In the Journals

Abdominal pain differs between IBS subtypes

The presentation and characteristics of abdominal pain are not the same among the different subtypes of irritable bowel syndrome, according to study results.

Eric D. Shah, MD, MBA, from the section of gastroenterology and hepatology at Dartmouth-Hitchcock Medical Center, and colleagues wrote that it is currently unknown if diarrhea- and constipation-predominant IBS carry different burdens of abdominal pain or if they just represent different bowel symptoms.

“Differences in intestinal permeability, mucosal immune activation and the gut microbiota between IBS-D and IBS-C contribute to the growing evidence underlying the importance of maintaining the distinction between IBS subtypes and support that the distinction between the subtypes likely involves much more than just the underlying bowel habit,” they wrote. “Just as bowel symptoms are managed differently between patients with IBS-D or IBS-C, it would thus be important to understand whether abdominal pain also manifests differently by subtype because this may lead to important and specific treatment targets for IBS-D and IBD-C abdominal pain.”

Patients who met modified Rome III criteria for IBS and reported abdominal pain in the previous 7 days were eligible for the study. Patients completed the NIH GI Patient-Reported Outcomes Measurement Information System (GI-PROMIS) questionnaires (n = 1,158). Researchers stratified outcomes, including abdominal pain severity, frequency and location, by IBS subtype (IBS-C, IBS-D and mixed).

Compared with patients with IBS-C, patients with IBS-D had lower GI-PROMIS scores (percentile scores, 75.5% vs. 68.6%; P = .001), as did patients with IBS-M (69.1%; P < .001).

Patients with IBS-C reported that abdominal pain was more bothersome (P = .001), caused more interference with daily activities (P = .03) and was more frequent (P = .047) than patients with IBS-D.

Additionally, patients with IBS-C and IBS-M reported more widespread pain compared with patients with IBS-D.

“Our findings support the Rome IV framework of subtyping IBS based on the predominant bowel habit, but add that more effort is needed to understand and address abdominal symptoms specific to each subtype,” Shah and colleagues wrote. – by Alex Young

Disclosures: Shah reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

The presentation and characteristics of abdominal pain are not the same among the different subtypes of irritable bowel syndrome, according to study results.

Eric D. Shah, MD, MBA, from the section of gastroenterology and hepatology at Dartmouth-Hitchcock Medical Center, and colleagues wrote that it is currently unknown if diarrhea- and constipation-predominant IBS carry different burdens of abdominal pain or if they just represent different bowel symptoms.

“Differences in intestinal permeability, mucosal immune activation and the gut microbiota between IBS-D and IBS-C contribute to the growing evidence underlying the importance of maintaining the distinction between IBS subtypes and support that the distinction between the subtypes likely involves much more than just the underlying bowel habit,” they wrote. “Just as bowel symptoms are managed differently between patients with IBS-D or IBS-C, it would thus be important to understand whether abdominal pain also manifests differently by subtype because this may lead to important and specific treatment targets for IBS-D and IBD-C abdominal pain.”

Patients who met modified Rome III criteria for IBS and reported abdominal pain in the previous 7 days were eligible for the study. Patients completed the NIH GI Patient-Reported Outcomes Measurement Information System (GI-PROMIS) questionnaires (n = 1,158). Researchers stratified outcomes, including abdominal pain severity, frequency and location, by IBS subtype (IBS-C, IBS-D and mixed).

Compared with patients with IBS-C, patients with IBS-D had lower GI-PROMIS scores (percentile scores, 75.5% vs. 68.6%; P = .001), as did patients with IBS-M (69.1%; P < .001).

Patients with IBS-C reported that abdominal pain was more bothersome (P = .001), caused more interference with daily activities (P = .03) and was more frequent (P = .047) than patients with IBS-D.

Additionally, patients with IBS-C and IBS-M reported more widespread pain compared with patients with IBS-D.

“Our findings support the Rome IV framework of subtyping IBS based on the predominant bowel habit, but add that more effort is needed to understand and address abdominal symptoms specific to each subtype,” Shah and colleagues wrote. – by Alex Young

Disclosures: Shah reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.