Prevalence of irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease in remission: a systematic review and meta-analysis

Abstract

This is a repository copy of Prevalence of irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease in remission: a systematic review and metaanalysis.

IBS-Symptoms in IBD Patients—Manifestation of Concomitant or Different Entities

“…Some data about the prevalence of this phenomenon have already been gathered. The most recent meta-analysis by Faibrass et al [79] revealed that 28.7% of patients in UC remission and 36.6% in CD remission reported IBS-like symptoms-substantially, this phenomenon was more common in those with CD than UC. Altogether, 35.2% (ranging from 11.2% to 63.6%) of patients diagnosed with IBD, in general, have symptoms similar to IBS without ongoing disease activity.…”

“…What is more, according to Simren et al [80], IBS-like symptoms appear to correspond rather with the duration of the disease than with patients' age, administered treatment, or extension of the disorder. However, they were more frequent in females, especially with high levels of anxiety and depression [1,2,79,81].…”

“…However, an FC level below 40 µg/g in patients reporting IBS-like symptoms has been shown to be connected with a 1% chance of IBD, which makes it a useful biomarker in directing patients on screening colonoscopy [92]. Interestingly, the prevalence of IBS symptoms in IBD was higher when the FC level <100 µg/g was used to define remission and lower when an endoscopic or histological assessment was taken into consideration [79]. Overall, it is worth remembering that basing diagnosis on fecal calprotectin remains debatable since it lacks a reference standard and a cut-off value clearly defining remission and also is not specific for IBD-it may play a role in the management of infectious gastroenteritis, acute appendicitis, celiac disease, or even cystic fibrosis [86].…”

Editorial: co‐morbid gastrointestinal conditions are an important consideration in IBS management—authors' reply

“…We are also aware of the importance of overlap between organic disease and functional symptoms, with a particular focus on inflammatory bowel disease. 4,5 Nevertheless, the population prevalence of these disorders is much lower than IBS, and our recent validation study of the Rome IV criteria for IBS demonstrated these criteria are more sensitive and specific than the previous iteration, Rome III. 6 Consequently, despite having no access to medical records, we believe that it is reasonable to assume the majority had IBS since our cohort met the Rome IV criteria for IBS.…”

“…We are certainly not suggesting IBS is a diagnosis of exclusion. We are also aware of the importance of overlap between organic disease and functional symptoms, with a particular focus on inflammatory bowel disease 4,5 . Nevertheless, the population prevalence of these disorders is much lower than IBS, and our recent validation study of the Rome IV criteria for IBS demonstrated these criteria are more sensitive and specific than the previous iteration, Rome III 6 .…”