Symptom‐based latent classes of persons with irritable bowel syndrome

Abstract

A large amount of interindividual variability exists in symptom experiences of persons with irritable bowel syndrome (IBS). Thus, consideration of multiple symptoms to identify distinct symptom subgroups may be useful in directing personalized health strategies for symptom management. We aimed to identify latent classes (i.e., subgroups) of persons with IBS who share similar patterns of symptoms using symptom‐related variables (six groups of daily diary symptoms, cognitive beliefs about IBS, and IBS quality of life [QOL]); and to examine how subgroups differed in patient characteristics. Data were derived from a baseline assessment of men and women enrolled in two cognitively‐focused intervention trials (N = 332). Using latent class analysis, four latent classes were identified: Class 1 (low symptoms and good QOL, n = 153), Class 2 (low symptoms and moderate QOL, n = 106), Class 3 (high symptoms with diarrhea and poor QOL, n = 38), and Class 4 (high symptoms with low diarrhea and moderate QOL, n = 35). Diarrhea, being female, less formal education, unemployment, and previous history of major depressive disorder were associated with membership in Class 3. Using these distinct symptom profiles, the next step is to explore underlying mechanisms accounting for symptom burden with the goal of designing tailored interventions to reduce that burden.

Longitudinal follow‐up of a novel classification system for irritable bowel syndrome: natural history and prognostic value

“…This implies that the participants, and the model we derived from their data, will be generalisable to many individuals living with IBS. Moreover, and in contrast to other subgroup modelling studies in IBS, [20][21][22] we validated our model in our previous study,…”

“…Other investigators have also examined the possibility of subgrouping people with IBS using factors beyond stool form. [20][21][22] Although there is a consensus that people with IBS can be separated into distinct groups using a combination of gastrointestinal symptoms and psychological factors, the specific characteristics and number of subgroups varies between studies. The current treatment paradigm for IBS advocates targeting therapy according to predominant gastrointestinal symptom; however, extraintestinal symptoms and psychological comorbidity, which are recognised as playing an important role in IBS symptomatology, are not considered as part of the current classification system for the condition.…”

“…Although other groups have performed similar studies, these have important limitations, and none have conducted any follow-up of their proposed models to assess their behaviour or prognostic value. [20][21][22]…”

“…We also examined if commencing new treatments was associated with a change in cluster membership. Although other groups have performed similar studies, these have important limitations, and none have conducted any follow‐up of their proposed models to assess their behaviour or prognostic value 20‐22 …”

Cytokine Levels and Symptoms Among Women with Irritable Bowel Syndrome: Considering the Role of Hormonal Contraceptive Use

“…Subscales were created by taking the average of each individual symptom: 1) Daily GI Distress included the average of the individual symptoms of gas, bloating, and distention and 2) Daily Psychological Distress included the average of individual symptoms: anxiety, depressed, panic, and stressed. The construct validity has been established in previous IBS studies (Han et al, 2019, 2020). The Daily Psychological Distress scale was significantly correlated with the retrospective Hospital Anxiety and Depression subscales.…”