Definition Of Irritable Bowel Syndrome Research Articles

The Burden of Irritable Bowel Syndrome in Medical and Nurse Italian University Student Population: The VANVITELLI-IBS Survey.

The increased prevalence of irritable bowel syndrome (IBS) among medical and nursing students is a global challenge. Unfortunately, data on the Italian medical and nurse student population are scarce. Therefore, this study was designed to assess the prevalence of IBS in this setting and to evaluate the demographic, university, Mediterranean diet adherence, and anxiety factors associated with its increased presence. To assess the prevalence of IBS, anxiety levels, and adherence to the Mediterranean diet in medical and nursing university students. An anonymous online questionnaire was sent to participants. Several demographic and educational variables were assayed, and the presence of symptoms associated with the definition of IBS (according to Rome IV criteria). In addition, anxiety levels and adherence to the Mediterranean diet were also assessed. Of 161 students, 21.11% met the Rome IV criteria for IBS. Some subgroups, the out-ofcourse students or no scholarship recipients, were found to have a higher percentage of IBS (p < 0.05). Being out-of-course was shown to be associated with an increased and unreported risk of presenting IBS (OR: 8.403, p < 0.001). Levels of anxiety and adherence to the Mediterranean diet were significantly worse in the IBS group (p < 0.01). Adherence to the Mediterranean diet was associated with a reduced risk of presenting IBS in our setting (OR 0.258, p = 0.002). Our sample of Italian medical and nursing students recorded a non-negligible percentage of IBS. Therefore, screening and awareness campaigns could be suggested.

Association between body mass index and irritable bowel syndrome in the young Japanese population: a cross-sectional study.

The association between body mass index (BMI) and irritable bowel syndrome (IBS) has been inconsistent in the Asian population. Also, no evidence regarding this issue in the young population exists. The aim of the present study is to investigate the association between BMI and IBS based on the Rome III criteria in young Japanese people. This study was a cross-sectional study consisted of 8923 Japanese university students. The definition of IBS was based on the Rome III criteria. BMI was divided into four categories (quartiles) on the basis of the study subjects' distribution (lowest, low, moderate, and high [reference]). The definition of lean, normal, and overweight was BMI < 18.5kg/m2, 18.5 ≤ BMI < 25kg/m2 (reference), and 25 ≤ BMI kg/m2, respectively. Age, sex, drinking, smoking, exercise habit, anemia, and sports injury were selected a priori as potential confounding factors. The prevalence of IBS was 6.5%, with females having a significantly higher prevalence than males (6.0% vs. 7.2%, p = 0.029). In females, being overweight was independently positively associated with IBS after adjustment (adjusted odds ratio [OR]: 1.81 [95% confidence interval (CI): 1.13-2.79]). In contrast, in males, no association between being lean or overweight and IBS was found. Among the young Japanese population, being overweight might be independently positively associated with prevalence of IBS in females but not in males.

Association of Consuming Tap Water or Purified Water during Infancy with Irritable Bowel Syndrome in Children.

Objective: The objective of this study was to analyze the effect of consuming formula powder prepared with tap water or purified water during the first 4 to 6 months of life on the subsequent development of irritable bowel syndrome (IBS). Study design and setting: A total of 917,707 children who were born in Korea between 2007 and 2008 were analyzed. All children were followed up until they lost eligibility for health care services or until 2017. Data on the water used to prepare formula powder were from questionnaires answered by the parents when the child was 4 to 6 months old. IBS was defined as two or more diagnoses of IBS after the age of 4 years. Inverse probability of treatment weighting (IPTW) using the propensity score was used to balance the two groups. The risk of IBS was evaluated using a Cox proportional hazards model. Results: After weighting, there were 73,355 children in the tap water group and 73,351 in the purified water group. The purified water group had a higher risk of IBS (HR: 1.05; 95% CI: 1.01, 1.09). This relationship was also present after the subgroup analyses of males and females and the sensitivity analysis that used different definitions of IBS. Conclusions: Drinking formula powder prepared with purified water rather than tap water during the first 4 to 6 months of age was found to be associated with IBS.

The Management of Irritable Bowel Syndrome: The Viewpoint of Italian General Practitioners in Activity and in Training

Background: Guidelines on Irritable Bowel Syndrome (IBS) are usually developed by specialists, with a possible translational gap in primary care. Aims: To evaluate the knowledge of IBS of Italian General Practitioners (GPs) and the difference compared to doctors in Training for General Practice (ITGPs). Methods: A questionnaire was completed by 170 GPs and 64 ITGPs. Results: The Rome Criteria and Bristol Scale are more familiar to ITGPs than GPs. The most frequently used diagnostic symptoms are abdominal pain, bowel movement frequency and bloating. GPs and ITGPs think that bloating and abdominal discomfort should be introduced into the definition of IBS. Intestinal motility disorders and psychological factors are considered to be the most probable cause of IBS. GPs report more frequently than ITGPs that the patient's request and difficulties in managing the disorder are reasons for a gastroenterological referral. Conclusions: There is still a gap between the indications provided by the experts and clinical practice, and this seems greater on the part of GPs than ITGPs. Abdominal pain and bowel frequency changes are considered the main symptoms for diagnosing IBS, but most GPs and ITGPs would like to include bloating among the diagnostic criteria. It would be highly desirable to develop commonly shared guidelines between gastroenterologists and GPs.

How individuals with the irritable bowel syndrome describe their own symptoms before formal diagnosis

Aim: To investigate how individuals fulfilling the Rome II criteria for irritable bowel syndrome (IBS) spontaneously described their symptoms. Method: From a general population, 1,244 randomly sampled adults were asked to describe their gastrointestinal symptoms (if any) verbally, in their own words, at a semi-structured interview. Their own descriptions were sorted into five symptom clusters. The participants independently completed a written questionnaire (the Rome II Modular Questionnaire (RMIIMQ)). Results: A total of 601 participants reported at least one gastrointestinal symptom, and 128 had IBS according to the RMIIMQ. After exclusion of organic causes, previously diagnosed IBS, or additional gastrointestinal diagnosis, 81 participants with IBS according to RMIIMQ remained. Five participants (6%) described symptoms included in the full definition of IBS, but none fulfilled the Rome II criteria completely. Abdominal pain or other IBS-related symptoms were reported by 64 (79%), and 12 (15%) did not report any IBS-like symptom. Conclusion: Previously undiagnosed individuals, who fulfil criteria for Rome II-IBS, often express their complaints in words that do not fit into the current diagnostic criteria.

PWE-060 Effect of gender on prevalence and subtype of irritable bowel syndrome: a systematic review and meta-analysis

IntroductionIt has always been assumed that irritable bowel syndrome (IBS) is more common in women. However, there has been no systematic review and meta-analysis that has synthesised data from all...

Su1016 Effect of Gender on Prevalence and Subtype of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Introduction It has always been assumed that irritable bowel syndrome (IBS) is more common in women. However, there has been no systematic review and meta-analysis that has synthesised data from all available studies to estimate prevalence of IBS according to gender. There has also been no study that has investigated whether the presumed higher prevalence in women varies according to the way in which IBS is defined, and whether it holds true for all IBS subtypes. Methods MEDLINE, EMBASE, and EMBASE Classic were searched through October 2011 for cross-sectional surveys reporting the prevalence of IBS. A recursive search was also conducted. There were no language restrictions. Eligible studies were population-based, recruited ≥50 adult (≥15 years) subjects, and were required to define IBS via the Manning or Rome I, II or III criteria. Eligibility assessment and data extraction were conducted independently in a double-blind fashion by two investigators, with discrepancies resolved by consensus. Data were extracted and pooled, with a random effects model, to estimate prevalence of IBS according to gender. An OR, with a 95% CI, was used to compare the female to male prevalence of IBS, as well as the prevalence of constipation-predominant (IBS-C), diarrhoea-predominant (IBS-D), and mixed-type (IBS-M) among women and men meeting criteria for IBS. Results The search yielded 20 146 results, of which 390 studies appeared relevant and were retrieved for further assessment. There were 80 separate population-based studies that reported the prevalence of IBS according to the above criteria. Of these, 55 reported IBS prevalence according to gender, with a pooled prevalence in women of 14.0% (95% CI 11.0% to 16.0%) compared with 8.9% (95% CI 7.3% to 10.5%) in men (OR 1.67; 95% CI 1.53 to 1.82). Prevalence was consistently higher in women when all definitions of IBS were considered: the OR for women compared to men was 1.55 (95% CI 1.35 to 1.78) with the Manning criteria, 1.99 (95% CI 1.76 to 2.25) with Rome I, 1.40 (95% CI 1.24 to 1.59) with Rome II, and 1.81 (95% CI 1.36 to 2.39) with Rome III. Nine studies, with 63 827 participants, also reported the breakdown of IBS according to subtype. Prevalence of IBS-C was significantly higher in women with IBS compared with men (OR 2.38; 95% CI 1.45 to 3.92), IBS-D was less common in women with IBS compared with men (OR 0.45; 95% CI 0.32 to 0.65), while prevalence of IBS-M was not significantly different according to gender (OR 1.07; 95% CI 0.84 to 1.38). Conclusion Prevalence of IBS was modestly increased in women. This observation remained stable according to the various diagnostic criteria used. However, among individuals with IBS, women were more likely to have IBS-C than men, and less likely to have IBS-D. These data suggest that gender may influence IBS subtype. Competing interests None declared.

Multidimensionality of symptom complexes in irritable bowel syndrome and other functional gastrointestinal disorders

The definition of irritable bowel syndrome (IBS) by Rome criteria was a major advancement in the nosology of the disease, but this goal was achieved by employing symptoms related to the gastrointestinal tract and by eliminating all symptoms that were nonspecific. The description of the course of the illness and response to treatment has been hampered by restrictions to the defining characteristics, abdominal pain and altered bowel habit. Other abdominal symptoms (e.g., bloating, nausea, and epigastric discomfort) and general somatic symptoms (e.g., fatigue, headache, and sleep disturbance) are not included in the Rome definition, yet are commonly reported by patients with IBS. This article addresses the following questions: Are comorbid conditions part of or distinct from the syndrome of IBS and other functional gastrointestinal disorders (FGIDs)? Are there overlapping abdominal or extra-abdominal symptoms confounding the definition of IBS? Are extra-abdominal somatic symptoms and/or syndromes part of the clinical presentation of IBS? Are “nondiagnostic” abdominal symptoms important in defining symptom burden in IBS? Is the concept of somatization related to IBS, and, if so, how? How can we better define the symptom burden in IBS and other FGIDs? In short, have we hampered the evaluation of IBS (and other FGIDs) by making the definitions too reductionist? While definite answers to the above questions are not possible at this time, this article proposes that the definitions of IBS or other FGIDs not be altered, but that in the process of evaluation of the clinical end points and/or severity of the diseases, consideration be given to the possibility of including other components of the symptom burden of these disorders.

Evaluation of Lower Functional Gut Disorders

There is an element of the art of medicine in the diagnosis of functional lower gut disorders. Functional disorders are believed to be problems of normal gut function; by definition, they imply or require a lack of organic disease. With advanced understanding and reliable definitions of irritable bowel syndrome (IBS) in particular, the concept that these disorders are purely a diagnosis of exclusion is outdated. Their cardinal symptoms, however, such as abdominal pain, diarrhea or constipation, have huge lists of potential organic causes. The key is to know how much investigation is needed before making the diagnosis. Many factors will influence this process, from both the patient and practitioner viewpoints.

Irritable Bowel Syndrome

As a group, functional gastrointestinal disorders are the most common gastrointestinal disorder seen by both generalists and specialists. These disorders can be frustrating to both patients and physicians as they are usually chronic in nature and difficult to treat. These disorders are associated with frequent healthcare visits, the scheduling of multiple, expensive diagnostic tests, and the use of both over-the-counter and prescription medications. All of these factors lead to a significant economic burden to society. In addition, functional gastrointestinal disorders are associated with a reduction in quality of life for the patient. Irritable bowel syndrome (IBS) is the most common of the functional gastrointestinal disorders. This syndrome has been the focus of a large number of research studies over the past two decades. These studies have resulted in a number of significant changes in our definition of IBS. In addition, these research studies have produced considerable changes in our understanding of the etiology and pathogenesis of IBS. In this section, we will review some of the evolutionary changes that have occurred in IBS. We will discuss how the definition of IBS has changed, consider our evolving strategies to evaluate and diagnose IBS, and finally, provide a brief overview of treatment options for this common disorder.

Prevalence of irritable bowel syndrome (IBS) and variability of diagnostic criteria

The main objectives of this study were to assess whether the use of different definitions of irritable bowel syndrome (IBS) could influence measurements of its prevalence and characterize the patient population fulfilling these different diagnostic criteria. A telephone survey was carried out by contacting 8,221 subjects aged >or=18 Years representative of the French population. A "screening" questionnaire based on three algorithms of IBS classification (Manning, with or without a notion of a minimal duration of symptoms, Rome I and Rome II) was used by specialised inquirers. Twenty three percent of the subjects interviewed stated that they had suffered from abdominal pain during the previous 12 Months. The prevalence of IBS considerably varied, depending on the diagnostic criteria used: 12% based on Manning criteria without reference to the duration of symptoms; 2.5% if the notion of duration of symptoms was added to the Manning criteria, and 2.1% and 1.1% based on the Rome I and Rome II criteria, respectively (the latter including the same notion of duration). In total, 212 subjects (2.6%) met at least one of the criteria including a minimal duration of symptoms, with a predominance for women (sex-ratio close to 2). The prevalence of IBS is strongly dependent on the classification algorithm employed. The requirement of a minimum duration of symptoms eliminates IBS in a large number of subjects complaining of abdominal disorders. Once these methodological variations were taken into account, the prevalence of IBS in France was found to be comparable to that published in international literature.

Irritable bowel syndrome

The prevalence of irritable bowel syndrome (IBS) ranges in all countries of the world between 6 and 25%, in Germany between 15 and 22%. The divergent rates of prevalence are mainly due to different definitions of IBS in epidemiological studies. In Germany, 20-50% of persons with IBS symptoms seek medical help. IBS patients produce high direct and indirect costs. The following psychophysiological mechanisms of IBS are presumed to be empirically validated: visceral hypersensitivity, postinfectious sequelae, psychiatric disorders, and psychosocial stress. Tricyclic antidepressant agents and psychotherapy (hypnosis, cognitive behavioral therapy, and psychodynamic therapy) are effective for treatment of IBS forms dominated by pain. In one controlled study, the combination of pharmacological therapy and cognitive behavioral therapy was superior to pharmacological therapy alone.

Medical and lay views of irritable bowel syndrome.

The purpose of this study was to investigate doctors' and patients' views of irritable bowel syndrome (IBS) in order to assess why problems in the doctor-IBS patient relationship seem to occur. A qualitative study was undertaken involving in-depth, semi-structured interviews that were tape-recorded, transcribed verbatim and analysed using the constant comparative method. The subjects comprised 12 doctors, including six GPs and six gastroenterologists, and 14 patients with IBS. Doctors hold two definitions of IBS, one 'public' and akin to a textbook definition, the other 'private' and including experiential knowledge and absorbed prejudices about IBS patients. Doctors are not universally hostile towards IBS patients, although the views of gastroenterologists may tend to be more pejorative than those of GPs. Most doctors experience frustration with IBS, and this is due as much to medical uncertainty and shortage of effective interventions as to intolerance of the personal characteristics of IBS patients. Doctors distinguish between 'good' and 'bad' IBS patients and manage them accordingly. Many patients tend to find their IBS symptoms very troublesome. Patients are more satisfied if they are taken seriously and helped to manage their symptoms, but many feel that they are labelled as neurotic by the medical profession. They tend to feel stigmatized and let down by doctors. Better partnerships could be created with patients, and better outcomes for IBS might be achieved, if doctors recognized the impact of medical beliefs about IBS on patients. Doctors should offer IBS patients empowering explanations for their disorder.

Identifying Dyspepsia and Irritable Bowel Syndrome: The Value of Pain or Discomfort, and Bowel Habit Descriptors

The utility of current diagnostic criteria for dyspepsia and irritable bowel syndrome (IBS) in clinical practice is largely unknown. We aimed to compare the diagnostic value of different definitions and questionnaires in a population. The Abdominal Symptom Questionnaire (ASQ) was mailed to a representative sample (n = 1506, 20-87 years old), and every fifth person (n = 302) concomitantly received the Bowel Disease Questionnaire (BDQ). The diagnostic agreement for dyspepsia and for IBS, defined in accordance with the Manning and the modified Rome criteria and a new simple definition, was analysed. In the ASQ the agreement on the IBS status for the three IBS definitions was > or = 88%, and in the BDQ > or = 93%. Agreement for the three definitions on the two questionnaires was > or = 88% regardless of which definition of IBS was applied. Agreement between questionnaires was similar (88%) for dyspepsia. For both IBS and dyspepsia the kappa coefficients indicated moderate to substantial concordance. 'Pain or discomfort' did not cover all linguistic aspects of dyspepsia. Prevalence rates of dyspepsia were comparable in the ASQ and BSQ, whereas higher prevalences of IBS with the ASQ was related to the cutoff levels for reporting abdominal pain or discomfort. It is possible to identify IBS more simply by self-report questionnaires.

Irritable bowel syndrome: which definitions are consistent?

Irritable bowel syndrome is inconsistently defined in international literature. Consequently, the resulting differences in study populations may impede any general application of results from one study to another. The aim of this study was to evaluate the consistency of various definitions of irritable bowel syndrome. By means of a questionnaire concerning abdominal symptoms, subjects were categorized as having IBS according to five definitions: (1) two positive Manning criteria; (2) the Rome criteria; (3) a consensus report by Drossman; (4) definition by Talley; and (5) a newly suggested definition by Kay. The study was carried out as part of a cohort study of 4122 Danes at the Centre of Preventive Medicine (former the Glostrup Population Studies), Glostrup County Hospital, Denmark. Kappa coefficients comparing the irritable bowel populations as defined by the above five definitions. The participation rate was 64.4%. Manning and Rome criteria of irritable bowel syndrome were consistent with a Kappa value of 0.72. A substantial degree of consistency was also present comparing definitions of Drossman, Talley and Kay (kappa, 0.60-0.62). All other comparisons had kappa values below 0.42. Variations in study populations selected by different definitions of irritable bowel syndrome are so large that they impede the general application of any results. There is a need for international agreement on consistent use of one definition of irritable bowel syndrome.

Differences between individuals with self-reported irritable bowel syndrome (IBS) and IBS-like symptoms.

Although there are several symptom classification systems for irritable bowel syndrome (IBS), for example, the Manning or Rome criteria, there has been no previous research on how well these classifications correspond to each other or to persons diagnosed with IBS. We examined data from the Digestive Disorders Supplement of the 1989 National Health Interview Survey (NHIS) to assess demographic, socioeconomic, and health status characteristics of two groups of IBS sufferers--those who met the Manning or Rome criteria and those who reported having IBS but did not meet either criteria. The results showed that the overlap between estimates of IBS and persons with IBS-like symptoms depended on the definition of IBS. There were socioeconomic differences between the two IBS groups and higher rates of functional or work-related activity limitation and health care utilization for all IBS groups relative to US national averages. In summary, these findings indicate that IBS affects a large portion of the US population, regardless of the definition used to describe the condition. Our results suggest that there is a large undiagnosed population with numerous symptoms consistent with IBS, but further research is required to determine the differences between people who do and do not seek care, their impact on the health care system, and future therapies to reduce symptomatology and suffering.

Irritable bowel syndrome

There is no strict definition of irritable bowel syndrome, but there are symptoms more likely to occur in IBS than in organic gastrointestinal disease, says David Gorard.

Redefining abdominal syndromes. Results of a population-based study.

Gastroenterologists use different definitions of irritable bowel syndrome and upper dyspepsia, and the different definitions select different populations with the syndromes. The aim of the study was, in an unselected population, to find combinations of abdominal symptoms that occur together more often than can be expected by chance and thereby find statistical support for standard definitions of the syndromes. A sex- and age-stratified random sample of 4851 Danes living in the western part of Copenhagen was interviewed about abdominal symptoms. Five years later an identical interview was carried out among the participants. The participation rate was 79% in the first study and 85% in the second. Independent of age, sex, and time, the following three definitions describe subjects with symptoms occurring together more often than could be expected by chance: 1) Subjects stating that they often experience both abdominal pain and distension and, additionally, either borborygmi or altering stool consistency. This combination occurred with a prevalence of 3.2% among men and 7.5% among women; 2) Subjects stating that they experience all of the following three symptoms: abdominal pain, heartburn, and acid regurgitation. This combination occurred with a prevalence of 1.3% among men and 0.8% among women; 3) Subjects stating that they often experience both nausea and abdominal pain. This combination occurred with a prevalence of 0.9% among men and 3.6% among women. It is suggested that these three definitions should be used as standards for irritable bowel syndrome, upper dyspepsia-heart burn type and upper dyspepsia-nausea type, respectively.

Repeated suicidal attempts by the ingestion of sharp foreign bodies (FB) in a severely depressed patients

REPEATED SUICIDAL ATTEMPTS BY THE INGESTION OF SHARP FOREIGN BODIES (FB) IN A SEVERELY DEPRESSED PATIENT H Yang, Y Bains. Jersey City Medical Center, Jersey City, NJ and Seton Hall University School of Graduate Medical Education FB ingestion is common in children between the ages of 6 months and 3 years, and coins are the most common FB ingested by children. Adults who intentionally swallow FB arc usually psychiatrically impaired, under the influence of alcohol, or prisoners seeking the relative comfort of hospitalization. We report the unique case of a patient under psychiatric evaluation for severe depression, who ingested multiple sharp FB in an apparent suicidal attempt. 80-90 % of the FB that reach the stomach are expelled without complication. The frequency of perforation due to FB is estimated to be less than 1%, but sharp FB may cause perforation in up to 15 to 35% of patients. The frequency of complication depends on the shape and size, of FB and anatomic variations causing sharp angulations. A 39 year old male resident of a mental institution was hospitalized after he swallowed several razor blades wl)ich were removed surgically from his stomach. He swallowed another set of razor blades which be kept in his pocket at the moment ofdischarge and underwent a second gastrostomy. During recovery, he continued to swallow sharp FB including a nail, a thumb tack, a screw, and a metal plate over a month period. The patient was able to acquire the objects despite being under close observation by staff members. Due to the continual ingestion of FB and multiple recent surgeries, it was decided to withh~ld surgery or other invasive means of recovery. The patient was observed closely for any evidence of sepsis and daily abdominal radiographs were performed to ensure that the FB continued to propagate distally. The.metal plate needed to be removed from the rectum manually, however all the others passed spontaneously without causing perforation or gastrointestinal bleeding. We were unable to find the management of a similar case in a review of the literature. In general, any sharp FB ingested should be removed endoscopically or surgically before they pass the stomach, or if risk of perforation appears to be high. When a patient presents with repeated ingestion of sharp FB despite being under observation, it may be reasonable to monitor them and await spontaneous evacuation. DO GASTROINTESTINAL (GI) SYMPTOM SUBGROUPS EXIST? A CLUSTER ANALYSIS BASED ON SELF-REPORTED SYMPTOMS FROM A COMMUNITY-BASED RANDOM SAMPLE. A.R.Zinsmeister, A.B.An, N.J.Taliey, Dept. of Health Sdenc~s Research, Mayo Clinic and Dept. of Medicine, Univ. of Sydney. Considerable controversy surrounds attempts to document subgroups based on symptoms such as abdominal pain, and altered bowel habit. Identifying underlying symptom complexes or combinations of symptoms that stratify subjects into distinct subgroups is difficult due to the overlapping presence of many individual symptoms, and the uncertainty of exactly how many subgroups exist in a given study group. In addition, studies based on referral practices at large medical centers may not accurately reflect the general population. AIMS Determine whether subgroups in the general population can be identified based on selfreported GI symptoms. METHODS An ageand gender-stratified random sample of healthy residents aged 20-95 of Olmsted Co., MN, were mailed a validated self, report questionnaire; 3022 (74%) responded. Based on the (symmetric) uncertainty measure of association for categorical data (1), a principle components decomposition of the association matrix for 19 GI symptoms (including frequency and severity of pain, the Manning criteria (MC) for irritable bowel syndrome (IBS), nausea, heartburn and dysphagia) and age, gender and n~rital status was used to develop principle components scores (pc-scores) which were thus weighted sums of indi~,idual symptoms and sociodemographic variables. The pc-scores were interpreted using logistic discriminant analysis to distinguish a priori subgroups (e.g., IBS vs. non-lBS). RESULTS Subjects were first stratified by presence of reported abdominal pain during the previous year. In the pain subgroup, five pc-scores provided over 95% concordance between the a priori definition of IBS (2.2 MC with frequent abdominal pain) and the predicted probability of IBS from the logistic model. Their distributions are summarized in the table. PC-Scores (mean :t: SE) non-~BS 1.84+.02 3.225:.03 0.36+.02 -1.11+.04 0.29+.04 IBS 2.55+.03 3.76+.05 0.56+.03 -0.83+.05 -0.67+.04 Although these pc-scores jointly could discriminate subjects with IBScompatible symptoms, their distributions indicated a continuum of underlying (latent) factors rather than distinct clusters of subjects in the general popUlation. CONCLUSIONS Symptom scores can be developed which accurately reflect reported symptom complexes (IBS), but they imply a continuum of underlying symptom composition rather than distinct symptom subgroups in the healthy general population. (1) Goodman LA, Kruskal WH (1972) l Am Statistical Assoc, 67,415-421.

The epidemiology of irritable bowel syndrome in a random population: prevalence, incidence, natural history and risk factors.

The aim of the study was to assess prevalence, incidence, recovery, and risk factors of irritable bowel syndrome according to different definitions in a large random population. A 5 year follow-up study of a sex- and age-stratified random sample of 4581 Danes interviewed about abdominal symptoms. The Glostrup Populations Studies Unit at Glostrup County Hospital. Prevalence, incidence, recovery, and the association of risk factors to irritable bowel syndrome (IBS). The percentage of subjects common to the populations selected by the various definitions of IBS. According to various definitions, the prevalence of IBS varied from 5 to 65% and the incidence varied from 1 to 36%. At the 5 year follow-up only 5% of subjects with IBS were completely free of all symptoms. Psychological vulnerability and the experience of having problems were strongly associated with prevalence and incidence of IBS, whereas lifestyle factors only showed a very weak or no relationship to IBS. Populations defined as suffering from IBS according to the various definitions had less than 50% of the subjects in common. Irritable bowel syndrome is frequent but fluctuating in the general population. Psychological factors seem to be of greater aetiological importance to IBS than lifestyle factors. However, a generally accepted and precise definition is essential to make future studies comparable and to allow general conclusions to be drawn. Furthermore, it still needs to be verified whether the syndrome is a disease entity or just an acceptable, common life-condition.