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Subgroups of IBS patients are characterized by specific, reproducible profiles of GI and non-GI symptoms and report differences in healthcare utilization: A population-based study

Journal article
Authors Annikka Polster
O. S. Palsson
Hans Törnblom
Lena Öhman
A. D. Sperber
W. E. Whitehead
Magnus Simrén
Published in Neurogastroenterology and Motility
Volume 31
Issue 1
ISSN 1350-1925
Publication year 2019
Published at Institute of Biomedicine, Department of Microbiology and Immunology
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Language en
Links dx.doi.org/10.1111/nmo.13483
Keywords general population, irritable bowel syndrome, latent profile analysis, mixture model, subgrouping, irritable-bowel-syndrome, quality-of-life, functional gastrointestinal, disorders, impact, habit, questionnaire, somatization, comorbidity, prevalence, severity, Gastroenterology & Hepatology, Neurosciences & Neurology, hwarz g, 1978, annals of statistics, v6, p461
Subject categories Gastroenterology and Hepatology

Abstract

Background In a previous clinical sample of IBS patients, subgroups characterized by profiles of GI and non-GI symptoms were identified. We aimed to replicate these subgroups and symptom associations in participants fulfilling IBS diagnostic criteria from a population-based study and relate them to healthcare utilization. Methods An Internet-based health survey was completed by general population adults from United States, Canada, and UK. Respondents fulfilling IBS diagnosis (Rome III and IV) were analyzed for latent subgroups using Gaussian mixture model analysis. Symptom measures were derived from validated questionnaires: IBS-related GI symptoms (Rome IV), extraintestinal somatic symptoms (PHQ-12), and psychological symptoms (SF-8). Key Results A total of 637 respondents fulfilled Rome III criteria (average age 46 years, range 18-87, 66% females) and 341 Rome IV criteria (average age 44, range 18-77, 64% female) for IBS. Seven subgroups were identified in the Rome III cohort, characterized by profiles of GI symptoms (constipation-related, diarrhea-related, and mixed, respectively), and further distinguished by the presence or absence of non-GI comorbidities. The Rome IV cohort showed five similar but less distinct subgroups with a preponderance of mixed symptom profiles. Higher severity of non-GI comorbidities was associated with more frequent healthcare visits and medication usage. Conclusions and Inferences In line with previous findings in a clinical IBS cohort, we were able to identify population-based subgroups characterized by a combination of GI symptoms with the additional distinction made by varying severity of non-GI symptoms and with differences in healthcare utilization.

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