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Irritable bowel syndrome: which definitions are consistent?

L Kay1, T Jørgensen, C Lanng

  • 1Copenhagen County Centre of Preventive Medicine, Medical Department C, Glostrup County Hospital, University of Copenhagen, Denmark.

Journal of Internal Medicine
|January 20, 1999
PubMed
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Different definitions of irritable bowel syndrome (IBS) create inconsistent study populations, hindering generalizable results. International agreement on a single IBS definition is crucial for consistent research.

Area of Science:

  • Gastroenterology
  • Clinical Epidemiology

Background:

  • Irritable bowel syndrome (IBS) lacks a universally accepted definition in international literature.
  • Inconsistent definitions lead to heterogeneous study populations, limiting the generalizability of research findings.

Purpose of the Study:

  • To evaluate the consistency of five different definitions of irritable bowel syndrome.
  • To assess the impact of varying diagnostic criteria on study population selection.

Main Methods:

  • A cohort of 4122 Danes completed a questionnaire on abdominal symptoms.
  • Subjects were categorized using five distinct IBS definitions: Manning criteria, Rome criteria, Drossman report, Talley definition, and Kay definition.
  • Kappa coefficients were calculated to compare the agreement between definitions.

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Main Results:

  • Manning and Rome criteria showed substantial consistency (Kappa = 0.72).
  • Definitions by Drossman, Talley, and Kay also demonstrated moderate consistency (Kappa = 0.60-0.62).
  • Other definition comparisons yielded low agreement (Kappa < 0.42).

Conclusions:

  • Significant variations exist in patient populations identified by different IBS definitions.
  • These discrepancies impede the application of research findings across studies.
  • There is a critical need for international consensus on a standardized definition for IBS.