Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis

Kamp, Eline; Kane, John S; Ford, Alexander C

doi:10.1016/j.cgh.2015.09.031

Cited by 57 publications

(39 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…IBS may not be considered an inherent clinical entity; therefore, a more detailed clinical evaluation may be recommended as the most appropriate practice to exclude organic diseases in patients evaluated for IBS. However, a meta-analysis reported evidence questioning the significance of routine colonoscopy and biopsy for excluding microscopic colitis diagnosis in patients with typical IBS symptoms; the meta-analysis revealed that despite one-third of patients with microscopic colitis reporting symptoms compatible with IBS, the IBS prevalence and the likelihood of microscopic colitis were not higher than those in other patients with diarrhea[21]. This phenomenon warrants further research.…”

Section: Discussionmentioning

confidence: 99%

Trends in Irritable Bowel Syndrome Incidence among Taiwanese Adults during 2003–2013: A Population-Based Study of Sex and Age Differences

Pan

Chang

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

BackgroundNo population-based irritable bowel syndrome (IBS) incidence data among Taiwanese adults are available. Whether IBS is associated with risk of organic colonic diseases remains unanswered. We investigated 1) the sex- and age-stratified trends in the annual incidence of IBS, and 2) the risk of selected organic diseases in patients with IBS compared with those without IBS among Taiwanese adults during 2003–2013.MethodsMedical claims data for 1 million randomly selected beneficiaries were obtained and analyzed. Patients with IBS were considered eligible for enrollment if they aged between 20 and 100 and had at least two medical encounters with IBS codes within 1 year. To test whether there was a linear secular trend in IBS incidence over time, multivariate Poisson regression with generalized estimating equation model was conducted. The risk of selected organic diseases associated with IBS was examined using multivariate Cox proportional hazard regression.ResultsFrom 2003 to 2013, the incidence of IBS significantly decreased over time [adjusted incidence rate ratio (IRR) = 0.97, p< 0.001]; the incidence of IBS significantly increased with age (adjusted IRR = 1.03, p < 0.001) and was significantly higher in women than in men (adjusted IRR = 1.14, p< 0.001). IBS significantly associated with increased risk of microscopic colitis, inflammatory bowel disease, and colorectal cancer during a 10-year follow-up period.ConclusionsThe incidence of IBS increased with age and was slightly higher in women than in men among Taiwanese adults. During 2003–2013, IBS incidence gradually decreased over time. IBS may increase risk of several colonic organic diseases.

show abstract

Section: Discussionmentioning

confidence: 99%

Trends in Irritable Bowel Syndrome Incidence among Taiwanese Adults during 2003–2013: A Population-Based Study of Sex and Age Differences

Pan

Chang

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…148–150 The most common diagnosis is microscopic colitis, with IBD generally a distant second. Although a recent meta-analysis suggested that colonoscopy may have limited benefit in detecting microscopic colitis in patients with IBS, 151 scoring systems have been developed that can guide the clinician to supect the diagnosis. 152,153 These include factors such as patient age, sex, and use of high risk medications such as proton-pump inhibitors, non-steroidal anti-inflammatory drugs, and serotonin reuptake inhibitors.…”

Section: Management Of Patients With Chronic Watery Diarrheamentioning

confidence: 99%

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

2017

View full text Add to dashboard Cite

Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (more than 4 weeks in duration) are more elusive. We review on the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties. We also describe the various extra-epithelial factors that activate diarrheal mechanisms. Finally, clinical evaluation and tests used in assessment of patients presenting with chronic diarrhea are reviewed, and an algorithm guiding therapeutic decisions and pharmacotherapy is presented.

show abstract

“…3 There is an expectation that physicians should try to reduce these costs by making a positive diagnosis of IBS, using symptom-based diagnostic criteria, whilst simultaneously minimizing invasive investigations. 4,5 Physicians may be reluctant to adopt this approach in clinical practice, as GI diseases manifest as a limited repertoire of symptoms, and those of IBS can mimic organic diseases such as inflammatory bowel disease, 6 microscopic colitis, 7 bile acid diarrhea, 8,9 or celiac disease. 10 The current "gold standard" for symptom-based diagnosis of IBS are the Rome III criteria, 1 but these have only been validated in one large study from Canada, 11 and performed modestly in distinguishing IBS from organic GI disease.…”

Section: Irritable Bowel Syndrome (Ibs) Is a Chronic Functional Gastrmentioning

confidence: 99%

Enhancing Diagnostic Performance of Symptom-Based Criteria for Irritable Bowel Syndrome by Additional History and Limited Diagnostic Evaluation

Sood

Camilleri

Gracie

et al. 2016

American Journal of Gastroenterology

View full text Add to dashboard Cite

Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis

Cited by 57 publications

References 54 publications

Trends in Irritable Bowel Syndrome Incidence among Taiwanese Adults during 2003–2013: A Population-Based Study of Sex and Age Differences

Trends in Irritable Bowel Syndrome Incidence among Taiwanese Adults during 2003–2013: A Population-Based Study of Sex and Age Differences

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

Enhancing Diagnostic Performance of Symptom-Based Criteria for Irritable Bowel Syndrome by Additional History and Limited Diagnostic Evaluation

Contact Info

Product

Resources

About