Although irritable bowel syndrome (IBS) can be defined using few symptoms, principal symptoms alone may be inadequate in monitoring disorder severity.
Dr Brian Bond and colleagues from the United Kingdom performed a secondary analysis of a published data set, to determine if more inclusive symptom measures would better reflect the burden of this disorder.
The team used a prospective naturalistic study of 213 patients meeting Rome II criteria.
All the data from daily questionnaires were recorded for 4 weeks, and repeated again after an interval of 4 weeks.
The total number of 11 symptoms and intensity grading score of each symptom were analyzed alongside individual symptom intensities by principal component analysis.
|Non–bowel habit symptoms contribute to the largest component of symptom burden|
|Clinical Gastroenterology & Hepatology|
The researchers explained the trend accounting for the most variance by the intensity of all symptoms together.
The second largest trend was explained by differences between bowel syndrome and bowel habits, such as constipation and diarrhea.
The constipation and diarrhea symptoms closely correlated within each group, but the category of other symptoms were not correlated directly with either, and represented a separate dimension.
The team found that other symptoms correlated more highly with disease intensity than either constipation or diarrhea symptoms.
These symptoms included pain/discomfort, abdominal uneasiness, flatulence/distension, incomplete evacuation, pain or burning in the stomach.
The sum of all symptoms and their intensity was consistent over each week, although the relative intensity of individual symptoms was more variable.
The team noted that investigator measures of disease intensity underestimated that reported by patients.
Dr Bond’s team concluded, “Non–bowel habit symptoms include more than abdominal pain and discomfort, and contribute to the largest component of the total symptom burden.”
“Thus, more than bowel habits and abdominal pain drive bowel syndrome symptom severity.”