Black, CJ, Yiannakou, Y, Guthrie, E orcid.org/0000-0002-5834-6616 et al. (3 more authors) (2021) Longitudinal follow-up of a novel classification system for irritable bowel syndrome: natural history and prognostic value. Alimentary Pharmacology and Therapeutics, 53 (10). pp. 1126-1137. ISSN 0269-2813
Abstract
Background
Conventionally, irritable bowel syndrome (IBS) is subgrouped using predominant stool form, yet it is a complex disorder, with multiple biopsychosocial contributors. We previously derived and validated a latent class model subgrouping people with IBS into seven clusters based on gastrointestinal and extraintestinal symptoms and psychological profile.
Aims
To conduct longitudinal follow‐up examining the natural history and prognostic value of these clusters.
Methods
Participants completed a 12‐month follow‐up questionnaire. We applied our model to these data, comparing cluster membership between the two time points in those still meeting Rome IV criteria at follow‐up, including stratifying the analysis by predominant stool pattern, and level of psychological burden, at baseline. We examined whether baseline cluster predicted the course of IBS, and whether starting new treatment was associated with changing cluster.
Results
Eight hundred and eleven participants met Rome IV criteria for IBS at baseline, of whom 452 (55.7%) responded, and 319 (70.6%) still met Rome IV criteria for IBS at follow‐up. Of these, 172 (53.9%) remained in the same IBS cluster as at baseline and 147 changed cluster. Cluster membership stratified according to psychological comorbidity was more stable; 84% of those in a cluster with high psychological burden at baseline remained in such a cluster at follow‐up. People in clusters with high psychological burden at baseline had more severe symptoms (P < 0.001), received a higher mean number of subsequent treatments (P < 0.001), and were more likely to consult a doctor than people in clusters with low psychological burden (P < 0.001). There was no significant association between starting a new treatment and changing cluster at follow‐up.
Conclusions
Longitudinal follow‐up demonstrated little transition between clusters with respect to psychological burden, and these appeared to predict disease course. Directing treatment according to cluster, including earlier use of psychological therapies, and exploring how this approach influences outcomes in IBS, should be examined.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Black, CJ, Yiannakou, Y, Guthrie, E et al. (3 more authors) (2021) Longitudinal follow-up of a novel classification system for irritable bowel syndrome: natural history and prognostic value. Alimentary Pharmacology and Therapeutics, 53 (10). pp. 1126-1137. ISSN 0269-2813, which has been published in final form at https://doi.org/10.1111/apt.16322. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Centre for Health Services Research (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 07 May 2021 12:18 |
Last Modified: | 11 Mar 2022 01:38 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/apt.16322 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:173608 |