have varying bowel habits, which is not uncommon in functional bowel disorders (7)(8)(9)(10). Indeed, studies from primary care and referral practices suggest that a majority of patients with irritable bowel syndrome (IBS) have symptoms of constipation and diarrhea, termed mixed IBS (or IBS-M) (11,12).…”

Subtyping the irritable bowel syndrome by predominant bowel habit: Rome II versus Rome III

“…2,3 Even though altered rectal perception has been proposed to be a biological marker of IBS, 4,5 the diagnosis still relies upon diagnostic criteria and normal findings on routine clinical investigations. 1,6 The bowel habits in IBS patients show considerable inter-and intra-individual variability, 7 and it has been common-place to use supporting symptom criteria to divide IBS patients into different subgroups based on their predominant bowel pattern. This has been important especially in drug trials, where a positive effect could be expected only in subgroups of patients, whereas side effects could be expected in other patients, based on the physiological mode of action of the drug.…”

A course of instruction for women with irritable bowel syndrome

“…One year after the women had completed the course, there was a trend towards less abdominal pain and experiences of more vitality according to the GSRS and the PGWB than before they started the programme. The symptoms in patients with IBS normally vary in intensity over time [2]. However, only a few percent is healed every year within the first five years, those with longer duration have a very stable disease [39].…”

“…Similar results have been presented in other studies [41] who reported that well informed patients were associated with fewer follow-up visits. Apart from increased knowledge, the characteristics of the symptoms as well as their duration may also influence the patients' need of consultations [2,26].…”

“…It is characterized by abdominal pain, bloating and disturbed defecation [1], and the symptoms vary in intensity over time [2]. A patient's physical, mental and social health is affected by the disorder [3][4][5][6] and it is well known that there is an interaction between IBS and psychiatric disorders [7][8][9][10].…”