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Irritable bowel syndrome classification

Introduction

Overview

Overview

Irritable bowel syndrome (IBS) may be classified according to Rome IV criteria into IBS with predominant constipation , IBS with predominant diarrhea, IBS with mixed bowel habits, and unclassified IBS. In addition, IBS occurring subsequent to gastrointestinal infections is known as post infectious-IBS (PI-IBS). The rationale behind these different sub-types is to maintain consistency of patient selection. This increases understanding of pathophysiological mechanisms, aids in effective diagnosis, treatment, and patient recruitment for clinical trials.

Classification

Classification

Irritable bowel syndrome (IBS) may be classified according to Rome IV criteria into 4 sub-types based on predominant type of bowel habits:[1][2][3][4][5][6]

  • IBS with predominant constipation
  • IBS with predominant diarrhea
  • IBS with mixed bowel habits:
  • IBS unclassified:
    • Patients who meet the diagnostic criteria for IBS but whose bowel habits do not fit into any of the above subtypes.
SUBTYPE HARD OR LUMPY STOOLS LOOSE (MUSHY) OR WATERY STOOLS
IBS with constipation β‰₯ 25 percent  ≀ 25 percent
IBS with diarrhea  ≀ 25 percent β‰₯ 25 percent
Mixed IBS β‰₯ 25 percent β‰₯ 25 percent
Unsubtyped IBS Insufficient abnormality of stool consistency to meet criteria for IBS with constipation, diarrhea, or mixed subtypes.
References

References

  1. ↑ Longstreth GF (2005). “Definition and classification of irritable bowel syndrome: current consensus and controversies”. Gastroenterol. Clin. North Am. 34 (2): 173–87. doi:10.1016/j.gtc.2005.02.011. PMIDΒ 15862928.
  2. ↑ Sayuk GS, Gyawali CP (2015). “Irritable bowel syndrome: modern concepts and management options”. Am. J. Med. 128 (8): 817–27. doi:10.1016/j.amjmed.2015.01.036. PMIDΒ 25731138.
  3. ↑ Lacy BE (2016). “Diagnosis and treatment of diarrhea-predominant irritable bowel syndrome”. Int J Gen Med. 9: 7–17. doi:10.2147/IJGM.S93698. PMCΒ 4755466. PMIDΒ 26929659.
  4. ↑ Wong RK, Palsson OS, Turner MJ, Levy RL, Feld AD, von Korff M, Whitehead WE (2010). “Inability of the Rome III criteria to distinguish functional constipation from constipation-subtype irritable bowel syndrome”. Am. J. Gastroenterol. 105 (10): 2228–34. doi:10.1038/ajg.2010.200. PMCΒ 3786710. PMIDΒ 20502449.
  5. ↑ Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, MΓΌller-Lissner SA (1999). “Functional bowel disorders and functional abdominal pain”. Gut. 45 Suppl 2: II43–7. PMCΒ 1766683. PMIDΒ 10457044.
  6. ↑ Talley NJ, Spiller R (2002). “Irritable bowel syndrome: a little understood organic bowel disease?”. Lancet. 360 (9332): 555–64. doi:10.1016/S0140-6736(02)09712-X. PMIDΒ 12241674.
  7. ↑ Holten KB, Wetherington A, Bankston L (2003). “Diagnosing the patient with abdominal pain and altered bowel habits: is it irritable bowel syndrome?”. Am Fam Physician. 67 (10): 2157–62. PMIDΒ 12776965.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]