Symptom Stability in Rome IV vs Rome III Irritable Bowel Syndrome.

Published on Feb 1, 2021in The American Journal of Gastroenterology10.171
· DOI :10.14309/AJG.0000000000000946
Brigida Barberio7
Estimated H-index: 7
(UNIPD: University of Padua),
Lesley A. Houghton53
Estimated H-index: 53
(University of Leeds)
+ 3 AuthorsAlexander C. Ford86
Estimated H-index: 86
(University of Leeds)
Sources
Abstract
Introduction Irritable bowel syndrome (IBS) is a chronic functional bowel disorder, which follows a relapsing and remitting course. Little is known about how evolving definitions of IBS or treatment for the condition affect symptom stability. We conducted a 12-month longitudinal follow-up study of individuals who self-identified as having IBS to examine these issues. Methods We collected demographic, gastrointestinal symptom, mood, and psychological health data at baseline, and gastrointestinal symptom data at 12 months, from adults who self-identified as having IBS, registered with 3 organizations providing services to people with IBS. We applied the Rome III and Rome IV criteria simultaneously at baseline and 12 months and subtyped participants according to predominant stool form or frequency. We examined stability of a diagnosis of IBS, and stability of IBS subtype, for the Rome IV and III criteria separately and examined the effect of commencing new therapy on fluctuation of symptoms. Results Of 1,375 individuals recruited at baseline, 784 (57.0%) provided data at 12 months. Of these, 452 met the Rome IV criteria for IBS at baseline, of whom 133 (29.4%) fluctuated to another functional bowel disorder at 12 months. In the remaining 319 (70.6%) who still met the Rome IV criteria for IBS, IBS subtype changed in 101 (31.7%) subjects, with IBS with mixed bowel habit (IBS-M) the least stable. Commencing a new treatment for IBS did not affect symptom stability. Among 631 who met the Rome III criteria at baseline responding at 12 months, 104 (16.5%) fluctuated to another functional bowel disorder. In the 527 (83.5%) who still met the Rome III criteria for IBS, IBS subtype fluctuated in 129 (24.5%), with IBS-M the most stable subtype. Again, commencing a new treatment for IBS did not affect symptom stability. Discussion Fluctuation between functional bowel disorders and predominant stool subtype is common in people with IBS and does not appear to be influenced solely by treatment. Rome IV IBS appears less stable than Rome III IBS.
References37
Newest
#1Christopher J Black (University of Leeds)H-Index: 13
#2Yan Yiannakou (County Durham and Darlington NHS Foundation Trust)H-Index: 13
Last. Alexander C. Ford (University of Leeds)H-Index: 86
view all 7 authors...
BACKGROUND: Gastrointestinal symptom-specific anxiety and somatization have both been associated with higher symptom severity in patients with irritable bowel syndrome (IBS); however, this relationship has not been explored fully. Moreover, the performance of the visceral sensitivity index (VSI) for measuring gastrointestinal symptom-specific anxiety has not been examined in a UK population. We conducted a cross-sectional survey to examine these issues. METHODS: Gastrointestinal symptom-specific...
14 CitationsSource
#1Christopher J Black (University of Leeds)H-Index: 13
#2Nicholas E Burr (University of Leeds)H-Index: 14
Last. Alexander C. Ford (University of Leeds)H-Index: 86
view all 3 authors...
: Irritable bowel syndrome (IBS) is a chronic functional bowel disorder affecting 1 in 10 people and associated with poor psychological health, reduced quality of life, and increased health care expenditure.1 The etiology is complex and incompletely understood.2 Approximately one-third of patients have IBS with constipation (IBS-C),1 for which there are licensed therapies available in the United States. We summarized comparative efficacy of these in a recent network meta-analysis of randomized c...
26 CitationsSource
#1Christopher J Black (University of Leeds)H-Index: 13
#2Yan Yiannakou (County Durham and Darlington NHS Foundation Trust)H-Index: 13
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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Objectives Few studies have examined the effects of applying the Rome IV criteria for irritable bowel syndrome (IBS) vs the previous standard, the Rome III criteria. We conducted a cross-sectional survey of individuals who self-identify as having IBS to examine this issue. Methods We collected complete demographic, symptom, mood, and psychological health data from 1375 adults who self-identified as having IBS, but were not recruited from a referral population. We applied the Rome III and the Rom...
29 CitationsSource
#1Christopher J Black (University of Leeds)H-Index: 13
#2Yuhong Yuan (McMaster University)H-Index: 35
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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Summary Background Although novel therapies for irritable bowel syndrome (IBS) continue to be developed, many doctors rely on more established, traditional therapies as first-line or second-line treatment options. These therapies include soluble fibre (eg, ispaghula husk), antispasmodic drugs, peppermint oil, and gut–brain neuromodulators (including tricyclic antidepressants, selective serotonin reuptake inhibitors, or α-2-δ calcium channel subunit ligands). However, the relative efficacy of tra...
32 CitationsSource
#1Christopher J Black (University of Leeds)H-Index: 13
#2Nicholas E Burr (University of Leeds)H-Index: 14
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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Objective Over half of patients with IBS have either diarrhoea (IBS-D) or a mixed stool pattern (IBS-M). The relative efficacy of licenced pharmacological therapies is unclear in the absence of head-to-head trials. We conducted a network meta-analysis to resolve this uncertainty. Design We searched MEDLINE, Embase, Embase Classic, the Cochrane central register of controlled trials, and Clinicaltrials.gov through January 2019 to identify randomised controlled trials (RCTs) assessing the efficacy ...
49 CitationsSource
#1Christopher J Black (University of Leeds)H-Index: 13
#2Nicholas E Burr (University of Leeds)H-Index: 14
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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Background & Aims Several secretagogues have been approved for the treatment of irritable bowel syndrome with constipation (IBS-C). However, their relative efficacy is unclear because there have been no head-to-head randomized controlled trials. We conducted a network meta-analysis to compare their efficacies in patients with IBS-C. Methods We searched MEDLINE, EMBASE, EMBASE Classic, and the Cochrane Central Register of Controlled Trials through June 2018 to identify randomized controlled trial...
68 CitationsSource
#1Imran Aziz (University of Gothenburg)H-Index: 21
#2Hans Törnblom (University of Gothenburg)H-Index: 33
Last. Magnus Simrén (UNC: University of North Carolina at Chapel Hill)H-Index: 21
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The diagnostic criteria for irritable bowel syndrome (IBS) have recently been updated from Rome III to Rome IV. Whereas in Rome III a diagnosis of IBS entailed chronic abdominal pain or discomfort at least 3 days per month, in Rome IV the term discomfort has been removed and the frequency of abdominal pain increased to at least 1 day per week. We examined how this change in IBS criteria impacts on clinical characteristics and pathophysiological factors. A total of 542 Swedish subjects with Rome ...
37 CitationsSource
#1David J. Gracie (University of Leeds)H-Index: 16
#2Elspeth Guthrie (University of Leeds)H-Index: 40
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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Abstract Background & Aims Inflammatory bowel diseases (IBD) are associated with mood disorders, such as anxiety or depression, but it is not clear whether one contributes to development of the other, or if the interaction is bi-directional (anxiety or depression contributes to the progression of IBD, and IBD affects psychologic health). We performed a 2-year longitudinal prospective study of patients in secondary to care investigate the bi-directionality of IBD and mood disorders. Methods We co...
113 CitationsSource
#1David J. Gracie (University of Leeds)H-Index: 16
#2P John Hamlin (University of Leeds)H-Index: 12
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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OBJECTIVES: The impact of irritable bowel syndrome (IBS)-type symptoms on the natural history of inflammatory bowel disease (IBD) is uncertain. We aimed to address this in a longitudinal study of secondary care patients. METHODS: Longitudinal disease activity was defined by disease flare, escalation of medical therapy, hospitalization, or intestinal resection. The number of investigations performed and clinics attended determined healthcare utilization. Psychological well-being and quality of li...
37 CitationsSource
#1Lisa Vork (UM: Maastricht University)H-Index: 7
#2Zsa Zsa R. M. Weerts (UM: Maastricht University)H-Index: 5
Last. Ad A.M. Masclee (UM: Maastricht University)H-Index: 74
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Background The Rome criteria for irritable bowel syndrome (IBS) have been revised and are expected to apply only to the subset of Rome III IBS subjects with abdominal pain as predominant symptom, occurring at least once a week. The aim of this study was to determine the percentage of Rome III IBS subjects that fulfills Rome IV criteria and to evaluate differences between Rome IV-positive and Rome IV-negative subjects. Methods Four hundred and four Rome III IBS subjects completed a 14-day end-of-...
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Cited By7
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#1Vivek C. Goodoory (University of Leeds)
#2Lesley A. Houghton (University of Leeds)H-Index: 53
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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ABSTRACT Objectives Irritable bowel syndrome (IBS) is a chronic functional bowel disorder diagnosed using the Rome criteria, which have evolved since their original description 30 years ago. Little is known about the effects on the natural history of IBS of moving to the latest iteration, Rome IV, from the previous Rome III criteria. We conducted a 12-month longitudinal follow-up study examining this. Methods We collected complete demographic, symptom, mood, and psychological health data at base...
1 CitationsSource
#1Christopher J Black (University of Leeds)H-Index: 13
#2Alexander C. Ford (University of Leeds)H-Index: 86
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#1Dipesh H. Vasant (University of Manchester)H-Index: 10
#2Peter Paine (University of Salford)H-Index: 15
Last. Alexander C. Ford (St James's University Hospital)H-Index: 86
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Irritable bowel syndrome (IBS) remains one of the most common gastrointestinal disorders seen by clinicians in both primary and secondary care. Since publication of the last British Society of Gastroenterology (BSG) guideline in 2007, substantial advances have been made in understanding its complex pathophysiology, resulting in its re-classification as a disorder of gut-brain interaction, rather than a functional gastrointestinal disorder. Moreover, there has been a considerable amount of new ev...
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#1Christopher J Black (St James's University Hospital)H-Index: 13
#2Alexander C. Ford (St James's University Hospital)H-Index: 86
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#1Brigida Barberio (UNIPD: University of Padua)H-Index: 7
#2Yan Yiannakou (County Durham and Darlington NHS Foundation Trust)H-Index: 13
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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ABSTRACT Objectives Disorders of gut-brain interaction, such as irritable bowel syndrome (IBS) and functional dyspepsia (FD) frequently overlap, but the impact of this on the natural history is unknown. We examined this issue in a longitudinal follow-up study conducted in a large cohort of individuals. Methods We collected complete demographic, symptom, mood, and psychological health data from 1374 adults who self-identified as having IBS. We applied the Rome IV criteria to examine what proporti...
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#1Vivek C. Goodoory (County Durham and Darlington NHS Foundation Trust)
#2Antonina Mikocka-Walus (University of Leeds)H-Index: 1
Last. Alexander C. FordH-Index: 86
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INTRODUCTION Psychological comorbidities are associated with irritable bowel syndrome (IBS), but little is known about their cumulative effect on its prognosis. We examined this issue in a longitudinal 12-month follow-up study. METHODS We collected complete demographic, symptom, and psychological comorbidity data (anxiety, depression, somatic symptom disorder, perceived stress, and gastrointestinal symptom-specific anxiety) at baseline from 807 adults who met Rome IV criteria for IBS. At 12 mont...
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#1Christopher J Black (University of Leeds)H-Index: 13
#2Yan Yiannakou (County Durham and Darlington NHS Foundation Trust)H-Index: 13
Last. Alexander C. Ford (University of Leeds)H-Index: 86
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BACKGROUND Conventionally, irritable bowel syndrome (IBS) is subgrouped using predominant stool form, yet it is a complex disorder, with multiple biopsychosocial contributors. We previously derived and validated a latent class model subgrouping people with IBS into seven clusters based on gastrointestinal and extraintestinal symptoms and psychological profile. AIMS To conduct longitudinal follow-up examining the natural history and prognostic value of these clusters. METHODS Participants complet...
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