Inclusion and exclusion criteria of importance in irritable bowel syndrome trials

Bergmann, Jean‐François

doi:10.1016/s0002-9343(99)00080-7

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…It has recently been shown in a Swedish study that it is possible to identify irritable bowel syndrome by means of a simplified self‐report questionnaire 30 . The use of symptom criteria and the absence of warning signs usually leads to an accurate diagnosis of irritable bowel syndrome 31 . However, it is possible that, due to the `branching' format of the questionnaire in our study, we may have underestimated the prevalence of irritable bowel syndrome in this population and may have only retrieved the most serious cases.…”

Section: Discussionmentioning

confidence: 90%

Extra‐intestinal manifestations associated with irritable bowel syndrome: a twin study

Svedberg

Johansson

Wallander

et al. 2002

Aliment Pharmacol Ther

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Background: Little is known about the role of genetic and environmental factors in irritable bowel syndrome. Various extra‐intestinal manifestations are more prevalent in cases than in controls. Genetic effects may be important in the liability to develop functional bowel disorders. Aims: To evaluate the associations of irritable bowel syndrome with several disorders co‐morbid with the condition, using both a case–control design and a co‐twin control design. Methods: A sample of 850 Swedish twin pairs, aged 18–85 years, was contacted for a telephone interview. Through a diagnostic algorithm, 72 unrelated cases of irritable bowel syndrome and 216 age‐ and gender‐matched controls were identified. Fifty‐eight twin pairs discordant for irritable bowel syndrome were evaluated in co‐twin analyses. Results: Renal problems (odds ratio (OR)=3.3; confidence interval (CI), 1.3–8.2), obesity (OR=2.6; CI, 1.0–6.4), underweight in the past (OR=2.4; CI, 1.1–6.4), gluten intolerance (OR=9.0; CI, 1.4–60.1), rheumatoid arthritis (OR=3.2; CI, 1.1–9.4) and poor self‐rated health (OR=1.8; CI, 1.0–3.2) were significantly associated with irritable bowel syndrome. In the co‐twin analyses, the only factors maintaining significance were renal and recurrent urinary tract problems. Conclusions: The association between irritable bowel syndrome and renal and urinary tract problems does not reflect a genetic or familial mediation. Eating disorders in childhood represent a familial–environmental influence on irritable bowel syndrome, whereas the association with rheumatoid arthritis and perhaps gluten intolerance probably reflects genetic mediation.

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Section: Discussionmentioning

confidence: 90%

Extra‐intestinal manifestations associated with irritable bowel syndrome: a twin study

Svedberg

Johansson

Wallander

et al. 2002

Aliment Pharmacol Ther

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“…This trial recruited patients from various resources using inclusion and exclusion criteria in concordance with literature recommendations. 8,30,35 It must be mentioned that various IBS trials have ruled out organic cause by standard laboratory and radiological tests, and rectosigmoidoscopy. [36][37][38] However, due to logistic reasons and with the intention to keep this trial as non-invasive as possible and naturalistic within the general practitioner environment, laboratory and radiological tests were not performed on IBS candidates unless clinically indicated and requested by the treating doctor.…”

Section: Discussionmentioning

confidence: 99%

The effects of an artificially enhanced clinoptilolite in patients with irritable bowel syndrome

et al. 2017

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Background: Irritable Bowel Syndrome (IBS) is one of the most common gastrointestinal disorders presenting in clinical practice. IBS is a functional bowel disorder in which abdominal pain or discomfort is associated with a change in bowel habit and with features of disordered defecation. Methods: IBS candidates were enrolled in the study using the Rome III diagnostic criteria. Participants were identified as IBS-D (diarrhoea dominant), IBS-C (constipation dominant) as well as an IBS-M (mixed group). The participants were randomly assigned; for intention to treat with 750 mg potentiated clinoptilolite three times daily or placebo. The primary endpoint was to determine whether or not the patient experienced adequate relief of symptoms. Results: At the end of treatment 67% and 40% of patients were classified as overall responders in the potentiated clinoptilolite and placebo groups respectively (N=50). After week three of treatment the number of weekly responders was significantly higher (p=0.048) in the potentiated clinoptilolite group compared to the Placebo group, and at week four of treatment the number of weekly responders was borderline significant higher in the potentiated clinoptilolite group (P=0.06). Secondary endpoints were measured but the population size proved too small to realistically obtain statistical significance (p > 0.5). Conclusion: Potentiated clinoptilolite shows clinical benefit, and should be tested further in larger clinical trials. In addition, potentiated clinoptilolite also shows reduced symptoms of IBD-D and IBS-M respectively. It is recommended that clinical response to dose variation should also be further investigated in designated populations of IBS-M and IBS-D patients.

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“…Although its pathophysiology is not known, a hallmark of the condition is the lack of objective findings by endoscopy or laboratory work. This led to a concept that IBS was a ''diagnosis of exclusion'' [7]. This characterization is problematic because it implies that IBS cannot have a cause, since any cause would mean that it cannot be IBS [8].…”

Section: Introductionmentioning

confidence: 99%

New Clinical Method for Distinguishing D-IBS from Other Gastrointestinal Conditions Causing Diarrhea: The LA/IBS Diagnostic Strategy

et al. 2009

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Modern methods of diagnosing diarrhea-predominant irritable bowel syndrome (D-IBS) require a "diagnosis of exclusion" approach. In this study we aim to test the diagnostic ability of using the fluctuation of frequency and consistency of bowel patterns in IBS to discriminate it from other causes of diarrhea. Eligible subjects were asked to complete a questionnaire on the changes in form and frequency of bowel habits by time. The primary endpoint was to evaluate the diagnostic effectiveness of having irregularly irregular bowel function and form as more characteristic of IBS versus non-IBS causes. Patients were prospectively recruited from a tertiary care GI clinic. Subjects had to have diarrhea as their primary complaint. In the case of IBS, D-IBS subjects were recruited. Subjects with celiac disease, Crohn's and ulcerative colitis were recruited for comparison and were categorically called "non-IBS." Non-IBS subjects could not have a recent history of blood in stool or a history of bowel surgery, fistulae or narcotic use. Sixty-two IBS and 37 non-IBS subjects were recruited. Among the 62 IBS subjects, 49 (79%) stated that their bowel habits varied in form and frequency on a daily basis compared to 35% in non-IBS subjects (OR = 8.9, CI = 3.5-22.5, P < 0.00001). When subjects were compared by the number of different stool forms they had witnessed in the prior week, IBS subjects noted 3.58 +/- 0.19 types and non-IBS reported 2.35 +/- 0.16 (P < 0.00001). Using > or = 3 stool forms per week as a method of discriminating IBS from non-IBS, 50 out of 62 subjects with IBS (81%) reported this greater number of forms compared to 15 out of 37 (41%) non-IBS subjects (sensitivity = 0.81; specificity = 0.60). The use of this simple tool that identifies an irregularly irregular bowel form and function is successful in separating D-IBS from non-IBS subjects.

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Inclusion and exclusion criteria of importance in irritable bowel syndrome trials

Cited by 4 publications

References 25 publications

Extra‐intestinal manifestations associated with irritable bowel syndrome: a twin study

Extra‐intestinal manifestations associated with irritable bowel syndrome: a twin study

The effects of an artificially enhanced clinoptilolite in patients with irritable bowel syndrome

New Clinical Method for Distinguishing D-IBS from Other Gastrointestinal Conditions Causing Diarrhea: The LA/IBS Diagnostic Strategy

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