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Related Concept Videos

Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation01:30

Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation

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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
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Irritable Bowel Syndrome I: Introduction01:17

Irritable Bowel Syndrome I: Introduction

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Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
879
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

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Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
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Irritable Bowel Syndrome III: Medical and Nursing Management01:30

Irritable Bowel Syndrome III: Medical and Nursing Management

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Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
608
Drugs for Treatment of Diarrhea-Predominant IBS01:17

Drugs for Treatment of Diarrhea-Predominant IBS

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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
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Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Stability of Classification Systems for Irritable Bowel Syndrome.

Mais Khasawneh1,2, Vivek C Goodoory1,2, Cho Ee Ng3

  • 1Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.

Alimentary Pharmacology & Therapeutics
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Irritable bowel syndrome (IBS) classification stability varies. Stool form and psychological burden classifications were most stable over 12 months, but no single method fully captured IBS symptom fluctuations.

Keywords:
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Area of Science:

  • Gastroenterology
  • Psychiatry
  • Clinical Research

Background:

  • Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder.
  • Current IBS classification relies on stool form but symptom patterns are dynamic.
  • This fluctuation presents challenges for effective subtype-based management.

Purpose of the Study:

  • To evaluate the 12-month stability of four distinct Irritable Bowel Syndrome (IBS) classification methods.
  • Assessing stability using stool form, most troublesome symptom, and two latent class analyses (LCA) models.
  • Investigating a comprehensive LCA including gastrointestinal and psychological symptoms, and a simplified LCA based on psychological burden.

Main Methods:

  • Recruitment of participants meeting Rome IV criteria for IBS from a UK registry.
  • Administration of validated online questionnaires assessing gastrointestinal and psychological symptoms at baseline and 12 months.
  • Evaluation of classification stability using Cohen's kappa statistic.

Main Results:

  • Stool form-based subtyping demonstrated the highest stability (κ=0.60), with 83% of diarrhea-predominant IBS cases remaining stable.
  • Classification based on psychological burden also showed moderate stability (κ=0.54).
  • Latent class analysis (LCA) methods, particularly the seven-cluster model (κ=0.37), exhibited lower stability over the 12-month period.

Conclusions:

  • Existing IBS classification systems exhibit only moderate stability over 12 months, reflecting the disorder's inherent variability.
  • Stool form and psychological burden appear to be the most stable classification parameters.
  • Future research should focus on dynamic models integrating both gastrointestinal and psychological factors for improved IBS management.