Slattery, SA, Niaz, O, Aziz, Q et al. (2 more authors) (2015) Systematic review with meta-analysis: The prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea. Alimentary Pharmacology and Therapeutics, 42 (1). pp. 3-11. ISSN 0269-2813
Abstract
Background: Irritable bowel syndrome is a widespread disorder with a marked socioeconomic burden. Previous studies support the proposal that a subset of patients with features compatible with diarrhoea-predominant IBS (IBS-D) have bile acid malabsorption (BAM). Aims: To perform a systematic review and meta-analysis to assess the prevalence of BAM in patients meeting the accepted criteria for IBS-D. Methods: MEDLINE and EMBASE were searched up to March 2015. Studies recruiting adults with IBS-D, defined by the Manning, Kruis, Rome I, II or III criteria and which used 23-seleno-25-homotaurocholic acid (SeHCAT) testing for the assessment of BAM were included. BAM was defined as 7 day SeHCAT retention of <10%. We calculated the rate of BAM and 95% confidence intervals (CI) using a random effects model. The methodological quality of included studies was evaluated using the Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2). Results: The search strategy identified six relevant studies comprising 908 individuals. The rate of BAM ranged from 16.9% to 35.3%. The pooled rate was 28.1% (95% CI: 22.6-34%). There was significant heterogeneity in effect sizes (Q-test χ<sup>2</sup> = 17.9, P < 0.004; I<sup>2</sup> = 72.1%). The type of diagnostic criteria used or study country did not significantly modify the effect. Conclusions: These data provide evidence that in excess of one quarter of patients meeting accepted criteria for IBS-D have bile acid malabsorption. This distinction has implications for the interpretation of previous studies, as well as contemporaneous clinical practice and future guideline development.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This is the peer reviewed version of the following article: Slattery, SA, Niaz, O, Aziz, Q, Ford, AC and Farmer, AD (2015) Systematic review with meta-analysis: The prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea. Alimentary Pharmacology and Therapeutics. ISSN 0269-2813 (In Press) , which has been published in final form at http://dx.doi.org/10.1111/apt.13227. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Molecular Gastroenterology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 19 May 2015 12:59 |
Last Modified: | 29 Apr 2016 07:10 |
Published Version: | http://dx.doi.org/10.1111/apt.13227 |
Status: | Published |
Publisher: | Blackwell Publishing Ltd |
Refereed: | Yes |
Identification Number: | 10.1111/apt.13227 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:86190 |