1
|
Cheng K, Lee C, Garniene R, Cabral H, Weber HC. Epidemiology of Irritable Bowel Syndrome in a Large Academic Safety-Net Hospital. J Clin Med 2024; 13:1314. [PMID: 38592187 PMCID: PMC10932219 DOI: 10.3390/jcm13051314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/11/2024] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut-brain interaction (DGBI) that is known to reduce the quality of life and raise healthcare costs. The aim of this study was to describe the epidemiology of IBS in a large multiracial academic safety-net hospital. (2) Methods: An electronic query was performed using ICD-9 codes to identify 740 IBS outpatients seen at the Boston Medical Center (BMC) between 1 January 2005 and 30 September 2007. Demographic data were collected from electronic medical records. Bivariate analyses using chi-square tests and ANOVA were used to calculate the significance of categorical and continuous dependent variables, respectively. (3) Results: Compared with the general BMC outpatient population, the IBS cohort consisted of significantly higher proportions of White and Asian patients and lower proportions of Black and Hispanic patients (p < 0.0001). White and Asian patients predominantly had private insurance, while Black and Hispanic patients mostly had government/state-funded or no insurance (p < 0.0001). The IBS subgroup frequencies were similar across racial groups; however, Hispanic patients had IBS with constipation (32%, p < 0.02) more often compared to non-Hispanic patients. (4) Conclusions: Significant differences were found across the racial groups studied in this large outpatient IBS cohort. These findings are likely attributed to racial and socioeconomic disparities in healthcare access and utilization.
Collapse
Affiliation(s)
- Kathleen Cheng
- Department of Medicine, Boston Medical Center, Boston, MA 02118, USA
| | - Christina Lee
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02118, USA
| | | | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Horst Christian Weber
- Department of Medicine, Boston Medical Center, Boston, MA 02118, USA
- Section of Gastroenterology, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA
| |
Collapse
|
2
|
Im EO, Choi MY, Jin R, Kim G, Chee W. Cluster Analysis on Gastrointestinal Symptoms during Menopausal Transition. West J Nurs Res 2023; 45:133-143. [PMID: 35801285 DOI: 10.1177/01939459221109810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of this secondary analysis was to determine the clusters of midlife women by gastrointestinal (GI) symptoms and to explore differences in the clusters by race/ethnicity. This analysis used the data from two internet-based studies among 1,054 midlife women. The analysis was conducted with the data on background characteristics, health and menopausal status, and GI symptoms (collected using the GI Symptom Index for Midlife Women). The data were analyzed using factor analyses, hierarchical cluster analyses, chi-square tests, multinomial logistic regression analyses, and analyses of covariance. Three clusters were adopted: Cluster 1 (with low total numbers and severity scores of symptoms; 46.0%), Cluster 2 (with moderate total numbers and severity scores of symptoms; 44.0%), and Cluster 3 (with high total numbers and severity scores of symptoms; 10.0%). Only in Cluster 2, there were significant racial/ethnic differences in individual GI symptoms. These results provide directions for future GI symptom management among midlife women.
Collapse
Affiliation(s)
- Eun-Ok Im
- School of Nursing, Emory University, Atlanta, GA, USA
| | - Mi-Young Choi
- School of Nursing, Emory University, Atlanta, GA, USA.,Department of Nursing Science, Chungbuk National University, Cheongju, South Korea
| | - Ruiqi Jin
- School of Nursing, Emory University, Atlanta, GA, USA
| | - Gayeong Kim
- School of Nursing, Emory University, Atlanta, GA, USA
| | - Wonshik Chee
- School of Nursing, Emory University, Atlanta, GA, USA
| |
Collapse
|
3
|
Sugaya N, Tomita Y, Funaba M, Iida H, Shirotsuki K, Gardner FC, Odawara T, Ando T, Inamori M. Validity and reliability of the Japanese versions of cognitive and behavioral scales for irritable bowel syndrome. Biopsychosoc Med 2022; 16:15. [PMID: 35871011 PMCID: PMC9308329 DOI: 10.1186/s13030-022-00244-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/24/2022] [Indexed: 12/02/2022] Open
Abstract
Background The Cognitive Scale for Functional Bowel Disorders (CS-FBD) and Irritable Bowel Syndrome-Behavioral Responses Questionnaire (IBS-BRQ) are a useful measures to assess cognitive-behavioral aspects in individuals with IBS. This study aimed to confirm the reliability and validity of the Japanese versions of the CS-FBD (CS-FBD-J) and IBS-BRQ (IBS-BRQ-J). Methods Participants comprised 192 students and 22 outpatients diagnosed with irritable bowel syndrome (IBS). There were 76 students who met the diagnostic criteria for IBS and two students who received treatment for IBS. Participants completed questionnaires containing the CS-FBD-J, IBS Severity Index (IBS-SI), Visceral Sensitivity Index (VSI), 24-item Dysfunctional Attitudes Scale (DAS-24), Hospital Anxiety and Depression Scale (HADS), and Social Adaptation Self-evaluation Scale (SASS). Results Our exploratory factor analysis revealed that the CS-FBD-J had a unidimensional factor structure and that the factor loadings for two of the 25 items were less than 0.4. The IBS-BRQ-J had a two-factor structure, and the factor loadings for eight of the 26 items were less than 0.4. The confirmatory factor analysis for the 18-item version of IBS-BRQ-J showed that the model fit indices were not sufficient. The CS-FBD-J and IBS-BRQ-J had significant, moderate correlations with the IBS-SI and VSI in the IBS and control groups. Correlation between the DAS-24 and the CS-FBD-J was not significant. The CS-FBD-J and IBS-BRQ-J were significantly correlated to the HADS and SASS (IBS-BRQ-J) only in the IBS group. The scores of CS-FBD-J and IBS-BRQ-J showed significant group differences between the IBS patient group, non-patient IBS group, and control group. The internal consistencies of the CS-FBD-J and IBS-BRQ-J were high. The item-total correlation analysis for the CS-FBD-J and IBS-BRQ-J showed that the correlations between each item and the total score were significant. Conclusion This study confirmed the reliability and validity of the 23-item version of the CS-FBS-J and the 18-item version of the IBS-BRQ-J with the deletion of items with low factor loadings. Regarding the IBS-BRQ-J, two factor structures were confirmed (factor 1: behavior obsessed with abdominal symptoms, factor 2: avoidance of abdominal symptoms and associated difficulties) although the model fit of the structure needs further study. Supplementary Information The online version contains supplementary material available at 10.1186/s13030-022-00244-3.
Collapse
|
4
|
Wieland ML, Grover M. Inclusive Clinical Trials for Disorders of Gut-Brain Interactions. Gastroenterology 2022; 163:583-585. [PMID: 35780870 DOI: 10.1053/j.gastro.2022.06.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota.
| | - Madhusudan Grover
- Division of Gastroenterology and Hepatology, Enteric Neuroscience Program, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
5
|
Immigration transition and gastrointestinal symptoms during menopausal transition: midlife women in the US. Menopause 2022; 29:840-849. [DOI: 10.1097/gme.0000000000001989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
6
|
Delivery Methods of Cognitive Behavior Therapy for Patients With Irritable Bowel Syndrome. Gastroenterol Nurs 2022; 45:149-158. [PMID: 35561102 DOI: 10.1097/sga.0000000000000671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/12/2021] [Indexed: 11/26/2022] Open
Abstract
Irritable bowel syndrome (IBS) is the most commonly diagnosed gastrointestinal disorder and negatively impacts individuals' quality of life. Cognitive behavioral therapy appears effective for reducing symptoms in many irritable bowel syndrome patients. However, the optimal methods to deliver cognitive behavioral therapy and the effective treatment dosage for patients with IBS remain unclear. This article aims to provide an update on cognitive behavioral therapy research in IBS, particularly considering the dose of treatment, route of delivery (in-person vs. web- and telephone-based delivery), and outcome measures. A systematic literature review was conducted using databases of PubMed, CINAHL Complete, and Web of Science from 2008 through 2021. Twelve studies reporting randomized clinical trials comparing cognitive behavioral therapy delivered with in-person, telephone, and web for the management of IBS symptoms among adults with irritable bowel syndrome were found. The dose of treatment varied from 4 to 10 sessions. Six different scales measured various outcomes. No severe adverse reactions to cognitive behavioral therapy were reported. Cognitive behavioral therapy is an effective treatment for IBS symptoms regardless of the dose and the route of treatment. However, it is difficult to compare the effectiveness of these randomized clinical trials due to the various cognitive behavioral therapy protocols, combined routes of therapy delivery, and different outcome measures used.
Collapse
|
7
|
Lenhart A, Naliboff B, Shih W, Gupta A, Tillisch K, Liu C, Mayer EA, Chang L. Postmenopausal women with irritable bowel syndrome (IBS) have more severe symptoms than premenopausal women with IBS. Neurogastroenterol Motil 2020; 32:e13913. [PMID: 32469130 PMCID: PMC7529855 DOI: 10.1111/nmo.13913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/26/2020] [Accepted: 05/11/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although irritable bowel syndrome (IBS) is more common in women, little is known about the role of hormonal changes and menopause in IBS. This study aimed to evaluate for differences in gastrointestinal (GI) and psychological symptoms between pre- and postmenopausal women with IBS compared to age-matched men with IBS. METHODS Patients with Rome-positive IBS were identified. Premenopausal women were <45 years of age with regular menses. Postmenopausal women were ≥45 years without menses for at least 1 year. Younger men were <45 years, and older men were ≥45 years. Questionnaires measured severity of IBS symptoms, somatic symptoms, health-related quality of life (HRQOL), and psychological symptoms. Multivariable linear or logistic regressions evaluating relationships between age and sex were performed. KEY RESULTS 190 premenopausal women (mean age 30.25 years), 52 postmenopausal women (mean age 54.38 years), 190 men <45 years (mean age 30.45 years), and 52 men ≥45 years (mean age 53.37 years) were included. Postmenopausal IBS women had greater severity of IBS symptoms (P = .003) and worse physical HRQOL (P = .048) compared to premenopausal women. No differences were observed between age-matched older and younger IBS men. Constipation increased with age for both sexes but was the principal IBS subtype in women only. CONCLUSIONS AND INFERENCES Postmenopausal women with IBS have more severe IBS symptoms than premenopausal women, while no comparable age-related changes were seen in IBS men. The modulatory effect of female sex hormones on brain-gut interactions which affect visceral perception and GI function likely contributes to these findings.
Collapse
Affiliation(s)
- Adrienne Lenhart
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
| | - Bruce Naliboff
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Wendy Shih
- Semel Institute for Neuroscience and Human Behavior,
University of California, Los Angeles, CA, USA
| | - Arpana Gupta
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Kirsten Tillisch
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Cathy Liu
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Emeran A. Mayer
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Lin Chang
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| |
Collapse
|