scholarly journals Patterns of alternation in irritable bowel syndrome

2016 ◽  
Vol 89 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Alexandra Chira ◽  
Mihaela Filip ◽  
Dan Lucian Dumitraşcu

Background and aims. Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, having its subtypes related to the predominant bowel pattern: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M) or alternating IBS (IBS-A). Some patients alternate between subtypes (IBS-A). We looked for the prevalence of alternation between subtypes in patients with IBS. We also analyzed changes in pharmacological therapy specifically addressed to IBS.Methods. We performed a retrospective observational study that included 60 patients diagnosed with IBS according to Rome III criteria. Patients were asked using a detailed structured interview about their stool form changes regarding previous six months. Alternators were defined as patients that changed IBS subtype over time (previous six months).Results. Out of the 60 patients diagnosed with IBS, 18 patients (30%) were alternators. Of these, 8 patients (44%) changed twice the subtype. Two patients (66.66%) of the IBS-M subgroup shifted between subtypes. Eight patients (44.44%) changed medication over the six months. Four patients (22.2%) of the alternators were on double association of therapy (antispasmodics) addressed to IBS. Four patients (22.22%) discontinued medication.Conclusions. Patients with IBS often change between subtypes even within six months. Alternators in our pilot study represented 30% of IBS patients. IBS-M seems to be the least stable phenotype. The rarest change is the shift between IBS-C and IBS-D. Alternators also often change their pharmacological treatment (antispasmodics).

2017 ◽  
Vol 2 (1) ◽  
pp. 34-39
Author(s):  
Md Rukunuzzaman ◽  
ASM Bazlul Karim ◽  
Wahiduzzaman Mazumder ◽  
Mohammed Nurullah ◽  
Faika Hussain ◽  
...  

Irritable bowel syndrome (IBS) is one of the most common and best studied disorders among the group of functional gastrointestinal disorders. It is a functional bowel disorder in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. Visceral hypersensitivity and increased GIT motility are the main patho-physiological mechanism for developing IBS. IBS present with diarrhoea or constipation or both. Investigations are least needed for diagnosis of IBS rather done to exclude differential diagnosis. Diagnosis of IBS is done on the basis of Rome-III criteria. Proper counseling, dietary management, antispasmotic and antidepressant are the mainstay of treatment. Journal of National Institute of Neurosciences Bangladesh, 2016;2(1): 34-39


2020 ◽  
Author(s):  
Marjan Mansourian ◽  
Hamid Reza Marateb ◽  
Ammar Hassanzadeh Keshteli ◽  
Hamed Daghagh Zadeh ◽  
Miquel Angel Mananas ◽  
...  

Background The validity of Rome III criteria for diagnosing functional gastrointestinal disorders (FGIDs) have been frequently questioned in the literature. In epidemiology, when a disease is diagnosed, the existence of a true cluster must be proven. Thus, clustering the common GI symptoms of individuals and comparing the clusters with FGIDs defined by the Rome III criteria could provide insights about the validity of FGIDs defined by those criteria. Well-separated compact clusters were detected in responses to questionnaires of the epidemiological features of different FGIDs in Iranian adults using fuzzy ordinal clustering. The representative sample from each cluster i.e. Cluster Representative (CR) was formed whose corresponding FGID was diagnosed with Rome III criteria. Then, FGID diagnosis was performed for all participants in each cluster and the percentage of cases whose FGID was the same as the cluster's identified FGID (agreement) was reported. Results Fourteen valid clusters were detected in 4763 people. The average membership of the objects in each cluster was 77.3%, indicating similarity of the objects in clusters to their corresponding CRs. Eight clusters were assigned to single FGIDs (irritable bowel syndromes: constipation IBS-C, diarrhea IBS-D and un-subtyped IBS-U; functional bloating FB; functional constipation FC; belching disorder BD. The agreement was higher than 50% in single FGID clusters except those whose diagnosis was IBS-U. Conclusions IBS-C, IBS-D, FC, BD, and FB defined with Rome III criteria exist in the population, which is not the case for IBS-U.


2021 ◽  
Vol 60 (6-7) ◽  
pp. 304-313
Author(s):  
Shailender Madani ◽  
Rohit Madani ◽  
Suchi Parikh ◽  
Ahila Manivannan ◽  
Wilma R. Orellana ◽  
...  

Our study aims to assess improvement with symptomatic treatment of pain-related functional gastrointestinal disorders (FGIDs) in a biopsychosocial construct and evaluate validity of Rome III criteria. Children with chronic abdominal pain diagnosed with an FGID or organic disease were followed for 1 year: 256/334 were diagnosed with an FGID and 78/334 were diagnosed with a possible organic disease due to alarm signs or not meeting Rome III criteria. After 1 year, 251 had true FGID and 46 had organic diseases. Ninety percent of FGID patients improved with symptomatic treatment over an average of 5.4 months. With a 95% confidence interval, Rome criteria predicted FGIDs with sensitivity 0.89, specificity 0.90, positive predictive value 0.98, and negative predictive value 0.59. We conclude that symptomatic treatment of pain-related FGIDs results in clinical improvement and could reduce invasive/expensive testing. Rome III criteria’s high specificity and positive predictive value suggest they can rule in a diagnosis of FGID.


Author(s):  
Desiree F. Baaleman ◽  
Carlos A. Velasco-Benítez ◽  
Laura M. Méndez-Guzmán ◽  
Marc A. Benninga ◽  
Miguel Saps

AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known:• The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs).• Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New:• We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia.• The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.


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