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- Josefsson, Axel, 1984, et al.
(author)
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Visceral sensitivity remains stable over time in patients with irritable bowel syndrome, but with individual fluctuations
- 2019
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In: Neurogastroenterology and Motility. - : Wiley. - 1350-1925 .- 1365-2982. ; 31:7
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Journal article (peer-reviewed)abstract
- Background: Visceral hypersensitivity in irritable bowel syndrome (IBS), measured with rectal balloon distensions, using a barostat, has been suggested to be a phenomenon that is reduced due to habituation at repeated investigations. We investigated the stability of rectal sensitivity in patients with IBS who had undergone a previous rectal barostat study and assessed variations in symptom pattern and severity in relation to rectal sensory function. Method: Irritable bowel syndrome patients, who had previously been undergone a rectal barostat study, were included. All patients underwent a second study 8-12years later. Symptoms were characterized by use of questionnaires. Key Results: We included 26 subjects (17 females, median age at the index investigation 44.5 (21-61) years). Pressure and volume sensory thresholds were unchanged at the follow-up compared with the index investigation (P>0.05 for all). At the index investigation, 8/26 patients had rectal hypersensitivity of which four were reclassified as normosensitive, and sixfrom normo- to hypersensitive, meaning that 10/26 patients were hypersensitive at the follow-up investigation. IBS-QOL had improved significantly in six of nine domainsat follow-up (P<0.05 for all). There were no differences in anxiety, depression, IBS symptom severity, or somatization (P>0.05) at follow-up. None of these were associated with change in rectal sensitivity at follow-up. Conclusions and Inferences: Rectal hypersensitivity and IBS symptoms remained stable at the group level over 8-12years in IBS patients, even though individual fluctuations were noted. Our findings contradict previous findings indicating that visceral hypersensitivity is an unstable trait. © 2019 John Wiley & Sons Ltd
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| 3. |
- Lindfors, Perjohan, et al.
(author)
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Online Education Is Non-Inferior to Group Education for Irritable Bowel Syndrome: A Randomized Trial and Patient Preference Trial
- 2021
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In: Clinical Gastroenterology and Hepatology. - : Elsevier BV. - 1542-3565. ; 19:4, s. 743-
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Journal article (peer-reviewed)abstract
- Background & Aims: Structured education can reduce symptoms in patients with irritable bowel syndrome (IBS), but the availability of such interventions is limited and online formats could facilitate their dissemination. We compared the effectiveness of Internet-delivered vs face-to-face education in patients with IBS, hypothesizing that the online format would not be inferior. Methods: We conducted 2 trials of Internet-delivered vs face-to-face group education (3 weeks) at a gastroenterology outpatient clinic in Sweden. In the first trial, 141 patients with IBS were assigned randomly (1:1) to either Internet-delivered or face-to-face education, from August 2016 through June 2017. In the second trial, 155 patients with IBS were allowed to choose whether to receive education via the Internet or face to face, from August 2017 through September 2018. Patients completed questionnaires before, during, and after education. The primary outcome measure was the irritable bowel syndrome severity scoring system, which measures IBS severity on a scale from 0 to 500, based on abdominal pain, bloating, dissatisfaction with bowel habits, and interference with life. The primary test of noninferiority adhered to the intent-to-treat principle and concerned the difference in change up to 6 months after education, tested using the 1-sided CI for the time by group interaction in a linear mixed model fitted on data from the randomized controlled trial. A secondary per-protocol analysis used data from all treatment completers in both trials. The noninferiority margin was 40 points on the irritable bowel syndrome severity scoring system. Results: In the primary analysis, patients who received face-to-face education had an average reduction in irritable bowel syndrome severity score that was 12.2 points more than that of patients who received Internet education (1-sided 95% CI upper bound, 38.4). In the per-protocol analysis, patients who received face-to-face education reduced their average irritable bowel syndrome severity score by 14.7 points more than patients who received Internet education (95% CI upper bound, 35.5). Face-to-face education had significantly higher credibility and produced a significantly larger increase in self-rated knowledge, although most patients preferred Internet-delivered education. Between-group effects on secondary symptoms were small. Conclusions: Based on the comparison of Internet-delivered vs face-to-face education for IBS, the upper bound of the CI for the difference in change up to 6 months after education was within the noninferiority margin of 40 points. We therefore conclude that Internet-delivered education is noninferior to face-to-face education. Future research should focus on increasing within-group effects. ClinicalTrials.gov no: NCT03466281. © 2020 AGA Institute
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| 4. |
- Ringström, Gisela, 1964, et al.
(author)
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What do patients with irritable bowel syndrome know about their disorder and how do they use their knowledge?
- 2009
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In: Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates. - 1538-9766. ; 32:4, s. 284-92
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Journal article (peer-reviewed)abstract
- Irritable bowel syndrome (IBS) is a common disorder for which many patients experience a lack of information. By using a questionnaire, we aimed to explore how much knowledge these patients have, and what they find important to receive information and explanation about. Eighty-six subjects with IBS diagnosed in primary care and referred to a gastroenterologist completed the questionnaire before meeting the gastroenterologist. Approximately 80% had knowledge about IBS, although 55% stated that their knowledge was "just vague." According to visual analogue scale measurement, knowledge as well as satisfaction with knowledge was poor. Most patients had correct knowledge about IBS. Only 15% considered themselves to be thoroughly informed, and 24% stated that they had not received any information at all. The most important issue they wanted information about was what to do to improve symptoms. Many IBS patients seem to have correct knowledge about IBS; however, they do not consider themselves to have that knowledge, and therefore probably do not feel confident in using their knowledge. Encouraging and supporting patients with IBS could contribute to an increased ability to use their knowledge in a more appropriate way.
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| 6. |
- Öhman, Lena, 1967, et al.
(author)
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Altered levels of fecal chromogranins and secretogranins in IBS: relevance for pathophysiology and symptoms?
- 2012
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In: The American journal of gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 1572-0241 .- 0002-9270. ; 107:3, s. 440-7
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Journal article (peer-reviewed)abstract
- Chromogranins (Cg) and secretogranins (Sg) are proteins ubiquitous in secretory cells of the enteric, endocrine, and immune systems, and may reflect activity of these systems. We therefore performed a hypothesis generating study to evaluate the association between fecal levels of CgA, CgB, SgII, and SgIII, with the clinical and pathophysiological phenotype of irritable bowel syndrome (IBS) patients.
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