Year 2016 / Volume 108 / Number 2
Original
Irritable bowel syndrome subtypes: Clinical and psychological features, body mass index and comorbidities

59-64

DOI: 10.17235/reed.2015.3979/2015

Cristiane Kibune Nagasako, Ciro Garcia Montes, Sônia Letícia Silva Lorena, Maria Aparecida Mesquita,

Abstract
Background: Irritable bowel syndrome (IBS) is classified into subtypes according to bowel habit. Objective: To investigate whether there are differences in clinical features, comorbidities, anxiety, depression and body mass index (BMI) among IBS subtypes. Methods: The study group included 113 consecutive patients (mean age: 48 ± 11 years; females: 94) with the diagnosis of IBS. All of them answered a structured questionnaire for demographic and clinical data and underwent upper endoscopy. Anxiety and depression were assessed by the Hospital Anxiety and Depression scale (HAD). Results: The distribution of subtypes was: IBS-diarrhea (IBS-D), 46%; IBS-constipation (IBS-C), 32%, and mixed IBS (IBS-M), 22%. IBS overlap with gastroesophageal reflux disease (GERD), functional dyspepsia, chronic headache and fibromyalgia occurred in 65.5%, 48.7%, 40.7% and 22.1% of patients, respectively. Anxiety and/or depression were found in 81.5%. Comparisons among subgroups showed that bloating was significantly associated with IBS-M compared to IBS-D (odds ratio-OR-5.6). Straining was more likely to be reported by IBS-M (OR 15.3) and IBS-C (OR 12.0) compared to IBS-D patients, while urgency was associated with both IBS-M (OR 19.7) and IBS-D (OR 14.2) compared to IBS-C. In addition, IBS-M patients were more likely to present GERD than IBS-D (OR 6.7) and higher scores for anxiety than IBS-C patients (OR 1.2). BMI values did not differ between IBS-D and IBS-C. Conclusion: IBS-M is characterized by symptoms frequently reported by both IBS-C (straining) and IBS-D (urgency), higher levels of anxiety, and high prevalence of comorbidities. These features should be considered in the clinical management of this subgroup.
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References
1. Drossman DA, Morris CB, Schneck S, et al. International survey of patients with IBS: symptom features and their severity, health status, treatments, and risk taking to achieve clinical benefit. J Clin Gastroenterol 2009; 43:541-50.
2.Nastaskin I, Mehdikhani E, Conklin J, et al. Studying the overlap between IBS and GERD: a systematic review of the literature. Dig Dis Sci 2006; 51:2113-20.
3. Piacentino D, Cantarini R, Alfonsi M, et al. Psychopathological features of irritable bowel syndrome patients with and without functional dyspepsia: a cross sectional study. BMC Gastroenterol 2011; 11:94.
4. Hausteiner-Wiehle C, Henningsen P. Irritable bowel syndrome: relations with functional, mental, and somatoform disorders. World J Gastroenterol 2014;20:6024-30.
5. Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology 2002;122:1140-56.
6. Vandvik PO, Wilhelmsen I, Ihlebaek C, et al. Comorbidity of irritable bowel syndrome in general practice: a striking feature with clinical implications. Aliment Pharmacol Ther 2004; 20:1195-203.
7. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology 2006;130:1480-91.
8. Rey de Castro NG, Miller V, Carruthers HR, et al. Irritable bowel syndrome: a comparison of subtypes. J Gastroenterol Hepatol 2015;30:279-85.
9. Muscatello MR, Bruno A, Pandolfo G, et al. Depression, anxiety and anger in subtypes of irritable bowel syndrome patients. J Clin Psychol Med Settings 2010;17:64-70.
10. Lin S, Mooney PD, Kurien M, et al. Prevalence, investigational pathways and diagnostic outcomes in differing irritable bowel syndrome subtypes. Eur J Gastroenterol Hepatol 2014;26:1176-80.
11. Keshteli AH, Dehestani B, Daghaghzadeh H, et al. Epidemiological features of irritable bowel syndrome and its subtypes among Iranian adults. Ann Gastroenterol 2015;28:253-8.
12. Gorospe EC, Oxentenko AS. Nutritional consequences of chronic diarrhoea. Best Pract Res Clin Gastroenterol 2012;26:663-75.
13. Kubo M, Fujiwara Y, Shiba M, et al. Differences between risk factors among irritable bowel syndrome subtypes in Japanese adults. Neurogastroenterol Motil 2011;23:249-54.
14. Sadik R, Björnsson E, Simrén M. The relationship between symptoms, body mass index, gastrointestinal transit and stool frequency in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol 2010; 22:102-8.
15. Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999; 45:172-80.
16. Fass R, Fennerty MB, Vakil N. Nonerosive reflux disease-current concepts and dilemmas. Am J Gastroenterol 2001; 96:303-14.
17. Tack J, Talley NJ, Camilleri M, et al. Functional gastroduodenal disorders. Gastroenterology 2006; 130:1466-79.
18. Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010;62:600-10.
19. Botega NJ, Bio MR, Zomignani MA, et al. Mood disorders among inpatients in ambulatory and validation of the anxiety and depression scale HAD. Rev Saude Publica 1995;29:355-63.
20. Quigley EM, Bytzer P, Jones R, et al. Irritable bowel syndrome: the burden and unmet needs in Europe. Dig Liver Dis 2006; 38:717-23.
21. Su AM, Shih W, Presson AP, et al. Characterization of symptoms in irritable bowel syndrome with mixed bowel habit pattern. Neurogastroenterol Motil 2014;26:36-45.
22. Yao X, Yang YS, Cui LH, et al. Subtypes of irritable bowel syndrome on Rome III criteria: a multicenter study. J Gastroenterol Hepatol. 2012;27:760-5.
23. Chial HJ, Camilleri M. Gender differences in irritable bowel syndrome. J Gend Specif Med 2002;5:37-45.
24. Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol 2014; 6:71-80.
25. Gunnarsson J, Simrén M. Efficient diagnosis of suspected functional bowel disorders. Nat Clin Pract Gastroenterol Hepatol 2008; 5:498-507.
26.Bouchoucha M, Fysekidis M, Devroede G, et al. Abdominal pain localization is associated with non-diarrheic Rome III functional gastrointestinal disorders. Neurogastroenterol Motil 2013;25:686-93.
27. Heitkemper M, Cain KC, Shulman R, et al. Subtypes of irritable bowel syndrome based on abdominal pain/discomfort severity and bowel pattern. Dig Dis Sci. 2011;56:2050-8.
28. Brasil estabiliza taxas de sobrepeso e obesidade [Portal Brasil web site]. April 30, 2014. Available at: http://www.brasil.gov.br/saude/2014/04/brasil-estabiliza-taxas-de-sobrepeso-e-obesidade. Accessed November 7, 2014.
29. Simrén M, Månsson A, Langkilde AM, et al. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion. 2001;63:108-15.
30. Fond G, Loundou A, Hamdani N, et al. Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2014;264:651-60.
31. Bigal ME, Bordini CA, Speciali JG. Etiology and distribution of headaches in two Brazilian primary care units. Headache 2000;40:241-7.
32. Senna ER, De Barros AL, Silva EO, et al. Prevalence of rheumatic diseases in Brazil: a study using the COPCORD approach. J Rheumatol 2004;31:594-7.
33. 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;98:2454-9.
34. Gasiorowska A, Poh CH, Fass R. Gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS)-is it one disease or an overlap of two disorders? Dig Dis Sci 2009;54:1829-34.
35. Noh YW, Jung HK, Kim SE, et al. Overlap of erosive and non-erosive reflux diseases with functional gastrointestinal disorders according to Rome III criteria. J Neurogastroenterol Motil 2010;16:148-56.
36. Vandvik PO, Wilhelmsen I, Ihlebaek C, et al. Comorbidity of irritable bowel syndrome in general practice: a striking feature with clinical implications. Aliment Pharmacol Ther 2004;20:1195-203.
37. 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;15:165-72 .
38. Creed F, Ratcliffe J, Fernandes L, et al. North of England IBS Research Group. Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders. Br J Psychiatry 2005;186:507-15.
39. Tillisch K, Labus JS, Naliboff BD, et al. Characterization of the alternating bowel habit subtype in patients with irritable bowel syndrome. Am J Gastroenterol 2005;100:896-904.
40. Jung HK, Halder S, McNally M, et al. Overlap of gastro-oesophageal reflux disease and irritable bowel syndrome: prevalence and risk factors in the general population. Aliment Pharmacol Ther 2007; 26:453-61.
41. Su AM, Shih W, Presson AP, et al. Characterization of symptoms in irritable bowel syndrome with mixed bowel habit pattern. Neurogastroenterol Motil 2014; 26:36-45.
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Kibune Nagasako C, Garcia Montes C, Silva Lorena S, Mesquita M. Irritable bowel syndrome subtypes: Clinical and psychological features, body mass index and comorbidities. 3979/2015


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Publication history

Received: 20/08/2015

Accepted: 15/11/2015

Online First: 30/11/2015

Published: 01/02/2016

Article revision time: 85 days

Article Online First time: 102 days

Article editing time: 165 days


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