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The prevalence of irritable bowel syndrome-type symptoms in inflammatory bowel disease patients in remission.
Eur J Gastroenterol Hepatol 2017; 29(9):1086-1090EJ

Abstract

OBJECTIVE

Symptoms of irritable bowel syndrome (IBS) are common in inflammatory bowel disease (IBD) and are believed to reflect ongoing inflammation. Consequently, a low prevalence of IBS-type symptoms in IBD patients with normal inflammatory markers is expected. We aimed to investigate the prevalence of IBS-type symptoms in IBD patients in biochemical remission (evidenced by low fecal calprotectin levels) and the relationship of these symptoms with fecal calprotectin levels.

PATIENTS AND METHODS

In this observational, cross-sectional study, we included all adults with a history of IBD who had calprotectin levels less than 200 µg/g during routine follow-up between August 2014 and May 2015 at our hospital. Patients were excluded if calprotectin was measured because of gastrointestinal complaints. All patients were approached by telephone to evaluate the presence of IBS-type symptoms using Rome III questionnaires. Patients fulfilling IBS criteria were subclassified according to bowel habits.

RESULTS

In total, 74 patients were included; 33 (45%, 95% confidence interval: 34-56%) fulfilled the IBS criteria. A larger proportion of Crohn's disease patients with IBS-type symptoms had ileal disease compared with Crohn's disease patients without IBS symptoms (55 vs. 24%; P=0.03). Other characteristics were similar between groups. No difference was found in calprotectin levels between patients with and without IBS-type symptoms (P=0.91). The majority of patients with IBS-type symptoms had diarrhea-predominant or mixed-type IBS (64 and 27% of patients with IBS-type symptoms, respectively).

CONCLUSION

The prevalence of IBS-type symptoms in IBD patients in biochemical remission is high. A significant proportion of IBS-type symptoms is unrelated to ongoing inflammation and probably reflects 'true IBS'.

Authors+Show Affiliations

Departments of aPediatric Gastroenterology and Nutrition bGastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

28639969

Citation

Hoekman, Daniël R., et al. "The Prevalence of Irritable Bowel Syndrome-type Symptoms in Inflammatory Bowel Disease Patients in Remission." European Journal of Gastroenterology & Hepatology, vol. 29, no. 9, 2017, pp. 1086-1090.
Hoekman DR, Zeevenhooven J, D'Haens GR, et al. The prevalence of irritable bowel syndrome-type symptoms in inflammatory bowel disease patients in remission. Eur J Gastroenterol Hepatol. 2017;29(9):1086-1090.
Hoekman, D. R., Zeevenhooven, J., D'Haens, G. R., & Benninga, M. A. (2017). The prevalence of irritable bowel syndrome-type symptoms in inflammatory bowel disease patients in remission. European Journal of Gastroenterology & Hepatology, 29(9), pp. 1086-1090. doi:10.1097/MEG.0000000000000921.
Hoekman DR, et al. The Prevalence of Irritable Bowel Syndrome-type Symptoms in Inflammatory Bowel Disease Patients in Remission. Eur J Gastroenterol Hepatol. 2017;29(9):1086-1090. PubMed PMID: 28639969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prevalence of irritable bowel syndrome-type symptoms in inflammatory bowel disease patients in remission. AU - Hoekman,Daniël R, AU - Zeevenhooven,Judith, AU - D'Haens,Geert R, AU - Benninga,Marc A, PY - 2017/6/24/pubmed PY - 2018/5/1/medline PY - 2017/6/23/entrez SP - 1086 EP - 1090 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 29 IS - 9 N2 - OBJECTIVE: Symptoms of irritable bowel syndrome (IBS) are common in inflammatory bowel disease (IBD) and are believed to reflect ongoing inflammation. Consequently, a low prevalence of IBS-type symptoms in IBD patients with normal inflammatory markers is expected. We aimed to investigate the prevalence of IBS-type symptoms in IBD patients in biochemical remission (evidenced by low fecal calprotectin levels) and the relationship of these symptoms with fecal calprotectin levels. PATIENTS AND METHODS: In this observational, cross-sectional study, we included all adults with a history of IBD who had calprotectin levels less than 200 µg/g during routine follow-up between August 2014 and May 2015 at our hospital. Patients were excluded if calprotectin was measured because of gastrointestinal complaints. All patients were approached by telephone to evaluate the presence of IBS-type symptoms using Rome III questionnaires. Patients fulfilling IBS criteria were subclassified according to bowel habits. RESULTS: In total, 74 patients were included; 33 (45%, 95% confidence interval: 34-56%) fulfilled the IBS criteria. A larger proportion of Crohn's disease patients with IBS-type symptoms had ileal disease compared with Crohn's disease patients without IBS symptoms (55 vs. 24%; P=0.03). Other characteristics were similar between groups. No difference was found in calprotectin levels between patients with and without IBS-type symptoms (P=0.91). The majority of patients with IBS-type symptoms had diarrhea-predominant or mixed-type IBS (64 and 27% of patients with IBS-type symptoms, respectively). CONCLUSION: The prevalence of IBS-type symptoms in IBD patients in biochemical remission is high. A significant proportion of IBS-type symptoms is unrelated to ongoing inflammation and probably reflects 'true IBS'. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/28639969/The_prevalence_of_irritable_bowel_syndrome_type_symptoms_in_inflammatory_bowel_disease_patients_in_remission_ L2 - http://Insights.ovid.com/pubmed?pmid=28639969 DB - PRIME DP - Unbound Medicine ER -