TY - JOUR
T1 - Subgroups of IBS patients are characterized by specific, reproducible profiles of GI and non-GI symptoms and report differences in healthcare utilization
T2 - A population-based study
AU - Polster, Annikka V.
AU - Palsson, Olafur S.
AU - Törnblom, Hans
AU - Öhman, Lena
AU - Sperber, Ami D.
AU - Whitehead, William E.
AU - Simrén, Magnus
N1 - Funding Information:
Funding information This study was supported by the Rome Foundation, NIDDK (grant RO1 DK31369), the Swedish Medical Research Council (grants 13409, 21691 and 21692), AFA Insurance, an unrestricted grant from Ferring Pharmaceuticals, and by the Faculty of Medicine, University of Gothenburg. Annikka Polster has received funding from the People Program of the European Union's Seventh Framework Program under REA grant agreement no. 607652 (NeuroGut).
Funding Information:
AP and LÖ had no competing interests. OP received salary sup‐ port from research grants from Takeda Pharmaceuticals and Salix Pharmaceuticals and from a consulting agreement with Ironwood Pharmaceuticals and an educational grant provided by Takeda Pharmaceuticals, and received a speaker honorarium in an edu‐ cational program supported by Ironwood Pharmaceuticals and Takeda Pharmaceuticals. HT served as consultant/Advisory Board member for Almirall, Allergan, and Shire. AS served as a consultant and speaker for Takeda Israel. WEW received research grants from Takeda, Ironwood, Salix, and the Rome Foundation; served as a con‐ sultant to Biomerica, USA, Ono Pharmaceuticals, and Ferring; and received unrestricted educational grants from Takeda and Ferring. MS received unrestricted research grants from Danone and Ferring Pharmaceuticals; served as a consultant/Advisory Board member for AstraZeneca, Danone, Nestlé, Almirall, Allergan, Albireo, Glycom, and Shire; and served as a speaker for Tillotts, Menarini, Takeda, Shire, Allergan, and Almirall.
Funding Information:
the Swedish Medical Research Council (grants 13409, 21691 and 21692), AFA Insurance, an unrestricted grant from Ferring Pharmaceuticals, and by the Faculty of Medicine, University of Gothenburg. Annikka Polster has received funding from the People Program of the European Union’s Seventh Framework Program under REA grant agreement no. 607652 (NeuroGut).
Funding Information:
This study was supported by the Rome Foundation, NIDDK (grant RO1 DK31369),
Publisher Copyright:
© 2018 John Wiley & Sons Ltd
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - general population
KW - irritable bowel syndrome
KW - latent profile analysis
KW - mixture model
KW - subgrouping
UR - http://www.scopus.com/inward/record.url?scp=85056143310&partnerID=8YFLogxK
U2 - 10.1111/nmo.13483
DO - 10.1111/nmo.13483
M3 - Article
C2 - 30393924
AN - SCOPUS:85056143310
VL - 31
JO - Neurogastroenterology and Motility
JF - Neurogastroenterology and Motility
SN - 1350-1925
IS - 1
M1 - e13483
ER -