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Irritable Bowel Syndrome: HELP
Articles by David J. Gracie
Based on 10 articles published since 2008
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Between 2008 and 2019, D. J. Gracie wrote the following 10 articles about Irritable Bowel Syndrome.
 
+ Citations + Abstracts
1 Editorial Editorial: latent class analysis to improve confidence in the diagnosis of IBS - authors' reply. 2017

Sood, R / Gracie, D J / Gold, M J / To, N / Pinto-Sanchez, M I / Bercik, P / Moayyedi, P / Ford, A C / Law, G R. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK. · Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. · School of Medicine, University of Leeds, Leeds, UK. · Gastroenterology Division, Health Sciences Center, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada. · Division of Epidemiology & Biostatistics, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK. ·Aliment Pharmacol Ther · Pubmed #28370047.

ABSTRACT: -- No abstract --

2 Review Symbiotics in irritable bowel syndrome--better than probiotics alone? 2015

Gracie, David J / Ford, Alexander C. ·aLeeds Gastroenterology Institute, St. James's University Hospital bLeeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. ·Curr Opin Clin Nutr Metab Care · Pubmed #26107141.

ABSTRACT: PURPOSE OF REVIEW: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder associated with significant physical and psychological comorbidity. The etiology of the condition is uncertain but recent research suggests that the gut bacterial composition may play a role in its development. Therefore, manipulation of the intestinal microbiome by using probiotics and symbiotics has the potential to improve patient outcomes in IBS. RECENT FINDINGS: Numerous randomized controlled trials suggest a benefit of probiotics in the management of IBS, with a significant reduction in the likelihood of symptoms persisting after therapy, and improvements in abdominal pain, bloating and flatulence when probiotics are compared with placebo. Evidence for the effect of probiotics on quality of life is conflicting. Relatively few randomized controlled trials have examined the effect of symbiotics on outcomes in IBS, but results thus far are promising. SUMMARY: Probiotics appear to be beneficial in IBS. Data supporting the use of symbiotics is sparse. Whether symbiotics are superior to probiotics is unclear.

3 Review Systematic review with meta-analysis: the accuracy of diagnosing irritable bowel syndrome with symptoms, biomarkers and/or psychological markers. 2015

Sood, R / Gracie, D J / Law, G R / Ford, A C. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK. · Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. · Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK. ·Aliment Pharmacol Ther · Pubmed #26076071.

ABSTRACT: BACKGROUND: Irritable bowel syndrome (IBS) is a complex, heterogeneous disease which can be challenging to diagnose. No study has identified and assessed the accuracy of all available methods of diagnosing IBS. AIM: To conduct a systematic review of the literature to identify and assess accuracy of symptom-based diagnostic criteria, biomarkers, psychological markers or combinations thereof. METHODS: MEDLINE, EMBASE and EMBASE Classic were searched (until April 2015) to identify studies reporting accuracy of available methods to diagnose IBS in adult populations. Eligible studies assessed accuracy of these diagnostic tests against an accepted reference standard. Data were extracted to calculate positive and negative likelihood ratios, with 95% confidence intervals (CIs), of the diagnostic test utilised. Where more than one study used the same test, data were pooled in a meta-analysis. RESULTS: Twenty-two studies (7106 patients) were eligible. Positive and negative likelihood ratios of the current gold standard, the Rome III criteria, were 3.35 (95% CI: 2.97-3.79) and 0.39 (95% CI: 0.34-0.46), similar to other symptom-based criteria. Eleven biomarkers performed no better than symptom-based criteria. Psychological markers performed well in one study. Five different combinations were assessed. The best in terms of positive likelihood ratio was faecal calprotectin, intestinal permeability and Rome I criteria (26.4; 95% CI: 11.4-61.9), and in terms of negative likelihood ratio serum-based biomarkers and psychological markers (0.18; 95% CI: 0.12-0.25). CONCLUSIONS: Symptom-based diagnostic criteria, biomarkers and psychological markers performed modestly in predicting IBS. Combining symptoms with markers appears more effective, and may represent the way forward in the diagnosis of IBS.

4 Article Derivation and validation of a diagnostic test for irritable bowel syndrome using latent class analysis. 2017

Sood, R / Gracie, D J / Gold, M J / To, N / Pinto-Sanchez, M I / Bercik, P / Moayyedi, P / Ford, A C / Law, G R. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK. · Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. · School of Medicine, University of Leeds, Leeds, UK. · Farncombe Family Digestive Health Research Institute, Gastroenterology Division, McMaster University, Health Sciences Center, Hamilton, ON, Canada. · Division of Epidemiology & Biostatistics, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK. ·Aliment Pharmacol Ther · Pubmed #28105700.

ABSTRACT: BACKGROUND: The accuracy of symptom-based diagnostic criteria for irritable bowel syndrome (IBS) is modest. AIMS: To derive and validate a new test that utilises latent class analysis. METHODS: Symptom, colonoscopy, and histology data were collected from 1981 patients and 360 patients in two cohorts referred to secondary care for investigation of their gastrointestinal symptoms in Canada and the UK, respectively. Latent class analysis was used to identify naturally occurring clusters in patient-reported symptoms in the Canadian dataset, and the latent class model derived from this was then applied to the UK dataset in order to validate it. Sensitivity, specificity, and positive and negative likelihood ratios (LRs) were calculated for the latent class models. RESULTS: In the Canadian cohort, the model had a sensitivity of 44.7% (95% CI 40.0-50.0) and a specificity of 85.3% (95% CI 83.4-87.0). Positive and negative LRs were 3.03 (95% CI 2.57-3.56) and 0.65 (95% CI 0.59-0.71) respectively. A maximum positive LR of 3.93 was achieved following construction of a receiver operating characteristic curve. The performance in the UK cohort was similar, with a sensitivity and specificity of 52.5% (95% CI 42.2-62.7) and 84.3% (95% CI 79.3-88.6), respectively. Positive and negative LRs were 3.35 (95% CI 2.38-4.70) and 0.56 (95% CI 0.45-0.68), respectively, with a maximum positive LR of 4.15. CONCLUSIONS: A diagnostic test for IBS, utilising patient-reported symptoms incorporated into a latent class model, performs as accurately as symptom-based criteria. It has potential for improvement via addition of clinical markers, such as coeliac serology and faecal calprotectin.

5 Article Negative Effects on Psychological Health and Quality of Life of Genuine Irritable Bowel Syndrome-type Symptoms in Patients With Inflammatory Bowel Disease. 2017

Gracie, David J / Williams, Christopher J M / Sood, Ruchit / Mumtaz, Saqib / Bholah, M Hassan / Hamlin, P John / Ford, Alexander C. ·Leeds Gastroenterology Institute, St James's University Hospital, Leeds, United Kingdom; Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kingdom. Electronic address: djgracie1982@doctors.org.uk. · Leeds Gastroenterology Institute, St James's University Hospital, Leeds, United Kingdom. · Leeds Gastroenterology Institute, St James's University Hospital, Leeds, United Kingdom; Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kingdom. ·Clin Gastroenterol Hepatol · Pubmed #27189912.

ABSTRACT: BACKGROUND & AIMS: Symptoms compatible with irritable bowel syndrome (IBS) are common in patients with inflammatory bowel disease (IBD), but it is unclear whether this relates to occult IBD activity. We attempted to resolve this issue in a secondary care population by using a cross-sectional study design. METHODS: We analyzed Rome III IBS symptoms, disease activity indices, and psychological, somatization, and quality of life data from 378 consecutive, unselected adult patients with IBD seen in clinics at St James's University Hospital in Leeds, United Kingdom from November 2012 through June 2015. Participants provided a stool sample for fecal calprotectin (FC) analysis; levels ≥250 μg/g were used to define mucosal inflammation. By using symptom data and FC levels we identified 4 distinct groups of patients: those with true IBS-type symptoms (IBS-type symptoms with FC levels <250 μg/g, regardless of disease activity indices), quiescent IBD (no IBS-type symptoms with FC levels <250 μg/g, regardless of disease activity indices), occult inflammation (normal disease activity indices and FC levels ≥250 μg/g, regardless of IBS symptom status), or active IBD (abnormal disease activity indices with FC levels ≥250 μg/g, regardless of IBS symptom status). We compared characteristics between these groups. RESULTS: Fifty-seven of 206 patients with Crohn's disease (27.7%) and 34 of 172 patients with ulcerative colitis (19.8%) had true IBS-type symptoms. Levels of psychological comorbidity and somatization were significantly higher among patients with true IBS-type symptoms than patients with quiescent IBD or occult inflammation. Quality of life levels were also significantly reduced compared with patients with quiescent disease or occult inflammation and were similar to those of patients with active IBD. By using FC levels ≥100 μg/g to define mucosal inflammation, we found a similar effect of IBS-type symptoms on psychological health and quality of life. CONCLUSIONS: In a cross-sectional study, we identified a distinct group of patients with IBD and genuine IBS-type symptoms in the absence of mucosal inflammation. These symptoms had negative effects on psychological well-being and quality of life to the same degree as active IBD. New management strategies are required for this patient group.

6 Article Enhancing Diagnostic Performance of Symptom-Based Criteria for Irritable Bowel Syndrome by Additional History and Limited Diagnostic Evaluation. 2016

Sood, Ruchit / Camilleri, Michael / Gracie, David J / Gold, Matthew J / To, Natalie / Law, Graham R / Ford, Alexander C. ·Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK. · Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. · Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota, USA. · School of Medicine, University of Leeds, Leeds, UK. · Division of Epidemiology and Biostatistics, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK. ·Am J Gastroenterol · Pubmed #27481310.

ABSTRACT: OBJECTIVES: Symptom-based criteria to diagnose irritable bowel syndrome (IBS) positively perform only modestly. Our aim was to assess whether including other items from the clinical history and limited diagnostic evaluation improves their performance. METHODS: We collected complete symptom, colonoscopy, and histology data from 318 consecutive, unselected adult patients with lower gastrointestinal (GI) symptoms in secondary care. All participants underwent colonoscopy, with relevant organic findings recorded. The reference standard used to define the presence of true IBS was patient-reported lower abdominal pain or discomfort associated with a change in bowel habit, in the absence of organic GI disease. Sensitivity, specificity, and positive and negative likelihood ratios (LRs), with 95% confidence intervals, were calculated for Rome III criteria, as well as for modifications, incorporating nocturnal stools, results of simple blood tests (hemoglobin and C-reactive protein (CRP)), measures of somatization, and/or affective disorders (hospital anxiety or depression scale (HADS) score). RESULTS: The sensitivity and specificity of the Rome III criteria for identifying IBS was 69.6%, and 82.0%, respectively, with positive and negative LRs of 3.87 and 0.37, respectively. Clinically useful enhancements in positive LRs were provided by combining Rome III criteria with: (a) high level of somatization (7.27); (b) normal hemoglobin and CRP with HADS score of ≥8 (5.04); (c) normal hemoglobin and CRP with a high level of somatization (7.56); or (d) no nocturnal passage of stool with a high level of somatization (17.3). Specificity was ≥95% with each of these modifications. CONCLUSIONS: Incorporating nocturnal stools, somatization, and affective disorders from the clinical history, and hemoglobin and CRP measurements, enhances the positive LR and specificity of symptom-based Rome III criteria for IBS.

7 Article Functional bowel symptoms in quiescent inflammatory bowel disease: more than just irritable bowel syndrome? 2014

Gracie, David J / Ford, Alexander C. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kingdom. ·Gastroenterology · Pubmed #25240166.

ABSTRACT: -- No abstract --

8 Minor Reply. 2017

Gracie, David J / Williams, Christopher J M / Sood, Ruchit / Mumtaz, Saqib / Bholah, M Hassan / Hamlin, P John / Ford, Alexander C. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kingdom. · Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom. ·Clin Gastroenterol Hepatol · Pubmed #28479498.

ABSTRACT: -- No abstract --

9 Minor Ongoing Symptoms in Ulcerative Colitis Patients in Remission: Irritable Bowel Syndrome or Gastrointestinal Symptoms in the Absence of Inflammation? 2017

Gracie, David J / Ford, Alexander C. ·*Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom †Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kingdom. ·Inflamm Bowel Dis · Pubmed #27930410.

ABSTRACT: -- No abstract --

10 Minor Limited evidence for the existence of postdiverticulitis irritable bowel syndrome. 2013

Gracie, David J / Everett, Simon M. ·Department of Gastroenterology, St. James's University Hospital, Leeds, United Kingdom. ·Clin Gastroenterol Hepatol · Pubmed #23660417.

ABSTRACT: -- No abstract --