Kayalvizhi, J (2010) An Analytical Study to Test the Validity of the New Questionnaire for the Diagnosis of Irritable Bowel Syndrome. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. Bloating, distension, and disordered defecation are commonly associated features. IBS is a common condition, affecting approximately 3% to 15% of the general population based on various diagnostic criteria. There seem to be differences in disease epidemiology between the eastern and the western world. As data from larger Asian epidemiological studies begin to surface, however, such differences appear to be less marked. Irritable bowel syndrome is a relapsing functional bowel disorder defined by symptom-based diagnostic criteria, in the absence of detectable organic causes. The symptomatic array is not specific for IBS, as such symptoms may be experienced occasionally by almost every individual. To distinguish IBS from transient gut symptoms, experts have underscored the chronic and relapsing nature of IBS and have proposed diagnostic criteria based on the occurrence rate of symptoms. The global picture of IBS prevalence is far from complete, with no data available from several regions. The prevalence of IBS is increasing in countries in the Asia–Pacific region, particularly in countries with developing economies. Estimates of the prevalence of IBS (using the Rome II diagnostic criteria) vary widely in the Asia–Pacific region. In addition, comparisons of data from different regions are often problematic due to the use of different diagnostic criteria, as well as the influence of other factors such as population selection, inclusion or exclusion of co morbid disorders (e.g., anxiety), access to health care, and cultural influences. Several attempts have been made to define the diagnostic criteria for IBS. Each attempt implies shortcomings in the previous ones. So , is the new questionnaire proposed by the WGO for diagnosis for Health Care Professionals to diagnose IBS. Present study was undertaken to find the usefulness of this questionnaire against the existing Rome III criteria. AIMS AND OBJECTIVES: 1. To study the validity of the questionnaire in patients with IBS 2. To compare against Rome III criteria. 3. To study the usefulness in delineating patients with IBS and other bowel diseases like IBD, Colonic cancer when compared with Rome III criteria. MATERIALS AND METHODS: This study is an analytical study conducted in a major public hospital from June 2009 to September 2009 and included a total of 52 patients. The reference population is Tamil speaking population belonging to lower and low middle socio – economic status attending government hospitals. The study population was taken from the Medical Gastroenterology out patient department and wards. Inclusion Criteria: Males and females with chronic abdominal pain / discomfort with duration of >3 months associated with disturbed defecation. Exclusion Criteria: 1. Those with known Ulcerative Colitis. 2. Those with known Crohn’s disease. 3. Those with known thyroid dysfunction. 4. Those with known abdominal malignancy. 5. Those with known abdominal tuberculosis. 6. Pregnant women. The questionnaire released by the World Gastroenterology Organization consists of 21 questions with points for questions 1 -16. The questions were translated into Tamil with the help of a team consisting of two non medicos with proficiency in Tamil, two non medicos with proficiency in English and two medicos. The questions were asked from the Tamil version to patients. And literate persons who volunteered to fill the questionnaire themselves were also encouraged to do so. A standardized pro forma was used to cover the subject’s age, education, duration of illness, past medical & surgical illness and concurrent medications. Also included were history of upper GI symptoms like bloating, dyspepsia & nausea. History of passing worms in stools was also elicited. CONCLUSIONS: 1. Comparing this questionnaire with ROME III criteria, the sensitivity of Rome(97%) was slightly higher than questionnaire (93%). 2. The specificity was much higher for questionnaire (83%) than Rome (14%). 3. The predictive value of a positive test and negative test were definitely higher with the questionnaire (98% and 62%) as against the Rome (88% and 50%). 4. The percentage of false positives was low with questionnaire (16%) against (86%) Rome. 5. The percentage of false negatives was only slightly higher in questionnaire (6%) than Rome (2%). Thus it is concluded that, The new questionnaire is definitely useful in identifying patients with IBS. Also it is more specific for IBS, reducing the need for invasive and costly procedures. And with this questionnaire the disadvantage of missing organic bowel disease is eliminated making this recommendable in patients with bowel disturbance of all age group. And this questionnaire can be used by primary care physicians and also paramedical staff and thereby guide those patients who will need further assessment by a Gastroenterologist. Therefore, the new questionnaire released by the WGO is better than the currently existing Rome III criteria.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | New Questionnaire ; Diagnosis of Irritable Bowel Syndrome ; Analytical Study. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 29 Mar 2018 02:57 |
| Last Modified: | 29 Mar 2018 02:57 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6725 |
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