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Symptoms discriminate irritable bowel syndrome from organic gastrointestinal diseases and food allergy.
Eur J Gastroenterol Hepatol 2000; 12(9):981-8EJ

Abstract

BACKGROUND

The value of specific gastrointestinal symptoms in discriminating irritable bowel syndrome (IBS) from organic disease has been documented. In contrast, there have been few attempts to identify symptoms that discriminate irritable bowel syndrome from food allergy, despite similarities in their respective symptom complexes. We aimed to investigate the value of symptoms in discriminating irritable bowel syndrome from organic disease and food allergy.

METHODS

Subjects (n = 288) were recruited from consecutive patients presenting to the Internal Medicine, Gastroenterology and Allergy Units in Chieti. Patients completed the validated Bowel Disease Questionnaire (BDQ) prior to an independent diagnostic evaluation, which included endoscopy when appropriate. Food allergy was diagnosed using a 2-week elimination diet, followed by a placebo-controlled food challenge test, a skin prick test and serum RAST for specific IgE for suspected foods or additives. The results of the BDQ were not considered in formulating a diagnosis. In total, 99 patients were diagnosed with the IBS, 79 patients were diagnosed with organic disease and 22 patients were diagnosed with food allergy. A further 88 patients with extraintestinal allergies were included as a control group.

RESULTS

Based on logistic regression analysis, six symptom items discriminated IBS from organic disease, while five symptoms discriminated patients with IBS from control subjects. A diagnosis of IBS compared to organic disease was positively associated with straining on defaecation (P=0.0001), diarrhoea (P=0.001) and abdominal bloating (P=0.01), but was negatively associated with pain in the upper abdomen (P=0.0004), reflux (P=0.0001) and appetite loss (P=0.004). A diagnosis of IBS compared to extraintestinal allergy was positively associated with pain relieved by bowel movement (P=0.0001), pain in the lower abdomen (P=0.0006), pain in both the upper and lower abdomen (P=0.003), frequent pain (P=0.001) and abdominal bloating (P=0.0009). In comparison between IBS and food allergy patients, a diagnosis of IBS was positively associated with pain in the lower abdomen (P=0.001), pain relieved by bowel movements (P=0.001), frequent pain (P=0.02) and abdominal bloating (P=0.03).

CONCLUSION

Symptoms appear to be useful for discriminating IBS from organic gastrointestinal disease and food allergy.

Authors+Show Affiliations

Dipartimento di Medicina e Scienze dell'Invecchiamento, Sezione di Medicina Interna e Gastroenterologia, Università G. D'Annunzio, Chieti, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11007133

Citation

Neri, M, et al. "Symptoms Discriminate Irritable Bowel Syndrome From Organic Gastrointestinal Diseases and Food Allergy." European Journal of Gastroenterology & Hepatology, vol. 12, no. 9, 2000, pp. 981-8.
Neri M, Laterza F, Howell S, et al. Symptoms discriminate irritable bowel syndrome from organic gastrointestinal diseases and food allergy. Eur J Gastroenterol Hepatol. 2000;12(9):981-8.
Neri, M., Laterza, F., Howell, S., Di Gioacchino, M., Festi, D., Ballone, E., ... Talley, N. J. (2000). Symptoms discriminate irritable bowel syndrome from organic gastrointestinal diseases and food allergy. European Journal of Gastroenterology & Hepatology, 12(9), pp. 981-8.
Neri M, et al. Symptoms Discriminate Irritable Bowel Syndrome From Organic Gastrointestinal Diseases and Food Allergy. Eur J Gastroenterol Hepatol. 2000;12(9):981-8. PubMed PMID: 11007133.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Symptoms discriminate irritable bowel syndrome from organic gastrointestinal diseases and food allergy. AU - Neri,M, AU - Laterza,F, AU - Howell,S, AU - Di Gioacchino,M, AU - Festi,D, AU - Ballone,E, AU - Cuccurullo,F, AU - Talley,N J, PY - 2000/9/28/pubmed PY - 2001/6/8/medline PY - 2000/9/28/entrez SP - 981 EP - 8 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 12 IS - 9 N2 - BACKGROUND: The value of specific gastrointestinal symptoms in discriminating irritable bowel syndrome (IBS) from organic disease has been documented. In contrast, there have been few attempts to identify symptoms that discriminate irritable bowel syndrome from food allergy, despite similarities in their respective symptom complexes. We aimed to investigate the value of symptoms in discriminating irritable bowel syndrome from organic disease and food allergy. METHODS: Subjects (n = 288) were recruited from consecutive patients presenting to the Internal Medicine, Gastroenterology and Allergy Units in Chieti. Patients completed the validated Bowel Disease Questionnaire (BDQ) prior to an independent diagnostic evaluation, which included endoscopy when appropriate. Food allergy was diagnosed using a 2-week elimination diet, followed by a placebo-controlled food challenge test, a skin prick test and serum RAST for specific IgE for suspected foods or additives. The results of the BDQ were not considered in formulating a diagnosis. In total, 99 patients were diagnosed with the IBS, 79 patients were diagnosed with organic disease and 22 patients were diagnosed with food allergy. A further 88 patients with extraintestinal allergies were included as a control group. RESULTS: Based on logistic regression analysis, six symptom items discriminated IBS from organic disease, while five symptoms discriminated patients with IBS from control subjects. A diagnosis of IBS compared to organic disease was positively associated with straining on defaecation (P=0.0001), diarrhoea (P=0.001) and abdominal bloating (P=0.01), but was negatively associated with pain in the upper abdomen (P=0.0004), reflux (P=0.0001) and appetite loss (P=0.004). A diagnosis of IBS compared to extraintestinal allergy was positively associated with pain relieved by bowel movement (P=0.0001), pain in the lower abdomen (P=0.0006), pain in both the upper and lower abdomen (P=0.003), frequent pain (P=0.001) and abdominal bloating (P=0.0009). In comparison between IBS and food allergy patients, a diagnosis of IBS was positively associated with pain in the lower abdomen (P=0.001), pain relieved by bowel movements (P=0.001), frequent pain (P=0.02) and abdominal bloating (P=0.03). CONCLUSION: Symptoms appear to be useful for discriminating IBS from organic gastrointestinal disease and food allergy. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/11007133/Symptoms_discriminate_irritable_bowel_syndrome_from_organic_gastrointestinal_diseases_and_food_allergy_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11007133.ui DB - PRIME DP - Unbound Medicine ER -