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Short-term stability of subtypes in the irritable bowel syndrome: prospective evaluation using the Rome III classification.
Aliment Pharmacol Ther. 2012 Feb; 35(3):350-9.AP

Abstract

BACKGROUND

In irritable bowel syndrome (IBS) subtyping is used in research and clinical practice. Knowledge of subtype stability is needed for proper design of trials and treatment strategies.

AIMS

To evaluate the stability of Rome III IBS subtypes over time and to determine the optimal time period for prospective, diary-based subtyping.

METHODS

Rome III IBS patients aged 18-70 years enrolled in two identical, randomised, placebo-controlled trials of probiotics, were included. No difference was found on stool pattern, thus patients were analysed as one group. Patients scored defaecations according to Bristol Stool Form Scale for 10 weeks. IBS subtypes were determined for all 1- and 2-week periods. Subtype distribution and stool pattern over time were determined. The proportions of patients having the same subtype all weeks (stable patients) or having a predominant subtype (same subtype ≥60% of time) were determined.

RESULTS

A total of 126 patients, mean age 46 ± 15 years, 72% women were included. Subtype distribution was similar over time with IBS with constipation, IBS with diarrhoea and IBS unsubtyped constituting one-third of the population each. Even though only 18-35% had the same subtype all weeks, the majority of patients had the same subtype for ≥60% of time (82-98%). Sixty-nine per cent had the same predominant and baseline subtypes. Two-week data increased the proportion of stable patients, of patients with a predominant subtype, and of patients who had similar baseline and predominant subtype.

CONCLUSIONS

Most IBS patients change subtype over time. However, an underlying stool pattern stability was demonstrated in the majority of patients. To increase stability, we recommend 2-week data for IBS subtyping.

Authors+Show Affiliations

Department of Medicine, Køge Hospital, University of Copenhagen, Denmark. alen@regionsjaelland.dkNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22176384

Citation

Engsbro, A L., et al. "Short-term Stability of Subtypes in the Irritable Bowel Syndrome: Prospective Evaluation Using the Rome III Classification." Alimentary Pharmacology & Therapeutics, vol. 35, no. 3, 2012, pp. 350-9.
Engsbro AL, Simren M, Bytzer P. Short-term stability of subtypes in the irritable bowel syndrome: prospective evaluation using the Rome III classification. Aliment Pharmacol Ther. 2012;35(3):350-9.
Engsbro, A. L., Simren, M., & Bytzer, P. (2012). Short-term stability of subtypes in the irritable bowel syndrome: prospective evaluation using the Rome III classification. Alimentary Pharmacology & Therapeutics, 35(3), 350-9. https://doi.org/10.1111/j.1365-2036.2011.04948.x
Engsbro AL, Simren M, Bytzer P. Short-term Stability of Subtypes in the Irritable Bowel Syndrome: Prospective Evaluation Using the Rome III Classification. Aliment Pharmacol Ther. 2012;35(3):350-9. PubMed PMID: 22176384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-term stability of subtypes in the irritable bowel syndrome: prospective evaluation using the Rome III classification. AU - Engsbro,A L, AU - Simren,M, AU - Bytzer,P, Y1 - 2011/12/18/ PY - 2011/12/20/entrez PY - 2011/12/20/pubmed PY - 2012/4/14/medline SP - 350 EP - 9 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 35 IS - 3 N2 - BACKGROUND: In irritable bowel syndrome (IBS) subtyping is used in research and clinical practice. Knowledge of subtype stability is needed for proper design of trials and treatment strategies. AIMS: To evaluate the stability of Rome III IBS subtypes over time and to determine the optimal time period for prospective, diary-based subtyping. METHODS: Rome III IBS patients aged 18-70 years enrolled in two identical, randomised, placebo-controlled trials of probiotics, were included. No difference was found on stool pattern, thus patients were analysed as one group. Patients scored defaecations according to Bristol Stool Form Scale for 10 weeks. IBS subtypes were determined for all 1- and 2-week periods. Subtype distribution and stool pattern over time were determined. The proportions of patients having the same subtype all weeks (stable patients) or having a predominant subtype (same subtype ≥60% of time) were determined. RESULTS: A total of 126 patients, mean age 46 ± 15 years, 72% women were included. Subtype distribution was similar over time with IBS with constipation, IBS with diarrhoea and IBS unsubtyped constituting one-third of the population each. Even though only 18-35% had the same subtype all weeks, the majority of patients had the same subtype for ≥60% of time (82-98%). Sixty-nine per cent had the same predominant and baseline subtypes. Two-week data increased the proportion of stable patients, of patients with a predominant subtype, and of patients who had similar baseline and predominant subtype. CONCLUSIONS: Most IBS patients change subtype over time. However, an underlying stool pattern stability was demonstrated in the majority of patients. To increase stability, we recommend 2-week data for IBS subtyping. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/22176384/Short_term_stability_of_subtypes_in_the_irritable_bowel_syndrome:_prospective_evaluation_using_the_Rome_III_classification_ L2 - https://doi.org/10.1111/j.1365-2036.2011.04948.x DB - PRIME DP - Unbound Medicine ER -