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Clinical patterns over time in irritable bowel syndrome: symptom instability and severity variability.
Am J Gastroenterol 2004; 99(1):113-21AJ

Abstract

OBJECTIVES

The clinical course of irritable bowel syndrome (IBS) remains poorly known. In 209 IBS patients meeting Rome II criteria (137 females and 72 males) we evaluated: (1). changes in frequency and intensity of abdominal pain/discomfort, abnormal number of bowel movements, loose or watery stools, defecatory urgency, hard or lumpy stools, straining during bowel movements, and feeling of incomplete evacuation); (2). use of resources, HRQoL, and psychological well being.

METHODS

Observational, prospective, multicenter study. Symptoms were registered in a diary over two 28-day periods with an interval of 4 wk; direct resource use and indirect costs were noted weekly. Three HRQoL questionnaires were administered.

RESULTS

High-intensity symptoms were present on more than 50% of the days. Sixty-one percent were classified in the same IBS subtype on both occasions (kappa= 0.48), while 49% had the same symptom predominance and intensity (kappa= 0.40). The greatest instability was observed among diarrhea (D-IBS) and constipation (C-IBS) subtypes: only 46% and 51% remained in the same pattern with a tendency to shift to alternating diarrhea/constipation subtype (A-IBS); however, practically no patient changed from D-IBS to C-IBS, or vice versa. The most reliable symptom characteristic was frequency, followed by intensity and number of episodes. Symptom frequency and intensity were directly related to resource use and HRQoL impairment.

CONCLUSIONS

IBS symptoms are instable over time and variables in intensity. Many patients with D-IBS or C-IBS move to A-IBS; however, shift from D-IBS to C-IBS, or vice versa, is very infrequent.

Authors+Show Affiliations

Institute of Functional and Motor Digestive Disorders, Centro Médico Teknon, Barcelona, Spain.No 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

14687152

Citation

Mearin, Fermin, et al. "Clinical Patterns Over Time in Irritable Bowel Syndrome: Symptom Instability and Severity Variability." The American Journal of Gastroenterology, vol. 99, no. 1, 2004, pp. 113-21.
Mearin F, Baró E, Roset M, et al. Clinical patterns over time in irritable bowel syndrome: symptom instability and severity variability. Am J Gastroenterol. 2004;99(1):113-21.
Mearin, F., Baró, E., Roset, M., Badía, X., Zárate, N., & Pérez, I. (2004). Clinical patterns over time in irritable bowel syndrome: symptom instability and severity variability. The American Journal of Gastroenterology, 99(1), pp. 113-21.
Mearin F, et al. Clinical Patterns Over Time in Irritable Bowel Syndrome: Symptom Instability and Severity Variability. Am J Gastroenterol. 2004;99(1):113-21. PubMed PMID: 14687152.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical patterns over time in irritable bowel syndrome: symptom instability and severity variability. AU - Mearin,Fermin, AU - Baró,Eva, AU - Roset,Montse, AU - Badía,Xavier, AU - Zárate,Natalia, AU - Pérez,Isabel, PY - 2003/12/23/pubmed PY - 2004/2/6/medline PY - 2003/12/23/entrez SP - 113 EP - 21 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 99 IS - 1 N2 - OBJECTIVES: The clinical course of irritable bowel syndrome (IBS) remains poorly known. In 209 IBS patients meeting Rome II criteria (137 females and 72 males) we evaluated: (1). changes in frequency and intensity of abdominal pain/discomfort, abnormal number of bowel movements, loose or watery stools, defecatory urgency, hard or lumpy stools, straining during bowel movements, and feeling of incomplete evacuation); (2). use of resources, HRQoL, and psychological well being. METHODS: Observational, prospective, multicenter study. Symptoms were registered in a diary over two 28-day periods with an interval of 4 wk; direct resource use and indirect costs were noted weekly. Three HRQoL questionnaires were administered. RESULTS: High-intensity symptoms were present on more than 50% of the days. Sixty-one percent were classified in the same IBS subtype on both occasions (kappa= 0.48), while 49% had the same symptom predominance and intensity (kappa= 0.40). The greatest instability was observed among diarrhea (D-IBS) and constipation (C-IBS) subtypes: only 46% and 51% remained in the same pattern with a tendency to shift to alternating diarrhea/constipation subtype (A-IBS); however, practically no patient changed from D-IBS to C-IBS, or vice versa. The most reliable symptom characteristic was frequency, followed by intensity and number of episodes. Symptom frequency and intensity were directly related to resource use and HRQoL impairment. CONCLUSIONS: IBS symptoms are instable over time and variables in intensity. Many patients with D-IBS or C-IBS move to A-IBS; however, shift from D-IBS to C-IBS, or vice versa, is very infrequent. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/14687152/Clinical_patterns_over_time_in_irritable_bowel_syndrome:_symptom_instability_and_severity_variability_ L2 - http://Insights.ovid.com/pubmed?pmid=14687152 DB - PRIME DP - Unbound Medicine ER -