Inaccuracy of patient-reported descriptions of and satisfaction with bowel actions in irritable bowel syndrome

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Background: Perception of diarrhea and constipation differs greatly. This study aimed to correlate subjective and objective assessment of fecal characteristics in irritable bowel syndrome (IBS) patients. Methods: Data from two interventional dietary trials with varying FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) or gluten content were interrogated. Subjects rated their dissatisfaction with stool consistency daily using a visual analog scale during the interventions. Subjects collected stools at the end of each intervention. Each stool was scored according to the King's Stool Chart (KSC). Fecal water content (FWC) was measured on pooled feces by freeze drying, with diarrhea defined as ≥78%. Key Results: Seventy IBS (Rome III) and eight healthy subjects were studied. Each subject's self-rating of stool consistency during the most symptomatic diet was approximately double that of their least. Degree of dissatisfaction with stool consistency correlated poorly with changes in FWC and KSC. IBS subtype related poorly to objective measures of stool consistency. Sixty percent of IBS-D subjects had diarrhea on objective measures. Eighty-five percent with IBS-C had hard and formed stools but three patients met the criteria for diarrhea. One healthy subject had diarrhea on FWC and KSC, and six had hard, formed stools. No differences in FWC was observed when subjects consumed differing amounts of FODMAPs or gluten (all P >.200). Conclusions and Inferences: There are major disparities between patients’ stool descriptions and objective features of constipation and diarrhea. Patient-reported bowel habits require more interrogation for accurate IBS subtyping. Varying FODMAP or gluten content of the diet is not associated with consistent change in FWC.

Original languageEnglish
Article numbere13187
Number of pages8
JournalNeurogastroenterology and Motility
Volume30
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Keywords

  • constipation
  • diarrhea
  • fecal water content
  • stool chart

Cite this

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title = "Inaccuracy of patient-reported descriptions of and satisfaction with bowel actions in irritable bowel syndrome",
abstract = "Background: Perception of diarrhea and constipation differs greatly. This study aimed to correlate subjective and objective assessment of fecal characteristics in irritable bowel syndrome (IBS) patients. Methods: Data from two interventional dietary trials with varying FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) or gluten content were interrogated. Subjects rated their dissatisfaction with stool consistency daily using a visual analog scale during the interventions. Subjects collected stools at the end of each intervention. Each stool was scored according to the King's Stool Chart (KSC). Fecal water content (FWC) was measured on pooled feces by freeze drying, with diarrhea defined as ≥78{\%}. Key Results: Seventy IBS (Rome III) and eight healthy subjects were studied. Each subject's self-rating of stool consistency during the most symptomatic diet was approximately double that of their least. Degree of dissatisfaction with stool consistency correlated poorly with changes in FWC and KSC. IBS subtype related poorly to objective measures of stool consistency. Sixty percent of IBS-D subjects had diarrhea on objective measures. Eighty-five percent with IBS-C had hard and formed stools but three patients met the criteria for diarrhea. One healthy subject had diarrhea on FWC and KSC, and six had hard, formed stools. No differences in FWC was observed when subjects consumed differing amounts of FODMAPs or gluten (all P >.200). Conclusions and Inferences: There are major disparities between patients’ stool descriptions and objective features of constipation and diarrhea. Patient-reported bowel habits require more interrogation for accurate IBS subtyping. Varying FODMAP or gluten content of the diet is not associated with consistent change in FWC.",
keywords = "constipation, diarrhea, fecal water content, stool chart",
author = "Halmos, {E. P.} and Biesiekierski, {J. R.} and Newnham, {E. D.} and Burgell, {R. E.} and Muir, {J. G.} and Gibson, {P. R.}",
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Inaccuracy of patient-reported descriptions of and satisfaction with bowel actions in irritable bowel syndrome. / Halmos, E. P.; Biesiekierski, J. R.; Newnham, E. D.; Burgell, R. E.; Muir, J. G.; Gibson, P. R.

In: Neurogastroenterology and Motility, Vol. 30, No. 2, e13187, 01.02.2018.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Inaccuracy of patient-reported descriptions of and satisfaction with bowel actions in irritable bowel syndrome

AU - Halmos, E. P.

AU - Biesiekierski, J. R.

AU - Newnham, E. D.

AU - Burgell, R. E.

AU - Muir, J. G.

AU - Gibson, P. R.

PY - 2018/2/1

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N2 - Background: Perception of diarrhea and constipation differs greatly. This study aimed to correlate subjective and objective assessment of fecal characteristics in irritable bowel syndrome (IBS) patients. Methods: Data from two interventional dietary trials with varying FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) or gluten content were interrogated. Subjects rated their dissatisfaction with stool consistency daily using a visual analog scale during the interventions. Subjects collected stools at the end of each intervention. Each stool was scored according to the King's Stool Chart (KSC). Fecal water content (FWC) was measured on pooled feces by freeze drying, with diarrhea defined as ≥78%. Key Results: Seventy IBS (Rome III) and eight healthy subjects were studied. Each subject's self-rating of stool consistency during the most symptomatic diet was approximately double that of their least. Degree of dissatisfaction with stool consistency correlated poorly with changes in FWC and KSC. IBS subtype related poorly to objective measures of stool consistency. Sixty percent of IBS-D subjects had diarrhea on objective measures. Eighty-five percent with IBS-C had hard and formed stools but three patients met the criteria for diarrhea. One healthy subject had diarrhea on FWC and KSC, and six had hard, formed stools. No differences in FWC was observed when subjects consumed differing amounts of FODMAPs or gluten (all P >.200). Conclusions and Inferences: There are major disparities between patients’ stool descriptions and objective features of constipation and diarrhea. Patient-reported bowel habits require more interrogation for accurate IBS subtyping. Varying FODMAP or gluten content of the diet is not associated with consistent change in FWC.

AB - Background: Perception of diarrhea and constipation differs greatly. This study aimed to correlate subjective and objective assessment of fecal characteristics in irritable bowel syndrome (IBS) patients. Methods: Data from two interventional dietary trials with varying FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) or gluten content were interrogated. Subjects rated their dissatisfaction with stool consistency daily using a visual analog scale during the interventions. Subjects collected stools at the end of each intervention. Each stool was scored according to the King's Stool Chart (KSC). Fecal water content (FWC) was measured on pooled feces by freeze drying, with diarrhea defined as ≥78%. Key Results: Seventy IBS (Rome III) and eight healthy subjects were studied. Each subject's self-rating of stool consistency during the most symptomatic diet was approximately double that of their least. Degree of dissatisfaction with stool consistency correlated poorly with changes in FWC and KSC. IBS subtype related poorly to objective measures of stool consistency. Sixty percent of IBS-D subjects had diarrhea on objective measures. Eighty-five percent with IBS-C had hard and formed stools but three patients met the criteria for diarrhea. One healthy subject had diarrhea on FWC and KSC, and six had hard, formed stools. No differences in FWC was observed when subjects consumed differing amounts of FODMAPs or gluten (all P >.200). Conclusions and Inferences: There are major disparities between patients’ stool descriptions and objective features of constipation and diarrhea. Patient-reported bowel habits require more interrogation for accurate IBS subtyping. Varying FODMAP or gluten content of the diet is not associated with consistent change in FWC.

KW - constipation

KW - diarrhea

KW - fecal water content

KW - stool chart

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U2 - 10.1111/nmo.13187

DO - 10.1111/nmo.13187

M3 - Article

VL - 30

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

SN - 1350-1925

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M1 - e13187

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