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Irritable bowel syndrome subtypes according to bowel habit: revisiting the alternating subtype.
Eur J Gastroenterol Hepatol 2003; 15(2):165-72EJ

Abstract

BACKGROUND

Disturbed bowel habit, diarrhoea or constipation is a key manifestation of irritable bowel syndrome (IBS). In some patients, diarrhoea and constipation alternate, giving rise to the so-called alternating subtype.

AIMS

To assess IBS subtype breakdown (constipation (C-IBS), diarrhoea (D-IBS) or alternating (A-IBS)) according to the Rome II criteria and patients' self-assessment, the predominance in the alternating subtype (i.e. constipation, diarrhoea or neither), and the medical and personal impact, including health-related quality of life (HRQoL), of the different IBS subtypes.

SUBJECTS AND METHODS

Two thousand individuals selected randomly to represent the general population were classified as potential IBS subjects (n = 281) or as non-potential IBS subjects (n = 1719) according to a validated questionnaire. Bowel habit classification was determined using the Rome II IBS supportive symptoms.

RESULTS

Among 201 subjects meeting the Rome I criteria, 15% presented with D-IBS, 44% presented with C-IBS, 19% presented with A-IBS, and 22% presented with normal bowel habit. Among the 63 subjects meeting the Rome II criteria, 23% presented with A-IBS. According to the subjects' self-assessment, of those meeting the Rome I criteria, 16% considered themselves to have D-IBS, 66% to have C-IBS and 18% to have A-IBS. In subjects meeting the Rome II criteria, 24% considered themselves to have A-IBS. Among those classified with A-IBS by the Rome II criteria, most considered themselves to be constipated. Regardless of the subtype self-classification, most subjects reported a normal frequency of bowel movements. Clinical manifestations in A-IBS were very similar to those of C-IBS but with the added presence of defecatory urgency. Abdominal discomfort/pain and frequency of visits to physicians were greater in the A-IBS subtype than in the other two IBS subtypes. HRQoL was affected similarly in all IBS subtypes.

CONCLUSIONS

Approximately one-quarter of subjects with IBS belong to the A-IBS subtype by the Rome II criteria, although the majority consider themselves to be constipated; indeed, clinical manifestations are more akin to the C-IBS subtype than to the D-IBS subtype. Abdominal discomfort/pain and frequency of visits to physicians are greater in the A-IBS subtype than in the other two IBS subtypes, while HRQoL is impaired similarly.

Authors+Show Affiliations

Institute of Functional and Motor Digestive Disorders, Centro Médico Teknon, C/Vilana 12, 08022 Barcelona, Spain. fmearinm@meditex.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

12560761

Citation

Mearin, Fermín, et al. "Irritable Bowel Syndrome Subtypes According to Bowel Habit: Revisiting the Alternating Subtype." European Journal of Gastroenterology & Hepatology, vol. 15, no. 2, 2003, pp. 165-72.
Mearin F, Balboa A, Badía X, et al. Irritable bowel syndrome subtypes according to bowel habit: revisiting the alternating subtype. Eur J Gastroenterol Hepatol. 2003;15(2):165-72.
Mearin, F., Balboa, A., Badía, X., Baró, E., Caldwell, E., Cucala, M., ... Talley, N. J. (2003). Irritable bowel syndrome subtypes according to bowel habit: revisiting the alternating subtype. European Journal of Gastroenterology & Hepatology, 15(2), pp. 165-72.
Mearin F, et al. Irritable Bowel Syndrome Subtypes According to Bowel Habit: Revisiting the Alternating Subtype. Eur J Gastroenterol Hepatol. 2003;15(2):165-72. PubMed PMID: 12560761.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Irritable bowel syndrome subtypes according to bowel habit: revisiting the alternating subtype. AU - Mearin,Fermín, AU - Balboa,Agustín, AU - Badía,Xavier, AU - Baró,Eva, AU - Caldwell,Ellen, AU - Cucala,Mercedes, AU - Díaz-Rubio,Manuel, AU - Fueyo,Arturo, AU - Ponce,Julio, AU - Roset,Montse, AU - Talley,Nicholas J, PY - 2003/2/1/pubmed PY - 2003/5/7/medline PY - 2003/2/1/entrez SP - 165 EP - 72 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 15 IS - 2 N2 - BACKGROUND: Disturbed bowel habit, diarrhoea or constipation is a key manifestation of irritable bowel syndrome (IBS). In some patients, diarrhoea and constipation alternate, giving rise to the so-called alternating subtype. AIMS: To assess IBS subtype breakdown (constipation (C-IBS), diarrhoea (D-IBS) or alternating (A-IBS)) according to the Rome II criteria and patients' self-assessment, the predominance in the alternating subtype (i.e. constipation, diarrhoea or neither), and the medical and personal impact, including health-related quality of life (HRQoL), of the different IBS subtypes. SUBJECTS AND METHODS: Two thousand individuals selected randomly to represent the general population were classified as potential IBS subjects (n = 281) or as non-potential IBS subjects (n = 1719) according to a validated questionnaire. Bowel habit classification was determined using the Rome II IBS supportive symptoms. RESULTS: Among 201 subjects meeting the Rome I criteria, 15% presented with D-IBS, 44% presented with C-IBS, 19% presented with A-IBS, and 22% presented with normal bowel habit. Among the 63 subjects meeting the Rome II criteria, 23% presented with A-IBS. According to the subjects' self-assessment, of those meeting the Rome I criteria, 16% considered themselves to have D-IBS, 66% to have C-IBS and 18% to have A-IBS. In subjects meeting the Rome II criteria, 24% considered themselves to have A-IBS. Among those classified with A-IBS by the Rome II criteria, most considered themselves to be constipated. Regardless of the subtype self-classification, most subjects reported a normal frequency of bowel movements. Clinical manifestations in A-IBS were very similar to those of C-IBS but with the added presence of defecatory urgency. Abdominal discomfort/pain and frequency of visits to physicians were greater in the A-IBS subtype than in the other two IBS subtypes. HRQoL was affected similarly in all IBS subtypes. CONCLUSIONS: Approximately one-quarter of subjects with IBS belong to the A-IBS subtype by the Rome II criteria, although the majority consider themselves to be constipated; indeed, clinical manifestations are more akin to the C-IBS subtype than to the D-IBS subtype. Abdominal discomfort/pain and frequency of visits to physicians are greater in the A-IBS subtype than in the other two IBS subtypes, while HRQoL is impaired similarly. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/12560761/Irritable_bowel_syndrome_subtypes_according_to_bowel_habit:_revisiting_the_alternating_subtype_ L2 - http://Insights.ovid.com/pubmed?pmid=12560761 DB - PRIME DP - Unbound Medicine ER -