Prospective diary evaluation of unexplained abdominal pain and bowel dysfunction: a population-based colonoscopy...

Area of Science:

• Gastroenterology
• Clinical Epidemiology
• Digestive Health

Background:

• Diagnostic criteria for Irritable Bowel Syndrome (IBS) lack validation through prospective symptom diaries.
• Investigated bowel patterns in community subjects with and without non-organic abdominal pain.

Purpose of the Study:

• To compare symptoms of subjects fulfilling Rome II criteria for IBS with those experiencing non-organic abdominal pain.
• To validate IBS diagnostic criteria using prospective gastrointestinal (GI) symptom diaries.

Main Methods:

• A random sample from the Swedish population register completed questionnaires and underwent clinical evaluation, including colonoscopy.
• 268 subjects completed prospective GI symptom diaries for one week.
• 23 subjects with organic GI disease were excluded.

Main Results:

• Subjects with abdominal pain in diaries reported higher stool frequency, urgency, incomplete evacuation, nausea, and bloating compared to pain-free subjects.
• Only 12% of subjects met Rome II criteria for IBS.
• No significant differences were found between IBS subjects and other non-organic abdominal pain subjects regarding pain improvement post-defecation, bloating, stool frequency, consistency, or defecatory symptoms.

Conclusions:

• Prospective measurement suggests current IBS criteria may overestimate the association between abdominal pain and bowel disturbances.
• Reliance on recall for IBS diagnosis may lead to overdiagnosis.