Irritable bowel syndrome classification
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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 four sub-types: IBS with predominant constipation , IBS with predominant diarrhea, IBS with mixed bowel habits, and unclassified IBS. In addition, IBS occurring subsequent to GI infections is known as post infectious-IBS or 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 stool type:[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.
IBS-PI or post infectious IBS. It is an additional sub type described that is acute in onset and occurs subsequent to an infectious illness of the GI tract. It is characterized by two or more of the following: vomiting, fever, positive stool culture or diarrhea.[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.