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Irritable Bowel Syndrome: HELP
Articles by Michael P. Jones
Based on 30 articles published since 2009
(Why 30 articles?)
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Between 2009 and 2019, M. Jones wrote the following 30 articles about Irritable Bowel Syndrome.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Editorial: subgroups in irritable bowel syndrome-more than just diarrhoea and constipation? Authors' reply. 2017

Polster, A / Van Oudenhove, L / Jones, M / Öhman, L / Törnblom, H / Simrén, M. ·Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, Gothenburg, Sweden. · Translational Research Center for Gastrointestinal Disorders (TARGID), Leuven, Belgium. · Psychology Department, Macquarie University, North Ryde, NSW, Australia. · Department of Microbiology and Immunology, Sahlgrenska Academy, Gothenburg, Sweden. · Center for Functional Gastrointestinal and Motility Disorders, Chapel Hill, NC, USA. ·Aliment Pharmacol Ther · Pubmed #28880440.

ABSTRACT: -- No abstract --

2 Editorial Editorial: differentiating chronic idiopathic constipation from constipation-predominant irritable bowel syndrome--possible and important?--Authors' reply. 2015

Talley, N J / Koloski, N A / Jones, M P. ·Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. nicholas.talley@newcastle.edu.au. · Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. · Department of Psychology, Macquarie University, North Ryde, NSW, Australia. ·Aliment Pharmacol Ther · Pubmed #25968151.

ABSTRACT: -- No abstract --

3 Editorial Editorial: the overlap of atopy and functional gastrointestinal disorders in primary care--authors' reply. 2014

Jones, M P / Walker, M M / Ford, A C / Talley, N J. ·Psychology Department, Macquarie University, North Ryde, NSW, USA. mike.jones@mq.edu.au. ·Aliment Pharmacol Ther · Pubmed #25303378.

ABSTRACT: -- No abstract --

4 Review Descending pain modulation in irritable bowel syndrome (IBS): a systematic review and meta-analysis. 2015

Chakiath, Rosemary J / Siddall, Philip J / Kellow, John E / Hush, Julia M / Jones, Mike P / Marcuzzi, Anna / Wrigley, Paul J. ·Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia. rosemary.chakiath@sydney.edu.au. · Pain Management Research Institute, Kolling Institute, Northern Sydney Local Health District, St Leonards, Sydney, NSW, Australia. rosemary.chakiath@sydney.edu.au. · Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia. psiddall@hammond.com.au. · Department of Pain Management, HammondCare, Greenwich Hospital, Sydney, NSW, Australia. psiddall@hammond.com.au. · Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia. psiddall@hammond.com.au. · Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia. john.kellow@sydney.edu.au. · Department of Gastroenterology, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia. john.kellow@sydney.edu.au. · Discipline of Physiotherapy, Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, Sydney, NSW, Australia. julia.hush@mq.edu.au. · The Centre for Physical Health, Macquarie University, North Ryde, Australia. julia.hush@mq.edu.au. · Psychology Department, Macquarie University, North Ryde, Sydney, NSW, Australia. mike.jones@mq.edu.au. · Discipline of Physiotherapy, Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, Sydney, NSW, Australia. anna.marcuzzi@students.mq.edu.au. · The Centre for Physical Health, Macquarie University, North Ryde, Australia. anna.marcuzzi@students.mq.edu.au. · Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia. paul.wrigley@sydney.edu.au. · Pain Management Research Institute, Kolling Institute, Northern Sydney Local Health District, St Leonards, Sydney, NSW, Australia. paul.wrigley@sydney.edu.au. ·Syst Rev · Pubmed #26652749.

ABSTRACT: BACKGROUND: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. While abdominal pain is a dominant symptom of IBS, many sufferers also report widespread hypersensitivity and present with other chronic pain conditions. The presence of widespread hypersensitivity and extra-intestinal pain conditions suggests central nervous dysfunction. While central nervous system dysfunction may involve the spinal cord (central sensitisation) and brain, this review will focus on one brain mechanism, descending pain modulation. METHOD/DESIGN: We will conduct a comprehensive search for the articles indexed in the databases Ovid MEDLINE, Ovid Embase, Ovid PsycINFO and Cochrane Central Register of Controlled Trial (CENTRAL) from their inception to August 2015, that report on any aspect of descending pain modulation in irritable bowel syndrome. Two independent reviewers will screen studies for eligibility, assess risk of bias and extract relevant data. Results will be tabulated and, if possible, a meta-analysis will be carried out. DISCUSSION: The systematic review outlined in this protocol aims to summarise current knowledge regarding descending pain modulation in IBS. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015024284.

5 Article Gastrointestinal symptoms - an illness burden that affects daily work in patients with IBS. 2019

Faresjö, Åshild / Walter, Susanna / Norlin, Anna-Karin / Faresjö, Tomas / Jones, Michael P. ·Department of Medicine and Health, Community Medicine, Faculty of Medicine and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden. ashild.olsen.faresjo@liu.se. · Department of Clinical and Experimental Medicine, Division of Gastroenterology, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden. · Department of Medicine and Health, Community Medicine, Faculty of Medicine and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden. · Psychology Department, Macquarie University, Sydney, NSW, Australia. ·Health Qual Life Outcomes · Pubmed #31262316.

ABSTRACT: BACKGROUND: Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder characterised by recurrent abdominal pain and disturbed bowel habits and unclear aetiology. IBS is also associated with psychosocial factors, impaired quality of life and lost work productivity. This study sought to determine whether the association between IBS and lost work productivity might be accounted for by poor coping strategies and loss of confidence in the healthcare system. METHODS: Case-control design was employed sampling IBS and non-gastrointestinal (non-GI) primary healthcare seekers in a defined region in Sweden. Non-GI patients were of similar age and sex distribution to the IBS patients. Questionnaires applied in this study included instruments designed to measure confidence in the social security system and in the community, as well as questions about whether gastrointestinal problems might affect working life and Sense of coherence (SOC) questionnaire. The study's primary hypothesis was evaluated via an a priori path model. RESULTS: Statistically significant differences were found between IBS cases (n = 305) and controls (n = 369) concerning abdominal pain or discomfort affecting everyday performance at work (p <  0.0001). IBS cases also showed significantly lower (p = 0.001) confidence in public healthcare. The study's hypothesis was supported with the finding of a statistically significant indirect association via poor coping strategies, although the indirect associations were lesser in magnitude than the direct association. CONCLUSIONS: This study found a clear association between clinically diagnosed IBS status and interference in work by gastrointestinal symptoms in which sense of coherence might be of importance.

6 Article Gastrointestinal recall questionnaires compare poorly with prospective patient diaries for gastrointestinal symptoms: data from population and primary health centre samples. 2019

Jones, Michael P / Walter, Susanna / Faresjö, Åshild / Grodzinsky, Ewa / Kjellström, Lars / Viktorsson, Lisa / Talley, Nicholas J / Agreus, Lars / Andreasson, Anna. ·Department of Psychology, Macquarie University, North Ryde. · Institution of Clinical and Experimental Medicine (IKE). · Department of Medicine and Health Sciences. · Division of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine and Institute of Medicine and Health Science. · Department of Clinical Neuroscience. · Research and Development Unit of Medical and Health Services, Linköping University, Linköping. · Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. · Division for Family Medicine and Primary Care, Karolinska Institutet. · Stress Research Institute, Stockholm University, Stockholm, Sweden. ·Eur J Gastroenterol Hepatol · Pubmed #30394943.

ABSTRACT: BACKGROUND: Clinical understanding of gastrointestinal symptoms is commonly based on patient reports of symptom experience. For diagnosis and treatment choices to be appropriate, symptom reports need to be accurate. We examined the agreement between questionnaire recall and prospective diary enumeration of symptoms relevant to the irritable bowel syndrome. PATIENTS AND METHODS: Data are reported from a randomly selected general population sample (n=238) and also a primary healthcare centre (PHC) sample (n=503, 10 PHCs). All the patients completed the questionnaires, which included Rome III-qualifying irritable bowel syndrome items and a stool and symptom diary over either 7 or 14 days. Agreement between retrospective questionnaire reports and prospective diaries was evaluated. RESULTS: Concordance between questionnaires and diaries was highest for the simple construct of the occurrence of abdominal pain, although after adjusting for possible chance, agreement was only moderate in the general population sample. More complex constructs, such as pain relieved by defecation, yielded poorer concordance. In general, concordance was stronger among PHC respondents than in the general population sample. CONCLUSION: Concordance between questionnaires and diaries was generally poor and related to the complexity of the symptom construct and the type of respondent. The information used to classify individuals based on patient self-report may be unreliable, and therefore, more effort is needed to develop data collection instruments.

7 Article Overlap of Irritable Bowel Syndrome and Functional Dyspepsia in the Clinical Setting: Prevalence and Risk Factors. 2019

von Wulffen, Moritz / Talley, Nicholas J / Hammer, Johann / McMaster, Jessica / Rich, Graeme / Shah, Ayesha / Koloski, Natasha / Kendall, Bradley J / Jones, Mike / Holtmann, Gerald. ·Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia. · Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia. · Translational Research Institute, Brisbane, QLD, Australia. · Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia. · Medical University of Vienna, Vienna, Austria. · Department of Psychology, Macquarie University, Sydney, NSW, Australia. · Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia. g.holtmann@uq.edu.au. · Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia. g.holtmann@uq.edu.au. · Translational Research Institute, Brisbane, QLD, Australia. g.holtmann@uq.edu.au. · Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia. g.holtmann@uq.edu.au. ·Dig Dis Sci · Pubmed #30368683.

ABSTRACT: BACKGROUND: According to Rome IV criteria, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are distinct functional gastrointestinal disorders (FGID); however, overlap of these conditions is common in population-based studies, but clinical data are lacking. AIMS: To determine the overlap of FD and IBS in the clinical setting and define risk factors for the overlap of FD/IBS. METHODS: A total of 1127 consecutive gastroenterology outpatients of a tertiary center were recruited and symptoms assessed with a standardized validated questionnaire. Patients without evidence for structural or biochemical abnormalities as a cause of symptoms were then categorized based upon the symptom pattern as having FD, IBS or FD/IBS overlap. Additionally, this categorization was compared with the clinical diagnosis documented in the integrated electronic medical records system. RESULTS: A total of 120 patients had a clinical diagnosis of a FGID. Based upon standardized assessment with a questionnaire, 64% of patients had FD/IBS overlap as compared to 23% based upon the routine clinical documentation. In patients with severe IBS or FD symptoms (defined as symptoms affecting quality of life), the likelihood of FD/IBS overlap was substantially increased (OR = 3.1; 95%CI 1.9-5.0) and (OR = 9.0; 95%CI 3.5-22.7), respectively. Thus, symptom severity for IBS- or FD symptoms were significantly higher for patients with FD/IBS overlap as compared to patients with FD or IBS alone (p all < 0.01). Age, gender and IBS-subtype were not associated with overlap. CONCLUSION: In the clinical setting, overlap of FD and IBS is the norm rather than the exception. FD/IBS overlap is associated with a more severe manifestation of a FGID.

8 Article Understanding statistical hypothesis tests and power. 2017

Jones, Michael P / Beath, Alissa / Oldmeadow, Christopher / Attia, John R. ·Macquarie University, Sydney, NSW mike.jones@mq.edu.au. · Macquarie University, Sydney, NSW. · Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW. ·Med J Aust · Pubmed #28814212.

ABSTRACT: -- No abstract --

9 Article Mixture model analysis identifies irritable bowel syndrome subgroups characterised by specific profiles of gastrointestinal, extraintestinal somatic and psychological symptoms. 2017

Polster, A / Van Oudenhove, L / Jones, M / Öhman, L / Törnblom, H / Simrén, M. ·Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium. · Psychology Department, Faculty of Human Sciences, Macquarie University, North Ryde, NSW, Australia. · Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. ·Aliment Pharmacol Ther · Pubmed #28671338.

ABSTRACT: BACKGROUND: Current subgrouping of Irritable Bowel Syndrome (IBS) is exclusively based on stool consistency without considering other relevant gastrointestinal (GI), extraintestinal somatic or psychological features. AIM: To identify subgroups based on a comprehensive set of IBS-related parameters. METHODS: Mixture model analysis was used, with the following input variables: 13 single-item scores from the IBS-specific Gastrointestinal Symptom Rating Scale, average stool consistency and frequency from a 7-day Bristol Stool Form diary, 12 single-item extraintestinal symptom scores from the Patient Health Questionnaire-12, and anxiety and depression subscale scores from the Hospital Anxiety and Depression scale. The resulting latent subgroups were compared regarding symptom profiles using analysis of variance followed by pair-wise comparisons. RESULTS: One hundred and seventy-two IBS patients (Rome III; 69% female; mean age 33.7 [range 18-60] years) were included. The optimal subgrouping showed six latent groups, characterised by: (I) constipation with low comorbidities, (II) constipation with high comorbidities, (III) diarrhoea with low comorbidities, (IV) diarrhoea and pain with high comorbidities, (V) mixed GI symptoms with high comorbidities, (VI) a mix of symptoms with overall mild severity. The subgroups showed differences in the distribution of Rome III-subtypes, IBS severity, presence of anxiety and depression, and gender, but not regarding age, IBS duration or reported post-infectious onset of IBS. CONCLUSIONS: This model-based subgrouping of IBS partly supports the distinction of subgroups based on bowel habits, but additionally distinguishes subgroups with or without co-morbid extraintestinal somatic and psychological symptoms. The resulting groups show specific profiles of symptom combinations.

10 Article Undiagnosed pancreatic exocrine insufficiency and chronic pancreatitis in functional GI disorder patients with diarrhea or abdominal pain. 2017

Talley, Nicholas J / Holtmann, Gerald / Nguyen, Quoc Nam / Gibson, Peter / Bampton, Peter / Veysey, Martin / Wong, James / Philcox, Stephen / Koloski, Natasha / Bunby, Lisa / Jones, Michael. ·Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. · Department of Gastroenterology, John Hunter Hospital, New Lambton, New South Wales, Australia. · Department of Gastroenterology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia. · Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, South Australia, Australia. · Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia. · Department of Gastroenterology, Monash University and Alfred Hospital, Melbourne, Victoria, Australia. · Department of Gastroenterology, Flinders Medical Centre, Bedford Park, South Australia, Australia. · Teaching & Research Unit, Gosford & Wyong Hospital, Gosford, New South Wales, Australia. · Mylan EPD, Macquarie, New South Wales, Australia. · Department of Psychology, Macquarie University, Ryde, New South Wales, Australia. ·J Gastroenterol Hepatol · Pubmed #28332731.

ABSTRACT: BACKGROUND AND AIM: A previous UK study showed that 6.1% of patients with diarrhea-predominant irritable bowel syndrome (IBS-D) had evidence of severe pancreatic exocrine insufficiency (PEI), but these findings need replication. We aimed to identify the prevalence of PEI based on fecal elastase stool testing in consecutive outpatients presenting with chronic unexplained abdominal pain and/or diarrhea and/or IBS-D. METHODS: Patients aged over 40 years presenting to hospital outpatient clinics from six sites within Australia with unexplained abdominal pain and/or diarrhea for at least 3 months and/or IBS-D were studied. Patients completed validated questionnaires and donated a stool sample in which elastase concentration was measured by ELISA. A concentration of < 100 mcg/g stool represented severe and < 200 mcg/g mild to moderate PEI. Patients whose fecal elastase was < 200 mcg/g underwent testing for pancreatic pathology with an endoscopic ultrasound or abdominal CT. RESULTS: Two hundred eighteen patients (mean age of 60 years, 29.4% male) were studied. PEI was found in 4.6% (95% CI 2.2-8.3%) (n = 10), with five patients (2.3% (95% CI 0.8-5.3%) having severe PEI. Only male sex and heavy alcohol use were significantly associated with abnormal versus normal pancreatic functioning. Of seven patients who underwent endoscopic ultrasound or CT, two had features indicative of chronic pancreatitis. CONCLUSION: One in 50 patients with IBS-D or otherwise unexplained abdominal pain or diarrhea have an abnormal fecal elastase, but unexpected pancreatic insufficiency was detected in only a minority of these. This study failed to confirm the high prevalence of PEI among patients with unexplained GI symptoms previously reported.

11 Article Cortisol levels in hair are altered in irritable bowel syndrome - A case control study in primary care. 2017

Norlin, A-K / Walter, S / Theodorsson, E / Tegelstrom, V / Grodzinsky, E / Jones, M P / Faresjö, Å. ·Division of Community Medicine, Department of Medicine and Health Sciences, Linköping University, Sweden. Electronic address: anna-karin.norlin@liu.se. · Division of Gastroenterology, Department of Clinical and Experimental Medicine, Linköping University, Sweden. · Division of Clinical Chemistry, Department of Clinical and Experimental Medicine, Linköping University, Sweden. · National board of forensic medicine, Sweden. · Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden; Division of Drug research, Department of Medicine and Health Sciences, Linköping University, Sweden. · Psychology Department, Macquarie University, Sydney, NSW, Australia. · Division of Community Medicine, Department of Medicine and Health Sciences, Linköping University, Sweden. ·J Psychosom Res · Pubmed #28107896.

ABSTRACT: OBJECTIVE: Stress is an important component in the pathophysiology of irritable bowel syndrome (IBS). Long term Hypothalamus Pituitary Adrenal (HPA)-axis activity can be studied by measuring hair cortisol concentrations (HCC). Some previous studies have indicated a dysregulated HPA-axis in IBS patients, but cortisol levels in hair have not yet been studied. We investigated whether HCC and self-reported stress differentiate IBS patients from controls. METHODS: In a cross-sectional study within 10 Swedish Primary Health Care Centers we compared patients in working age with active IBS to patients without GI complaints. The participants donated hair samples and completed questionnaires including a scale of self-reported perceived stress (PSS). 169 Rome III-fulfilling IBS patients and 316 non-IBS patients were available for final analyses. RESULTS: IBS patients had significantly lower HCC, median=16.3pg/mg, IQR=26.9pg/mg, compared to non-IBS patients, median=22.8pg/mg, IQR=29.1pg/mg. There was also a difference in the distribution of HCC quintiles between the two groups, with 30.2% IBS patients and 14.2% of non-IBS patients in the lowest quintile of HCC. PSS was higher among IBS patients with a mean (SD) total score of 25.3 (8.0) compared to controls 21.4, (7.5). Quintiles of HCC and PSS stayed significantly but very weakly related to IBS (B=-0.332, Std error=0.146, p<0.005) in multivariable analyses. CONCLUSION: This study suggests a possible suppression of the HPA-axis activity in a considerable portion of IBS patients.

12 Article The epidemiology of irritable bowel syndrome: Symptom development over a 3-year period in Denmark. A prospective, population-based cohort study. 2017

Krogsgaard, L R / Engsbro, A L / Jones, M P / Bytzer, P. ·Department of Medical Gastroenterology, Køge University Hospital, Køge, Denmark. · Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark. · Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark. · Psychology Department, Macquarie University, North Ryde, NSW, Australia. ·Neurogastroenterol Motil · Pubmed #27865035.

ABSTRACT: BACKGROUND: We aimed to explore the natural history of irritable bowel syndrome (IBS) in Denmark over 3 years by studying development of IBS symptoms and associated factors. METHODS: A cohort study was carried out using a web panel representative of the Danish general population 18-50 years. The survey, including a questionnaire based on the Rome III criteria for IBS, was conducted in January 2010, January 2011, and March 2013. KEY RESULTS: The prevalence of IBS was 15.4% (920/5986). The incidence was 10.3%, and was three times higher for persons with unspecific gastrointestinal (GI) symptoms compared to asymptomatic persons. Of respondents with IBS symptoms in both 2010 and 2011, 69% (131/191) also reported symptoms of IBS in 2013, which was significantly more compared to respondents with IBS symptoms in 2010 reporting to be asymptomatic or having unspecific GI symptoms in 2011 (20% and 39%, respectively, P<.001). Being diagnosed with IBS predicted fulfilling the criteria for IBS 3 years later (OR: 2.59, 95% CI: 1.11-6.10). Fulfilling criteria for IBS after 1 year also led to a high risk of IBS symptoms 3 years later in asymptomatic persons and persons with unspecific symptoms at baseline. CONCLUSIONS & INFERENCES: The vast majority of persons fulfilling criteria for IBS report GI symptoms after one and 3 years. Fulfilling IBS criteria after 1 year led to a high risk of reporting IBS symptoms after 3 years. In the general population having an IBS diagnosis predicts persistently fulfilling the Rome III criteria for IBS 3 years later.

13 Article Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: a 1-year population-based prospective study. 2016

Koloski, N A / Jones, M / Talley, N J. ·Faculty of Health & Medicine, University of Newcastle, Newcastle, NSW, Australia. · Department of Psychology, Macquarie University, North Ryde, NSW, Australia. ·Aliment Pharmacol Ther · Pubmed #27444264.

ABSTRACT: BACKGROUND: Traditionally, functional gastrointestinal disorders (FGIDs) are conceptualised as originating in the brain via stress pathways (brain-to-gut). It is uncertain how many with irritable bowel syndrome (IBS) and functional dyspepsia (FD) have a gut origin of symptoms (gut-to-brain pathway). AIMS: To determine if there is a distinct brain-to-gut FGID (where psychological symptoms begin first) and separately a distinct gut-to-brain FGID (where gut symptoms start first). METHODS: A prospective random population sample from Newcastle, Australia who responded to a validated survey in 2012 and completed a 1-year follow-up survey (n = 1900). The surveys contained questions on Rome III IBS and FD and the Hospital Anxiety and Depression Scale. RESULTS: We found that higher levels of anxiety and depression at baseline were significant predictors of developing IBS (OR = 1.31; 95% CI 1.06-1.61, P = 0.01; OR = 1.54; 95% CI 1.29-1.83, P < 0.001) and FD (OR = 1.28; 95% CI 1.05-1.55, P = 0.01; OR = 1.55, 95% CI 1.32-1.83, P < 0.001), respectively, at the 1-year follow-up. Among those people who did not have elevated levels of anxiety and depression at baseline, subjects at baseline with documented IBS (mean difference 0.34; 95% CI 0.13-0.55, P = 0.002; 0.81; 95% CI 0.47-1.15, P < 0.001) and FD (0.38; 95% CI 0.14-0.63, P = 0.002; 0.92; 95% CI 0.57-1.27, P < 0.001), reported significantly higher levels of anxiety and depression at the 1-year follow-up. We calculated in one-third of individuals a mood disorder precedes FGID but in two-thirds an FGID precedes the mood disorder. CONCLUSION: While brain-gut pathways are bidirectional, a major subset begin with gut symptoms first and only then psychological distress develops, implicating primary gut mechanisms as drivers of the gut and extra-intestinal features in many cases.

14 Article Identification of early environmental risk factors for irritable bowel syndrome and dyspepsia. 2015

Koloski, N A / Jones, M / Weltman, M / Kalantar, J / Bone, C / Gowryshankar, A / Walker, M M / Talley, N J. ·Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. · Department of Psychology, Macquarie University, North Ryde, NSW, Australia. · Department of Gastroenterology & Hepatology, Nepean Hospital, Penrith, NSW, Australia. ·Neurogastroenterol Motil · Pubmed #26202154.

ABSTRACT: BACKGROUND: The role of childhood environment including exposure to infection via siblings and pets in irritable bowel syndrome (IBS) and dyspepsia is relatively unknown. We assessed proxy measures of microbial exposure in early childhood to assess if these are associated with IBS and functional dyspepsia in later life. METHODS: Participants (n = 767, response rate = 53%) were a random population sample from Sydney, Australia who previously responded to a validated survey. IBS and functional dyspepsia were defined using Rome III criteria. Early environmental risk factors assessed included type of birth delivery, premature birth, breastfeeding, bedroom sharing, and pet exposure (the latter two then combined as early hygiene factors) up to 5 years of age. Post infectious IBS (PI-IBS) was assessed by development of IBS following gastroenteritis. KEY RESULTS: In this sample, in adult life 17% developed IBS (of which 20% had PI-IBS) and 12% functional dyspepsia. Development of IBS was associated with childhood factors-a shorter duration of breastfeeding (odds ratios [OR] = 0.87, 95% CI: 0.78-0.97, p = 0.01), sharing a bedroom (OR = 1.89, 95% CI: 1.73-3.08, p = 0.01), exposure to a herbivore pet (OR = 1.65 (1.10, 2.48), p = 0.02), and hygiene factors (OR = 4.39; 95% CI: 1.89-10.21, p = 0.001). The sole factor associated with functional dyspepsia was exposure to a herbivore pet (1.79; 95% CI: 1.19-2.87, p = 0.02). CONCLUSIONS & INFERENCES: Childhood environment factors, particularly bedroom sharing and pet exposure, combined with subsequent risk of microbial exposure are a risk factor for IBS in later life. These associations however need confirmation to rule out any risk of a type I error.

15 Article Inpatient burden of childhood functional GI disorders in the USA: an analysis of national trends in the USA from 1997 to 2009. 2015

Park, R / Mikami, S / LeClair, J / Bollom, A / Lembo, C / Sethi, S / Lembo, A / Jones, M / Cheng, V / Friedlander, E / Nurko, S. ·Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. ·Neurogastroenterol Motil · Pubmed #25809794.

ABSTRACT: BACKGROUND: Functional gastrointestinal disorders (FGIDs) are among the most common outpatient diagnoses in pediatric primary care and gastroenterology. There is limited data on the inpatient burden of childhood FGIDs in the USA. The aim of this study was to evaluate the inpatient admission rate, length of stay (LoS), and associated costs related to FGIDs from 1997 to 2009. METHODS: We analyzed the Kids' Inpatient Sample Database (KID) for all subjects in which constipation (ICD-9 codes: 564.0-564.09), abdominal pain (ICD-9 codes: 789.0-789.09), irritable bowel syndrome (IBS) (ICD-9 code: 564.1), abdominal migraine (ICD-9 code: 346.80 and 346.81) dyspepsia (ICD-9 code: 536.8), or fecal incontinence (ICD-codes: 787.6-787.63) was the primary discharge diagnosis from 1997 to 2009. The KID is the largest publicly available all-payer inpatient database in the USA, containing data from 2 to 3 million pediatric hospital stays yearly. KEY RESULTS: From 1997 to 2009, the number of discharges with a FGID primary diagnosis increased slightly from 6,348,537 to 6,393,803. The total mean cost per discharge increased significantly from $6115 to $18,058 despite the LoS remaining relatively stable. Constipation and abdominal pain were the most common FGID discharge diagnoses. Abdominal pain and abdominal migraine discharges were most frequent in the 10-14 year age group. Constipation and fecal incontinence discharges were most frequent in the 5-9 year age group. IBS discharge was most common for the 15-17 year age group. CONCLUSIONS & INFERENCES: Hospitalizations and associated costs in childhood FGIDs have increased in number and cost in the USA from 1997 to 2009. Further studies to determine optimal methods to avoid unnecessary hospitalizations and potentially harmful diagnostic testing are indicated.

16 Article Differentiation of functional constipation and constipation predominant irritable bowel syndrome based on Rome III criteria: a population-based study. 2015

Koloski, N A / Jones, M / Young, M / Talley, N J. ·Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. ·Aliment Pharmacol Ther · Pubmed #25736433.

ABSTRACT: BACKGROUND: While the Rome III classification recognises functional constipation (FC) and constipation predominant IBS (IBS-C) as distinct disorders, recent evidence has suggested that these disorders are difficult to separate in clinical practice. AIM: To identify whether clinical and lifestyle factors differentiate Rome III-defined IBS-C from FC based on gastrointestinal symptoms and lifestyle characteristics. METHOD: 3260 people randomly selected from the Australian population returned a postal survey. FC and IBS-C were defined according to Rome III. The first model used logistic regression to differentiate IBS-C from FC based on lifestyle, quality-of-life and psychological characteristics. The second approach was data-driven employing latent class analysis (LCA) to identify naturally occurring clusters in the data considering all symptoms involved in the Rome III criteria for IBS-C and FC. RESULTS: We found n = 206 (6.5%; 95% CI 5.7-7.4%) people met strict Rome III FC whereas n = 109 (3.5%; 95% CI 2.8-4.1%) met strict Rome III IBS-C. The case-control approach indicated that FC patients reported an older age at onset of constipation, were less likely to exercise, had higher mental QoL and less health care seeking than IBS-C. LCA yielded one latent class that was predominantly (75%) FC, while the other class was approximately half IBS-C and half FC. The FC-dominated latent class had clearly lower levels of symptoms used to classify IBS (pain-related symptoms) and was more likely to be male (P = 0.046) but was otherwise similar in distribution of lifestyle factors to the mixed class. CONCLUSION: The latent class analysis approach suggests a differentiation based more on symptom severity rather than the Rome III view.

17 Article Colonic spirochetosis is associated with colonic eosinophilia and irritable bowel syndrome in a general population in Sweden. 2015

Walker, Marjorie M / Talley, Nicholas J / Inganäs, Linn / Engstrand, Lars / Jones, Michael P / Nyhlin, Henry / Agréus, Lars / Kjellstrom, Lars / Öst, Åke / Andreasson, Anna. ·Anatomical Pathology, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, 2308 NSW, Australia. Electronic address: marjorie.walker@newcastle.edu.au. · Faculty of Health and Medicine, University of Newcastle, Newcastle, 2308 NSW, Australia. · Center of Family Medicine, Karolinska Institutet, SE-141 83 Huddinge Stockholm, Sweden; Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-141 83 Stockholm, Sweden. · Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-141 83 Stockholm, Sweden. · Psychology Department, Macquarie University, North Ryde, 2109 NSW, Australia. · Internal Medicine, Karolinska Hospital, SE-141 83 Huddinge, Sweden. · Center of Family Medicine, Karolinska Institutet, SE-141 83 Huddinge Stockholm, Sweden. · Internal Medicine, Aleris Sabbatsbergs Hospital, SE-113 24 Stockholm, Sweden. · Pathology, Aleris Medilab, SE-183 53 Täby, Sweden. · Center of Family Medicine, Karolinska Institutet, SE-141 83 Huddinge Stockholm, Sweden; Stress Research Institute, Stockholm University, SE-106 91 Stockholm, Sweden. ·Hum Pathol · Pubmed #25540866.

ABSTRACT: Irritable bowel syndrome (IBS) is a functional disorder defined by symptoms in the absence of overt pathology. Colonic spirochetosis (CS), defined by histologic observation of spirochetal strains of Brachyspira in colonic biopsies, is uncommon and considered of doubtful significance. We aimed to determine the prevalence of CS in the general population, identify subtle colon pathologies, and evaluate a link with symptoms of IBS. Colonoscopy was performed in 745 subjects (aged 19-70 years, mean age 51 years, 43% male) with biopsies (ileum and 4 colonic sites) from a random population sample, Stockholm, Sweden, who completed a validated questionnaire of gastrointestinal symptoms; IBS was identified by Rome III criteria. CS was identified by histology and immunohistochemistry. In a general population, 17 individuals (2.28%; 95% confidence interval, 1.2%-3.5%) were diagnosed as having CS by histology; 6 (35%) had IBS. CS was always present in the sigmoid colon, but only 14 rectal biopsies. Eosinophils were increased in colon biopsies in CS cases versus controls, in the transverse (P = .02), sigmoid colon (P = .001), and rectum (P = .0005) with subepithelial eosinophil clusters (P = .053). Lymphoid follicles (at any site) were present in 13 CS (P = .0003). There was a 3-fold increased risk of IBS in CS (odds ratio, 3.59; 95% confidence interval, 1.27-10.11; P = .015). Polyps and diverticular disease were similar in CS cases and controls. The prevalence of CS in a general population is 2% and associated with nonconstipating IBS. Colonic eosinophilia with lymphoid follicles may signify the presence of CS.

18 Article Increased prevalence of autoimmune diseases in functional gastrointestinal disorders: case-control study of 23471 primary care patients. 2014

Ford, A C / Talley, N J / Walker, M M / Jones, M P. ·Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK; Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK. ·Aliment Pharmacol Ther · Pubmed #25131320.

ABSTRACT: BACKGROUND: There is increasing evidence that impaired mucosal defence mechanisms are implicated in the pathogenesis of the functional gastrointestinal disorders (FGIDs), allowing inappropriate immune activation. AIM: To test the hypothesis that an excess of autoimmune disorders among sufferers, using a large primary care database to examine this. METHODS: Cases were diagnosed with FGIDs - irritable bowel syndrome (IBS), functional dyspepsia (FD), chronic idiopathic constipation (CIC), and multiple FGIDs. Controls were those without FGIDs. Prevalence of autoimmune disorders was compared between cases and controls using odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: We included 23,471 patients (mean age 51.4 years, 66.1% female). Prevalence of autoimmune disorders was greater among all FGIDs, compared with controls without. In those with FD (OR 1.35; 95% CI 1.12-1.63), CIC (OR 1.75; 95% CI 1.11-2.75), or multiple FGIDs (OR 1.49; 95% CI 1.25-1.77) this was statistically significant after controlling for age and gender. Rheumatological autoimmune disorders were significantly more frequent in those with FD (OR 1.44; 95% CI 1.15-1.80), CIC (OR 1.84; 95% CI 1.08-3.13), or multiple FGIDs (OR 1.53; 95% CI 1.24-1.88), after controlling for age and gender. However, endocrine autoimmune disorders were no more frequent in those with FGIDs, after controlling for age and gender. CONCLUSIONS: In a large sample of primary care patients, there was a significantly higher prevalence of autoimmune disorders among those with FD, CIC, or multiple FGIDs not explained by differences in age or gender. We were unable to control for concomitant drug use, which may partly explain this association.

19 Article The overlap of atopy and functional gastrointestinal disorders among 23,471 patients in primary care. 2014

Jones, M P / Walker, M M / Ford, A C / Talley, N J. ·Psychology Department, Macquarie University, North Ryde, NSW, USA. ·Aliment Pharmacol Ther · Pubmed #24961872.

ABSTRACT: BACKGROUND: Activation of the immune system has been demonstrated in atopy and functional gastrointestinal disorders (FGIDs). Previous data from our group have suggested a connection between immune dysregulation, FGIDs and mood disorders. AIM: To investigate if these data translate to clinical practice and examine connections from the perspective of FGIDs to determine whether atopy and FGIDs are connected via mood disorders. METHODS: Evidence of irritable bowel syndrome (IBS), functional dyspepsia (FD) and constipation was sought from the medical records of 30,000 primary care records over a minimum 5 year period. The same records yielded diagnoses of four atopic conditions (asthma, eczema, allergic rhinitis/hay fever and conjunctivitis). RESULTS: Atopic conditions were found in excess among all FGID groups considered when compared with controls. In the groups with IBS alone (OR = 1.43, 1.29-1.58), FD alone (OR = 1.41, 1.26-1.58) and those with multiple FGIDs (OR = 1.92, 1.75-2.12) there was elevated prevalence of asthma compared with controls without a FGID. Across disorders the excess was generally highest among patients diagnosed with multiple FGIDs (rhinitis/hay fever OR = 3.74, 3.32-4.20; conjunctivitis OR = 3.00, 2.49-3.62) and was only partly explained by a common association between both FGIDs and atopic conditions with mood disorders, although not for every atopic/FGID combination (rhinitis/hay fever OR = 2.60, 2.29-2.96, conjunctivitis OR = 2.34, 1.90-2.87). CONCLUSIONS: Irritable bowel syndrome, functional dyspepsia and constipation share an association with atopy that is only partly explained via a common connection with mood disorders. These data have important implications for understanding both the pathophysiology of functional gastrointestinal disorders and development of new treatments.

20 Article A biomarker panel and psychological morbidity differentiates the irritable bowel syndrome from health and provides novel pathophysiological leads. 2014

Jones, M P / Chey, W D / Singh, S / Gong, H / Shringarpure, R / Hoe, N / Chuang, E / Talley, N J. ·Psychology Department, Macquarie University, North Ryde, NSW, Australia. ·Aliment Pharmacol Ther · Pubmed #24387672.

ABSTRACT: BACKGROUNDS: The development of a reliable biomarker for irritable bowel syndrome (IBS) remains one of the major aims of research in functional gastrointestinal disorders (FGIDs) and is complicated by the absence of a perfect reference standard. Previous efforts based on genetic and immune markers have showed promise, but have not been robust. AIM: To evaluate an extensive panel of gene expression and serology markers combined with psychological measures in differentiating IBS from health and between subtypes of IBS. METHODS: Of subjects eligible for analysis (N = 244), 168 met criteria for IBS (60 IBS-C, 57 IBS-D and 51 mixed), while 76 were free of any FGID. A total of 34 markers were selected based on pathways implicated in pathophysiology of IBS or whole human genome screening. Psychological measures were recorded that covered anxiety, depression and somatisation. Models differentiating disease and health were based on unconditional logistic regression and performance assessed through area under the receiver-operator characteristic curve (AUC), sensitivity and specificity. RESULTS: The performance of a combination of 34 markers was good in differentiating IBS from health (AUC = 0.81) and was improved considerably with the addition of four psychological markers (combined AUC = 0.93). Of the 34 markers considered, discrimination was derived largely from a small subset. Good discrimination was also obtained between IBS subtypes with the best being observed for IBS-C vs. IBS-D (AUC = 0.92); however, psychological variables provided almost no incremental discrimination subtypes over biological markers (combined AUC = 0.94). CONCLUSIONS: A combination of gene expression and serological markers in combination with psychological measures shows exciting progress towards a diagnostic test for IBS compared with healthy subjects, and to discriminate IBS-C from IBS-D.

21 Article In-patient discharge rates for the irritable bowel syndrome - an analysis of national trends in the United States from 1997 to 2010. 2013

Sethi, S / Wadhwa, V / LeClair, J / Mikami, S / Park, R / Jones, M / Sethi, N / Brown, A / Lembo, A. ·Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA. ·Aliment Pharmacol Ther · Pubmed #24206371.

ABSTRACT: BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common out-patient diagnoses in primary care and gastroenterology. There are limited data on the rate and costs associated with in-patient discharges for IBS. AIM: To estimate the incidence and costs of hospital discharges for IBS in the United States. METHODS: We analysed the National Inpatient Sample database for all subjects in which IBS (ICD-9 code: 564.1) was the principal discharge diagnosis from 1997 to 2010. The National Inpatient Sample contains data from approximately 8 million hospital stays each year. Our findings reflected patient and hospital characteristics like geographical region and bed size. RESULTS: In 1997, there were 11 433 patients with a principal discharge diagnosis of IBS as compared to 12 842 in 2010 (P > 0.9, GoF test). The mean length of stay for IBS also remained the same between 1997 and 2010 at 3.7 ± 0.1 days. However, during this period, the mean hospital charges per hospitalization increased by 207.8% from $6873 ± 198 in 1997 to $21 153 ± 598 in 2010 (P < 0.01). The aggregate charges (i.e., 'national bill') for IBS increased by 245.5% from $78 524 129 ± 3 781 316 in 1997 to $271 311 405 ± 14 023 289 in 2010 (P < 0.01). CONCLUSIONS: The number of in-patient discharges and length of stay for IBS have remained relatively stable between 1997 and 2010, whereas the cost associated with these discharges has increased significantly. In-patient costs associated with IBS contribute significantly to the total healthcare bill. Further research on the cost-effectiveness of diagnostic procedures and therapies in IBS is required.

22 Article Stool characteristics and colonic transit in irritable bowel syndrome: evaluation at two time points. 2013

Shim, Lisa / Talley, Nicholas J / Boyce, Philip / Tennant, Chris / Jones, Mike / Kellow, John E. ·Department of Gastroenterology, Royal North Shore Hospital, University of Sydney, NSW, Australia. ·Scand J Gastroenterol · Pubmed #23320464.

ABSTRACT: OBJECTIVE: Information on the relationships between stool characteristics and colonic transit time (CTT) in irritable bowel syndrome (IBS) is limited. Our aims were: (i) to relate stool frequency and consistency to total and segmental CTTs, (ii) to correlate changes in these stool characteristics with changes in CTTs between a baseline assessment and a 12-week assessment, and (iii) to examine the confounding effects of mood on these relationships, in patients with IBS. MATERIALS AND METHODS: Twenty-one female patients with IBS underwent, on two occasions 12 weeks apart, a colonic transit study and completed at these times Bristol Stool Form Scale (BSFS) and Bowel Symptoms Severity Rating Scale (BSSRS). All patients also completed the Hospital Anxiety and Depression scale. RESULTS: Between baseline and the 12-week assessment, an increase in the number of days over the past week without a bowel motion correlated with prolonged total CTT (r = 0.54, p = 0.01). An increase in the number of days with more than three bowel motions per day correlated with a shorter right CTT (r = -0.52, p = 0.02). Only after adjusting for anxiety and depression, did an increase in loose or watery bowel motions (for BSSRS but not for BSFS) correlate with a shorter right CTT (r = -0.47, p = 0.03). CONCLUSIONS: Stool frequency, as well as stool consistency, correlates with CTT. Correlations between stool consistency and CTT are more robust for BSSRS than for BSFS. An effect of mood appears to be important in the relationship between stool consistency and CTT.

23 Article The brain--gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. 2012

Koloski, N A / Jones, M / Kalantar, J / Weltman, M / Zaguirre, J / Talley, N J. ·Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia. nicholas.talley@newcastle.edu.au ·Gut · Pubmed #22234979.

ABSTRACT: OBJECTIVE: Psychological factors are known to be associated with functional gastrointestinal disorders (FGIDs) including irritable bowel syndrome (IBS) and functional dyspepsia (FD). No prospective studies have evaluated whether it is the brain (eg, via anxiety) that drives gut symptoms, or whether gut dysfunction precipitates the central nervous system features such as anxiety. In a 12-year longitudinal, prospective, population-based study, we aimed to determine the directionality of the brain-gut mechanism in FGIDs. DESIGN: Participants (n=1775) were a random population sample from Australia who responded to a survey on FGIDs in 1997 and agreed to be contacted for future research; 1002 completed the 12-year follow-up survey (response rate =60%), with 217, 82 and 45 people meeting Rome II for new onset FGIDs, IBS and FD, respectively. Anxiety and depression were measured using the Delusions Symptom States Inventory at baseline and follow-up. RESULTS: Among people free of a FGID at baseline, higher levels of anxiety (OR 1.11; 95% CI 1.03 to 1.19, p=0.006) but not depression at baseline was a significant independent predictor of developing new onset FGIDs 12 years later. Among people who did not have elevated levels of anxiety and depression at baseline, those with a FGID at baseline had significantly higher levels of anxiety and depression at follow-up (mean difference coefficient 0.76, p<0.001 and 0.30, p=0.01 for anxiety and depression, respectively). In IBS higher levels of anxiety and depression at baseline were predictive of IBS at follow-up, while only depression was predictive of FD at follow-up. CONCLUSIONS: The central nervous system and gut interact bidirectionally in FGIDs.

24 Article What level of IBS symptoms drives impairment in health-related quality of life in community subjects with irritable bowel syndrome? Are current IBS symptom thresholds clinically meaningful? 2012

Koloski, Natasha A / Boyce, Philip M / Jones, Michael P / Talley, Nicholas J. ·Faculty of Health, University of Newcastle, Callaghan, New South Wales 2308, Australia. Natasha.Koloski@newcastle.edu.au ·Qual Life Res · Pubmed #21833813.

ABSTRACT: BACKGROUND: Quality of life is impaired in some people with IBS, but the level of symptoms that may drive this impairment is unclear. AIMS: We aimed to identify whether current frequency and severity cut-offs for IBS-type symptoms are associated with a clinically meaningful impairment of quality of life in the community. METHODS: People who met modified Rome III criteria for IBS (n = 201) and controls (n = 1,904) were assessed. Frequency of IBS symptoms was grouped a priori into 'less frequent' (not at all and sometimes) and 'more' frequent (often, very often and almost always). Severity of abdominal pain was grouped into 'mild' (very mild and mild) and severe (moderate, severe and very severe). Mental and physical functioning was measured using the valid SF-12, with 'normal' functioning (defined as a score of >43 and >48) and 'impaired' functioning (defined as a score of ≤43 and ≤48), respectively. Psychological variables were assessed via valid self-report. RESULTS: Having 'more' versus 'less' severe abdominal pain (OR = 9.41; 95% CI 1.17-75.43, P = 0.03) and 'more' versus 'less' frequent diarrhoea (OR = 2.19; 95% CI 1.13-4.26, P = 0.02) along with increasing age (OR = 1.03; 95% CI 1.01-1.05, P = 0.003) were significant independent predictors of having impairment in physical functioning. In terms of psychological factors, having higher levels of depression (OR = 1.61; 95% CI 1.36-1.91) and somatic distress (OR = 1.17; 95% CI 1.09-1.27) were independently associated with mental and physical impairment, respectively. CONCLUSION: The current frequency and severity threshold cut-offs for IBS symptoms in the Rome III criteria are associated with a clinically meaningful impairment of quality of life in community subjects with IBS.

25 Article Perceptions of illness stigma in patients with inflammatory bowel disease and irritable bowel syndrome. 2011

Taft, Tiffany H / Keefer, Laurie / Artz, Caroline / Bratten, Jason / Jones, Michael P. ·Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair Street, #1400, Chicago, IL 60611, USA. ttaft@northwestern.edu ·Qual Life Res · Pubmed #21424542.

ABSTRACT: PURPOSE: To compare the experiences of perceived stigma (PS) in both patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) and examine its relationship to patient-reported outcomes in both patient populations. METHODS: IBD and IBS patients were recruited from an outpatient gastroenterology clinic and online via support message boards and classifieds. Participants completed a series of questionnaires to measure the perception of illness stigma, psychological functioning, and clinical and demographic data. RESULTS: Two hundred and sixty-nine IBS and 227 IBD patients participated. IBS patients were more likely to report high levels of perceived stigma across a wider range of sources, with the largest difference being for health care providers. Twenty-seven percent of IBS patients reported moderate to high levels of perceived stigma, compared with 8% of IBD. While perception of stigma was correlated with poorer patient-reported outcomes in both patient groups, correlations were larger for IBD compared with IBS. CONCLUSIONS: This study demonstrates that both IBD and IBS patients perceive stigma about their illness. As demonstrated by increased depression and anxiety, decreased self-esteem and self-efficacy, and lower quality of life in both patient groups, PS was shown to have a negative impact on clinical outcomes.

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