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Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea.
Am J Gastroenterol 2003; 98(11):2454-9AJ

Abstract

OBJECTIVES

Distinguishing between irritable bowel syndrome (IBS) and functional dyspepsia can be challenging because of the variations in symptom patterns, which commonly overlap. However, the overlap is poorly quantified, and it is equally uncertain whether symptom patterns differ in subgroups of IBS arbitrarily defined by primary bowel patterns of constipation (IBS-C) and diarrhea (IBS-D). We aimed to determine and to compare the distribution of GI symptoms, both, upper and lower, among IBS-C and IBS-D patients.

METHODS

A total of 121 consecutive patients presenting with a diagnosis of IBS were grouped according to primary bowel symptoms as IBS-C (58 women and 18 men, mean age 47 +/- 17 yr) or IBS-D (26 women and 19 men, mean age 47 +/- 15 yr). The Hopkins Bowel Symptom Questionnaire, which includes a brief Quality of Life assessment, and the Hopkins Symptom Checklist 90-Revised were completed by all patients at intake.

RESULTS

IBS-C patients reported significantly more overall GI symptoms when compared to patients with IBS-D (6.67 vs 4.62, respectively, p<0.001). Abdominal pain patterns differed in patients with IBS-C versus IBS-D (lower abdominal pain: 40.8% vs 24.4% p=0.05 and upper abdominal pain: 36.8% vs 24.4%, respectively). Bloating was substantially more common in IBS-C patients (75%) than in IBS-D (40.9%). There were no significant differences in personality subscales by IBS subgroup; however, somatization was positively associated with multiple symptom reports and was negatively correlated with quality of life.

CONCLUSIONS

Upper GI symptoms consistent with functional dyspepsia were more frequent in IBS-C. Although there was considerable overlap of upper and lower GI symptoms in patients with IBS-C and IBS-D, the former had more frequent lower abdominal pain and bloating.

Authors+Show Affiliations

Mayo Foundation, Mayo Medical School, Rochester, Minnesota 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

14638348

Citation

Talley, Nicholas J., et al. "Overlapping Upper and Lower Gastrointestinal Symptoms in Irritable Bowel Syndrome Patients With Constipation or Diarrhea." The American Journal of Gastroenterology, vol. 98, no. 11, 2003, pp. 2454-9.
Talley NJ, Dennis EH, Schettler-Duncan VA, et al. Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol. 2003;98(11):2454-9.
Talley, N. J., Dennis, E. H., Schettler-Duncan, V. A., Lacy, B. E., Olden, K. W., & Crowell, M. D. (2003). Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. The American Journal of Gastroenterology, 98(11), pp. 2454-9.
Talley NJ, et al. Overlapping Upper and Lower Gastrointestinal Symptoms in Irritable Bowel Syndrome Patients With Constipation or Diarrhea. Am J Gastroenterol. 2003;98(11):2454-9. PubMed PMID: 14638348.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. AU - Talley,Nicholas J, AU - Dennis,Eslie Helen, AU - Schettler-Duncan,V Ann, AU - Lacy,Brian E, AU - Olden,Kevin W, AU - Crowell,Michael D, PY - 2003/11/26/pubmed PY - 2004/1/6/medline PY - 2003/11/26/entrez SP - 2454 EP - 9 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 98 IS - 11 N2 - OBJECTIVES: Distinguishing between irritable bowel syndrome (IBS) and functional dyspepsia can be challenging because of the variations in symptom patterns, which commonly overlap. However, the overlap is poorly quantified, and it is equally uncertain whether symptom patterns differ in subgroups of IBS arbitrarily defined by primary bowel patterns of constipation (IBS-C) and diarrhea (IBS-D). We aimed to determine and to compare the distribution of GI symptoms, both, upper and lower, among IBS-C and IBS-D patients. METHODS: A total of 121 consecutive patients presenting with a diagnosis of IBS were grouped according to primary bowel symptoms as IBS-C (58 women and 18 men, mean age 47 +/- 17 yr) or IBS-D (26 women and 19 men, mean age 47 +/- 15 yr). The Hopkins Bowel Symptom Questionnaire, which includes a brief Quality of Life assessment, and the Hopkins Symptom Checklist 90-Revised were completed by all patients at intake. RESULTS: IBS-C patients reported significantly more overall GI symptoms when compared to patients with IBS-D (6.67 vs 4.62, respectively, p<0.001). Abdominal pain patterns differed in patients with IBS-C versus IBS-D (lower abdominal pain: 40.8% vs 24.4% p=0.05 and upper abdominal pain: 36.8% vs 24.4%, respectively). Bloating was substantially more common in IBS-C patients (75%) than in IBS-D (40.9%). There were no significant differences in personality subscales by IBS subgroup; however, somatization was positively associated with multiple symptom reports and was negatively correlated with quality of life. CONCLUSIONS: Upper GI symptoms consistent with functional dyspepsia were more frequent in IBS-C. Although there was considerable overlap of upper and lower GI symptoms in patients with IBS-C and IBS-D, the former had more frequent lower abdominal pain and bloating. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/14638348/Overlapping_upper_and_lower_gastrointestinal_symptoms_in_irritable_bowel_syndrome_patients_with_constipation_or_diarrhea_ L2 - http://Insights.ovid.com/pubmed?pmid=14638348 DB - PRIME DP - Unbound Medicine ER -