Irritable bowel syndrome classification: Difference between revisions
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==Overview== | ==Overview== | ||
[[Irritable bowel syndrome|Irritable bowel syndrome (IBS)]] may be classified according to Rome IV [[Criterion|criteria]] into | [[Irritable bowel syndrome|Irritable bowel syndrome (IBS)]] may be classified according to Rome IV [[Criterion|criteria]] into [[Irritable bowel syndrome|IBS]] with predominant [[constipation]] , [[Irritable bowel syndrome|IBS]] with predominant [[diarrhea]], [[Irritable bowel syndrome|IBS]] with mixed [[Bowel|bowel habits]], and unclassified [[Irritable bowel syndrome|IBS]]. In addition, [[Irritable bowel syndrome|IBS]] occurring subsequent to [[gastrointestinal]] [[Infection|infections]] is known as post [[Infection|infectious]]-IBS (PI-[[Irritable bowel syndrome|IBS]]). The rationale behind these different sub-types is to maintain consistency of [[patient]] selection. This increases understanding of [[Pathophysiology|pathophysiological]] mechanisms, aids in effective [[diagnosis]], [[Treatment Planning|treatment]], and patient recruitment for [[Clinical trial|clinical trials]]. | ||
==Classification== | ==Classification== | ||
[[Irritable bowel syndrome|Irritable bowel syndrome (IBS)]] may be classified according to Rome IV [[Criterion|criteria]] into 4 sub types based on predominant | [[Irritable bowel syndrome|Irritable bowel syndrome (IBS)]] may be classified according to Rome IV [[Criterion|criteria]] into 4 sub-types based on predominant type of [[bowel]] habits:<ref name="pmid15862928">{{cite journal |vauthors=Longstreth GF |title=Definition and classification of irritable bowel syndrome: current consensus and controversies |journal=Gastroenterol. Clin. North Am. |volume=34 |issue=2 |pages=173–87 |year=2005 |pmid=15862928 |doi=10.1016/j.gtc.2005.02.011 |url=}}</ref><ref name="pmid25731138">{{cite journal |vauthors=Sayuk GS, Gyawali CP |title=Irritable bowel syndrome: modern concepts and management options |journal=Am. J. Med. |volume=128 |issue=8 |pages=817–27 |year=2015 |pmid=25731138 |doi=10.1016/j.amjmed.2015.01.036 |url=}}</ref><ref name="pmid26929659">{{cite journal |vauthors=Lacy BE |title=Diagnosis and treatment of diarrhea-predominant irritable bowel syndrome |journal=Int J Gen Med |volume=9 |issue= |pages=7–17 |year=2016 |pmid=26929659 |pmc=4755466 |doi=10.2147/IJGM.S93698 |url=}}</ref><ref name="pmid20502449">{{cite journal |vauthors=Wong RK, Palsson OS, Turner MJ, Levy RL, Feld AD, von Korff M, Whitehead WE |title=Inability of the Rome III criteria to distinguish functional constipation from constipation-subtype irritable bowel syndrome |journal=Am. J. Gastroenterol. |volume=105 |issue=10 |pages=2228–34 |year=2010 |pmid=20502449 |pmc=3786710 |doi=10.1038/ajg.2010.200 |url=}}</ref><ref name="pmid10457044">{{cite journal |vauthors=Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Müller-Lissner SA |title=Functional bowel disorders and functional abdominal pain |journal=Gut |volume=45 Suppl 2 |issue= |pages=II43–7 |year=1999 |pmid=10457044 |pmc=1766683 |doi= |url=}}</ref><ref name="pmid12241674">{{cite journal |vauthors=Talley NJ, Spiller R |title=Irritable bowel syndrome: a little understood organic bowel disease? |journal=Lancet |volume=360 |issue=9332 |pages=555–64 |year=2002 |pmid=12241674 |doi=10.1016/S0140-6736(02)09712-X |url=}}</ref> | ||
* [[Irritable bowel syndrome|IBS]] with predominant [[constipation]] | * [[Irritable bowel syndrome|IBS]] with predominant [[constipation]] | ||
* [[Irritable bowel syndrome|IBS]] with predominant [[diarrhea]] | * [[Irritable bowel syndrome|IBS]] with predominant [[diarrhea]] | ||
* [[Irritable bowel syndrome|IBS]] with mixed [[Intestine|bowel]] habits: | * [[Irritable bowel syndrome|IBS]] with mixed [[Intestine|bowel]] habits: | ||
* [[Irritable bowel syndrome|IBS]] unclassified: Patients who meet the diagnostic criteria for [[Irritable bowel syndrome|IBS]] but | ** Alternating patterns of [[stool]] passage which is not in conjuncture with the normal [[Bowel movement|bowel movements]]. | ||
* [[Irritable bowel syndrome|IBS]] unclassified: | |||
** Patients who meet the diagnostic criteria for [[Irritable bowel syndrome|IBS]] but whose bowel habits do not fit into any of the above subtypes. | |||
* Post [[Infection|infectious]] IBS (PI-IBS): | |||
** Post-infectious IBS is an additional sub-type that is [[Acute (medicine)|acute]] in onset and occurs subsequent to an [[Infection|infectious]] illness of the [[gastrointestinal tract]]. Post-infectious IBS is characterized by two or more of the following:<ref name="pmid12776965">{{cite journal |vauthors=Holten KB, Wetherington A, Bankston L |title=Diagnosing the patient with abdominal pain and altered bowel habits: is it irritable bowel syndrome? |journal=Am Fam Physician |volume=67 |issue=10 |pages=2157–62 |year=2003 |pmid=12776965 |doi= |url=}}</ref> | |||
*** [[Vomiting]] | |||
*** [[Fever]] | |||
*** Positive [[stool culture]] | |||
*** [[Diarrhea]] | |||
{| class="wikitable" | {| class="wikitable" | ||
! style="background:#4479BA; color: #FFFFFF;" ! |SUBTYPE | ! style="background:#4479BA; color: #FFFFFF;" ! |SUBTYPE | ||
! style="background:#4479BA; color: #FFFFFF;" ! |HARD OR LUMPY STOOLS | ! style="background:#4479BA; color: #FFFFFF;" ! |HARD OR LUMPY STOOLS | ||
! style="background:#4479BA; color: #FFFFFF;" ! |LOOSE(MUSHY) OR WATERY STOOLS | ! style="background:#4479BA; color: #FFFFFF;" ! |LOOSE (MUSHY) OR WATERY STOOLS | ||
|- | |- | ||
| style="background:#DCDCDC;" align="center" |IBS with constipation | | style="background:#DCDCDC;" align="center" |IBS with [[constipation]] | ||
|≥ 25 percent | |≥ 25 percent | ||
| ≤ 25 percent | | ≤ 25 percent | ||
|- | |- | ||
| style="background:#DCDCDC;" align="center" |IBS with diarrhea | | style="background:#DCDCDC;" align="center" |IBS with [[diarrhea]] | ||
| ≤ 25 percent | | ≤ 25 percent | ||
|≥ 25 percent | |≥ 25 percent | ||
Latest revision as of 22:12, 1 December 2017
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Irritable bowel syndrome Microchapters |
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Differentiating Irritable bowel syndrome from other Diseases |
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Diagnosis |
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Irritable bowel syndrome classification On the Web |
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American Roentgen Ray Society Images of Irritable bowel syndrome classification |
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Risk calculators and risk factors for Irritable bowel syndrome classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
Irritable bowel syndrome (IBS) may be classified according to Rome IV criteria into IBS with predominant constipation , IBS with predominant diarrhea, IBS with mixed bowel habits, and unclassified IBS. In addition, IBS occurring subsequent to gastrointestinal infections is known as post infectious-IBS (PI-IBS). The rationale behind these different sub-types is to maintain consistency of patient selection. This increases understanding of pathophysiological mechanisms, aids in effective diagnosis, treatment, and patient recruitment for clinical trials.
Classification
Irritable bowel syndrome (IBS) may be classified according to Rome IV criteria into 4 sub-types based on predominant type of bowel habits:[1][2][3][4][5][6]
- IBS with predominant constipation
- IBS with predominant diarrhea
- IBS with mixed bowel habits:
- Alternating patterns of stool passage which is not in conjuncture with the normal bowel movements.
- IBS unclassified:
- Patients who meet the diagnostic criteria for IBS but whose bowel habits do not fit into any of the above subtypes.
- Post infectious IBS (PI-IBS):
- Post-infectious IBS is an additional sub-type that is acute in onset and occurs subsequent to an infectious illness of the gastrointestinal tract. Post-infectious IBS is characterized by two or more of the following:[7]
- Vomiting
- Fever
- Positive stool culture
- Diarrhea
- Post-infectious IBS is an additional sub-type that is acute in onset and occurs subsequent to an infectious illness of the gastrointestinal tract. Post-infectious IBS is characterized by two or more of the following:[7]
| SUBTYPE | HARD OR LUMPY STOOLS | LOOSE (MUSHY) OR WATERY STOOLS |
|---|---|---|
| IBS with constipation | ≥ 25 percent | ≤ 25 percent |
| IBS with diarrhea | ≤ 25 percent | ≥ 25 percent |
| Mixed IBS | ≥ 25 percent | ≥ 25 percent |
| Unsubtyped IBS | Insufficient abnormality of stool consistency to meet criteria for IBS with constipation, diarrhea, or mixed subtypes. | |
References
- ↑ Longstreth GF (2005). "Definition and classification of irritable bowel syndrome: current consensus and controversies". Gastroenterol. Clin. North Am. 34 (2): 173–87. doi:10.1016/j.gtc.2005.02.011. PMID 15862928.
- ↑ Sayuk GS, Gyawali CP (2015). "Irritable bowel syndrome: modern concepts and management options". Am. J. Med. 128 (8): 817–27. doi:10.1016/j.amjmed.2015.01.036. PMID 25731138.
- ↑ Lacy BE (2016). "Diagnosis and treatment of diarrhea-predominant irritable bowel syndrome". Int J Gen Med. 9: 7–17. doi:10.2147/IJGM.S93698. PMC 4755466. PMID 26929659.
- ↑ Wong RK, Palsson OS, Turner MJ, Levy RL, Feld AD, von Korff M, Whitehead WE (2010). "Inability of the Rome III criteria to distinguish functional constipation from constipation-subtype irritable bowel syndrome". Am. J. Gastroenterol. 105 (10): 2228–34. doi:10.1038/ajg.2010.200. PMC 3786710. PMID 20502449.
- ↑ Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Müller-Lissner SA (1999). "Functional bowel disorders and functional abdominal pain". Gut. 45 Suppl 2: II43–7. PMC 1766683. PMID 10457044.
- ↑ Talley NJ, Spiller R (2002). "Irritable bowel syndrome: a little understood organic bowel disease?". Lancet. 360 (9332): 555–64. doi:10.1016/S0140-6736(02)09712-X. PMID 12241674.
- ↑ Holten KB, Wetherington A, Bankston L (2003). "Diagnosing the patient with abdominal pain and altered bowel habits: is it irritable bowel syndrome?". Am Fam Physician. 67 (10): 2157–62. PMID 12776965.