Prevalence, clinical characteristics, and management of irritable bowel syndrome in Vietnam: A scoping review

Anxiety and Depression Disorders in Vietnamese Patients With Irritable Bowel Syndrome: A Cross-Sectional Clinic-Based Study

Background

Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder. Growing evidence suggests a significant association between IBS and psychological problems, such as anxiety and depression. This study was conducted to assess the prevalence of anxiety and depression in Vietnamese patients diagnosed with IBS according to Rome IV criteria.

Methods

This cross-sectional study recruited 186 consecutive patients who underwent outpatient clinic visits and colonoscopy for gastrointestinal symptoms. IBS diagnosis was established using the validated Rome IV criteria. Anxiety and depression were assessed using a validated Vietnamese version of the Hospital Anxiety and Depression Scale (HADS).

Results

The mean age of IBS patients was 49.5 ± 12.0 years, with females comprising 53.8%. IBS-M was the most prevalent subtype (39.8%), followed by IBS-C (39.2%) and IBS-D (21.0%). Using the HADS cut-off of ≥ 11 points for probable anxiety and depression, the prevalence was 21.0% and 11.8%, respectively. Expanding the criterion to a HADS of ≥ 8, indicating significant symptoms, increased the prevalence to 55.9% for anxiety and 40.8% for depression disorders. Patients with IBS-C, IBS-D, or IBS-M exhibited a significantly higher risk of depressive disorders compared to those without IBS, with odds ratios of 4.261, 7.013, and 6.585, respectively (p < 0.001). Additionally, men were less likely than women to experience depressive disorders.

Conclusion

The findings revealed a high prevalence of depression and anxiety disorders among Vietnamese patients with IBS. Those with the IBS-M or IBS-D subtypes and a greater number of gastrointestinal symptoms were more likely to experience higher levels of depression and anxiety, particularly women.

Role of Calprotectin, IL-6, and CRP in Distinguishing Between Inflammatory Bowel Disease and Diarrhea Predominant Irritable Bowel Syndrome

Background

The early establishment of prophylaxis and immediate administration of anticoagulant therapy upon the diagnosis of venous thromboembolism should be the treatment objectives in these patients.

Objective

The study aimed to determine the optimal cut-off point of Calprotectin, IL-6 (interleukin-6), CRP (C reactive protein) to differentiate UC, IBS-D.

Methods

A cross-sectional descriptive study of 335 individuals ≥15 years old was performed, including 31 healthy controls, 215 with IBS-D, 71 diagnosed with UC, and 18 diagnosed with CD. Receiver Operating Characteristics (ROC), sensitivity, specificity, and area under curve (AUC) were computed.

Results

The results showed that the median value of calprotectin (IQR) in healthy participants was 20.0 (6.0 - 34.0) µg/g; 17,7 (8,7-38,9) µg/g in IBS-D group; 1710.0 (588 - 4260,0) µg/g in UC group; and 560.5 (177.8 - 1210.0) µg/g in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of CRP (range IQR) was 1,3 (0,9 - 2,3) mg/L in IBS-D group; 7.0 (2.4 -16.6) mg/L in UC group; and 10.1 (2.2 - 42.5) mg/L in CD group. CRP concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of IL-6 (range IQR) was 2.3 (1.6 - 5.7) pg/mL in IBS-D group; 16.8 (9.4 - 47.0) pg/mL in UC group; and 9.4 (7.9 - 11.0) pg/mL in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The optimal cut-off point of calprotectin that differentiated IBS-D from IBD was 110.5 µg/g, with sensitivity and specificity of 93.3% and 91.4%, respectively; of IL-6 was 7.2 pg/mL with sensitivity and specificity of 92.0% and 78.0%, respectively; of CRP of 2.4 mg/L had specific sensitivities of 83.3% and 86.0%, respectively.

Conclusion

The Calprotectin immunoassay has the best value in discriminating between IBD and IBS-D.