Irritable bowel syndrome: Epidemiology, overlap disorders, pathophysiology and treatment

Huang, Kai-Yue; Wang, Fengyun; Lv, Mi; Ma, Xiang‐Xue; Tang, Xudong; Lv, Lin

doi:10.3748/wjg.v29.i26.4120

Cited by 15 publications

(8 citation statements)

References 138 publications

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“…20 The PHQ-4 consists of four questions, with four response options ('not at all', 'several days', 'more than half the days' and 'nearly every day'; scored as 0, 1, 2 and 3, respectively). According to their scores, patients are categorised as normal (0-2) or as experiencing mild (3)(4)(5), moderate (6)(7)(8) or severe (9)(10)(11)(12) depression and/ or anxiety. A score of ≥3 on the first two items suggests that a person has anxiety, while a score ≥3 on the last two questions suggests that a person has depression.…”

Section: Instrumentsmentioning

confidence: 99%

Prevalence of and factors associated with symptoms consistent with a diagnosis of irritable bowel syndrome among resident physicians in standardised training in China: a cross-sectional study

Zhao,

Li,

Yang

et al. 2023

BMJ Open

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ObjectivesThis study aims to investigate the incidence of and factors associated with irritable bowel syndrome (IBS) among resident physicians in standardised training at eight traditional Chinese medicine (TCM) hospitals in China.DesignA cross-sectional survey was administered to resident physicians in their first to third years of standardised training at eight TCM hospitals.Participants and settingA total of 514 resident physicians in standardised training were included.MeasuresThe questionnaire consisted of two sections, namely: section A collected basic information, and section B included the four-item Perceived Stress Scale (PSS-4), the Patient Health Questionnaire-4 (PHQ-4), the Pittsburgh Sleep Quality Index (PSQI) and the Rome IV criteria for IBS. Univariate and multivariate logistic regression models were constructed to assess the associations of age, sex, body mass index, stress, depression, anxiety, sleep quality and IBS.ResultsOf the included resident doctors, 77.2% were female, 20.4% were obese or underweight and 8.6% had symptoms consistent with a diagnosis of IBS. There were no statistically significant differences in lifestyle factors (night shift work, overtime work or working efficiency during the COVID-19 pandemic) between patients with IBS and participants without IBS (hereafter, non-IBS participants) (p=0.429, p=0.572 or p=0.464, respectively). Notably, compared with non-IBS participants, patients with IBS had significantly higher mean scores on the PSS-4 and PHQ-4 (p=0.028 and p=0.012, respectively); however, there was not a significant difference in PSQI scores between these two groups (p=0.079). Depression symptoms were significantly associated with IBS (unadjusted OR 0.498, 95% CI 0.265 to 0.935, p=0.030).ConclusionThese findings suggest that IBS is common among resident physicians in standardised training. Future studies should investigate emotional distress, especially stress and depression, in the development of prevention or treatment of IBS.

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Section: Instrumentsmentioning

confidence: 99%

Prevalence of and factors associated with symptoms consistent with a diagnosis of irritable bowel syndrome among resident physicians in standardised training in China: a cross-sectional study

Zhao,

Li,

Yang

et al. 2023

BMJ Open

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“…In clinical settings, after exclusion of organic disorders like GERD, gastritis, and others employing standard work-up including endoscopy, such chronic symptoms may be differentiated into non-ulcer dyspepsia (NUD) 1 or irritable bowel syndrome (IBS), when meeting the criteria of functional gastrointestinal disorders established by the Rome Foundation. Comorbidities with other disorders and overlap between the major functional gastrointestinal disorders are frequent 2 3 . Therefore, the exact attribution in daily practice may be challenging due to variability and overlap of symptoms 4 .…”

Section: Introductionmentioning

confidence: 99%

Grapefruit Seed Extract Reduces Gastrointestinal Symptoms

Uehleke,

Storr,

Hörning

2024

Zeitschrift für Phytotherapie

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In this explorative longitudinal survey, self-reported data was collected from persons suffering from chronic gastrointestinal symptoms, who were seeking relief employing self-medication with a grapefruit seed extract (GKE). This is not a clinical trial nor a non-interventional study, but an explorative longitudinal survey with self-reports. The data was collected online and there were no personal contacts with a physician or a study nurse. Participants followed their own decision to use GKE and to provide their data to a data retrieval system, following informed consent according to existing national regulations on data protection. The test product was provided by the sponsor to make sure that the correct product was used for the intended observation period.Drop in criteria were chronic gastrointestinal symptoms, including those of functional dyspepsia (FD, resp. non-ulcer dyspepsia NUD) and/or irritable bowel syndrome (IBS) for more than 4 weeks, resulting in a score of an expanded Nepean Index (‘total gastrointestinal score’) higher than 20. Symptoms were documented 4–12 days (VA) prior to GKE use on day 1 and then on day 1, days 28, 42 and 56 of continuous oral use. New symptoms, predominating symptoms, stool habits, amount of oral intake and global status was retrieved every day during the observation period. On day 56 some global assessments were additionally recorded.The evaluation cohort was intended to be at least 100, and within the survey cohort we were able to evaluate 100 subjects (15 m and 85 f). Total gastrointestinal symptom score decreased from a mean (±SD) of 78.7±36.9 points by 26.4% on day 14, by 53.1% on day 28, by 58.7% on day 42, and by 49.9% on day 56, when compared to day 1. Upper gastrointestinal symptoms like heartburn improved better compared to lower GI symptoms (by 57.9% versus 47.3% on day 56). Overall complaints were rated as “very strongly improved” by 30%, “strongly improved” by 42%, “somewhat improved” or “unchanged” by 20% and as “deteriorated” by 1%. GKE was tolerated well. Minor adverse events reported were judged as most probably unrelated by the authors. More than half of the participants rated the intake as “very pleasant” or “pleasant” and intended to continue GKE beyond the observation period.In this prospective uncontrolled survey, GKE seemed to improve GI-symptoms, based on users reports. These results need to be confirmed in controlled clinical trials proofing efficacy and tolerance of GKE in functional GI-diseases. Data collected from participants without any personal contact bear a high risk of bias. Evaluation of self-treatment as presented here is clearly restricted to marketed products and may report interesting details of self-treatment outside prescription settings.

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“…Irritable bowel syndrome (IBS) is classified as a functional gastrointestinal (GI) disorder with a global prevalence that varies from 9% to 23%, influenced by the diagnostic criteria and research methodologies in use[ 1 , 2 ]. IBS is characterized by a diverse clinical spectrum and is associated with a significant disease burden.…”

Section: Introductionmentioning

confidence: 99%

Immune cell signatures and causal association with irritable bowel syndrome: A mendelian randomization study

Chai,

Ma,

et al. 2024

World J Clin Cases

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BACKGROUND The mucosal barrier's immune-brain interactions, pivotal for neural development and function, are increasingly recognized for their potential causal and therapeutic relevance to irritable bowel syndrome (IBS). Prior studies linking immune inflammation with IBS have been inconsistent. To further elucidate this relationship, we conducted a Mendelian randomization (MR) analysis of 731 immune cell markers to dissect the influence of various immune phenotypes on IBS. Our goal was to deepen our understanding of the disrupted brain-gut axis in IBS and to identify novel therapeutic targets. AIM To leverage publicly available data to perform MR analysis on 731 immune cell markers and explore their impact on IBS. We aimed to uncover immunophenotypic associations with IBS that could inform future drug development and therapeutic strategies. METHODS We performed a comprehensive two-sample MR analysis to evaluate the causal relationship between immune cell markers and IBS. By utilizing genetic data from public databases, we examined the causal associations between 731 immune cell markers, encompassing median fluorescence intensity, relative cell abundance, absolute cell count, and morphological parameters, with IBS susceptibility. Sensitivity analyses were conducted to validate our findings and address potential heterogeneity and pleiotropy. RESULTS Bidirectional false discovery rate correction indicated no significant influence of IBS on immunophenotypes. However, our analysis revealed a causal impact of IBS on 30 out of 731 immune phenotypes (P < 0.05). Nine immune phenotypes demonstrated a protective effect against IBS [inverse variance weighting (IVW) < 0.05, odd ratio (OR) < 1], while 21 others were associated with an increased risk of IBS onset (IVW ≥ 0.05, OR ≥ 1). CONCLUSION Our findings underscore a substantial genetic correlation between immune cell phenotypes and IBS, providing valuable insights into the pathophysiology of the condition. These results pave the way for the development of more precise biomarkers and targeted therapies for IBS. Furthermore, this research enriches our comprehension of immune cell roles in IBS pathogenesis, offering a foundation for more effective, personalized treatment approaches. These advancements hold promise for improving IBS patient quality of life and reducing the disease burden on individuals and their families.

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Irritable bowel syndrome: Epidemiology, overlap disorders, pathophysiology and treatment

Cited by 15 publications

References 138 publications

Prevalence of and factors associated with symptoms consistent with a diagnosis of irritable bowel syndrome among resident physicians in standardised training in China: a cross-sectional study

Prevalence of and factors associated with symptoms consistent with a diagnosis of irritable bowel syndrome among resident physicians in standardised training in China: a cross-sectional study

Grapefruit Seed Extract Reduces Gastrointestinal Symptoms

Immune cell signatures and causal association with irritable bowel syndrome: A mendelian randomization study

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