Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Ghoshal, Uday C; Sachdeva, Sanjeev; Pratap, Nitesh; Karyampudi, Arun; Mustafa, Uzma; Abraham, Philip; Bhatt, Chetan; Chakravartty, Karmabir; Chaudhuri, Swapna; Makharia, Govind; Panigrahi, Manas; Parida, Pramod Kumar; Patwari, Sudhanshu; Sainani, Rajesh; Sadasivan, Shine; Srinivas, M; Upadhyay, Rajesh Kumar; Venkataraman, Jayanthi

doi:10.1007/s12664-022-01333-5

Cited by 9 publications

(8 citation statements)

References 136 publications

(224 reference statements)

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“…2 This could be attributed to a higher fiber intake in the Indian population compared with the western world. There were studies that showed high prevalence of constipation in pregnancy and puerperium, ranging from 45% to 55% like those by Goshal et al 3 and Beksac et al 4 This can be attributed to the lower fiber consumption in western countries. On the other hand, lower prevalence, ranging between 4.5% and 13%, were shown in a few studies, such as those by Shi et al 5 and Van Brummen et al.…”

Section: Discussionmentioning

confidence: 93%

Perianal Complications in Puerperium and Associated Risk Factors

Iyer

Jadhav

Kandi

et al. 2023

Journal of Coloproctology

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Introduction Puerperium is defined as the period of about 6 weeks after childbirth during which the mother's reproductive organs return to their original nonpregnant condition. Perianal problems, including constipation, hemorrhoids, and fissure, are among the most common digestive complications among women in puerperium, observed in about 30 to 50 percent of women. Considering this great prevalence and the paucity of similar research in this aspect in an Indian population, the present study was done to assess the prevalence of perianal problems seen in puerperium and the risk factors associated with it. Methods This was a prospective observational cohort study done over the span of 3 years on 902 puerperal women. A self-structured questionnaire covered detailed history and per-rectal and proctoscopy examination. Patients were followed up telephonically for regression of perianal problems post management. Results The total prevalence of all the perianal problems in puerperium encountered in the present study, out of 902 subjects, was 36.3% (327 subjects). The perianal problems encountered were fissure in 185 patients (20.5%) followed by hemorrhoids in 110 patients (12.2%), perianal episiotomy infections in 25 patients (2.8%), and perineal tears in 7 patients (0.8%). On comparative analysis, positive family history, macrosomia, past history of perianal diseases, and second stage of labour > 50 minutes showed a higher prevalence in the perianal disease group as compared with the healthy group. Out of these, positive family history of perianal diseases (p = 0.015) and past history of perianal diseases (p = 0.016) were statistically significant. The percentage of multipara with hemorrhoids was more when compared to primipara (p = 0.01), patients who had a past history of any perianal disease have a higher chance of hemorrhoids during puerperium (p = 0.00). Patients with constipation in pregnancy have higher chance of hemorrhoids in pregnancy (p = 0.00). Patients who had a past history of any perianal disease had higher chance of fissure during puerperium (p = 0.00). A total of 27.74% of the study subjects with macrosomic babies had fissure in their puerperal period which on comparison with patients with non macrosomic babies was only 19.22%, which was statistically significant (p = 0.02). Conclusion Constipation, hemorrhoids, and anal fissures are the most common perianal problems in postpartum period causing significant reduction in the quality of life of those afflicted with them.

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Section: Discussionmentioning

confidence: 93%

Perianal Complications in Puerperium and Associated Risk Factors

Iyer

Jadhav

Kandi

et al. 2023

Journal of Coloproctology

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“…Making abdominal pain mandatory in the Rome IV criteria and raising its frequency threshold 7 would be expected to have major impact on the diagnostic performance of the Rome IV criteria in these population as the frequency and severity of abdominal pain have been shown to be less in these parts of the World. 9,10 Application of the Rome IV criteria in subjects meeting the III IBS criteria resulted in an internal shift in the diagnostic categories to other subtypes of DGBI (Figure 4). This is not unexpected as the Rome IV criteria require abdominal pain and its frequency threshold was changed to at least 1 day per week from at least 3 days a month.…”

Section: Discussionmentioning

confidence: 99%

“…There is no study to date on the diagnostic performance of the Rome IV criteria as compared to the Rome III criteria in an Indian and Bangladeshi population. Making abdominal pain mandatory in the Rome IV criteria and raising its frequency threshold 7 would be expected to have major impact on the diagnostic performance of the Rome IV criteria in these population as the frequency and severity of abdominal pain have been shown to be less in these parts of the World 9,10 …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, pain may be absent or less frequent in a considerable number of patients (30-67% of IBS patients). [9][10][11][12][13][14] Hence, it may be possible that there is a significant internal shift of IBS patients, particularly its different subtypes, diagnosed by the Rome III criteria to functional diarrhea, functional constipation, or other categories of DGBI when the Rome IV criteria are applied instead.…”

Section: Introductionmentioning

confidence: 99%

“…Studies from India and Bangladesh, two neighboring countries with similar sociocultural environments, have shown that abdominal discomfort is a common symptom among Indian and Bangladeshi IBS patients. Moreover, pain may be absent or less frequent in a considerable number of patients (30–67% of IBS patients) 9–14 . Hence, it may be possible that there is a significant internal shift of IBS patients, particularly its different subtypes, diagnosed by the Rome III criteria to functional diarrhea, functional constipation, or other categories of DGBI when the Rome IV criteria are applied instead.…”

Section: Introductionmentioning

confidence: 99%

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Comparisons of the Rome III and Rome IV criteria for diagnosis of irritable bowel syndrome in Indian and Bangladeshi communities and internal shifts in the diagnostic categories of bowel disorders of gut–brain interactions

Ghoshal

Rahman²,

Pratap³

et al. 2023

Neurogastroenterology Motil

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Background Although the Rome IV criteria are the most recent criteria to diagnose irritable bowel syndrome (IBS), their sensitivity has been shown to be low in Chinese and Western populations. There are scanty data comparing the Rome III and Rome IV criteria in diagnosis of IBS in the Indian and Bangladeshi populations where abdominal pain, an essential component of diagnosis of IBS by the Rome IV criteria, is less in frequency and of lower severity. Methods We analyzed the Indian and Bangladeshi data from the Rome Global Epidemiology Study to compare diagnostic sensitivity of the Rome III and Rome IV criteria for IBS, internal shifts in diagnostic categories of disorders of gut–brain interaction (DGBI), the severity of IBS diagnosed by the Rome III and Rome IV criteria, and consultation patterns in these populations. Key Results The Rome IV criteria were less sensitive than the Rome III criteria to diagnose IBS in these populations, and the subjects with Rome III IBS shifted internally to other DGBI when the Rome IV criteria were applied. Moreover, Rome IV IBS subjects had greater symptom severity than the Rome III IBS. A third of people fulfilling diagnostic criteria for IBS consulted doctors, and those diagnosed using Rome IV criteria, those with higher anxiety and depression symptom score, lower global physical health score, and greater IBS symptom severity score had greater correlation coefficients with doctors' consultation. Conclusions and Inferences The Rome IV diagnostic criteria for IBS are less sensitive than the Rome III criteria in Indian and Bangladesh communities. Application of the Rome IV criteria to people who meet the Rome III IBS criteria selects a subgroup of people with greater severity of symptoms, and hence, Rome IV IBS is more strongly associated with physician consultation. These findings may have important bearing in future iterations of the Rome criteria for a broader global applicability.

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Treating disorders of brain–gut interaction with multidisciplinary integrated care. Moving towards a new standard of care

Burgell,

Hoey,

Norton

et al. 2024

JGH Open

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Disorders of brain–gut interaction (DGBI) are highly prevalent in our community with a negative burden on the quality of life and function. Symptoms are frequently food‐induced, and psychological disorders are commonly co‐morbid and contribute greatly to symptom severity and healthcare utilization, which can complicate management. Pathophysiological contributors to the development and maintenance of DGBI are best appreciated within the biopsychosocial model of illness. Established treatments include medical therapies targeting gastrointestinal physiology, luminal microbiota or visceral sensitivity, dietary treatments including dietary optimization and specific therapeutic diets such as a low‐FODMAP diet, and psychological interventions. The traditional “medical model” of care, driven predominantly by doctors, poorly serves sufferers of DBGI, with research indicating that a multidisciplinary, integrated‐care approach produces better outcomes. This narrative review explores the current evidence for multidisciplinary care and provides the best practice recommendations for physicians and healthcare systems managing such patients.

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Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Cited by 9 publications

References 136 publications

Perianal Complications in Puerperium and Associated Risk Factors

Perianal Complications in Puerperium and Associated Risk Factors

Comparisons of the Rome III and Rome IV criteria for diagnosis of irritable bowel syndrome in Indian and Bangladeshi communities and internal shifts in the diagnostic categories of bowel disorders of gut–brain interactions

Treating disorders of brain–gut interaction with multidisciplinary integrated care. Moving towards a new standard of care

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