Predictive factors of irritable bowel syndrome improvement: 1-year prospective evaluation in 400 patients.
BACKGROUND
The natural history of the irritable bowel syndrome is poorly understood.


OBJECTIVE
To assess the clinical course of the irritable bowel syndrome and the factors that might predict it.


METHODS
An observational prospective study, involving 400 irritable bowel syndrome patients meeting Rome II criteria. Symptoms were recorded in a diary over four non-consecutive months (1, 4, 7 and 10). Demographic data, associated disorders, psychological status and health-related quality of life were obtained.


RESULTS
At 1-year follow-up, half of the patients and half of their physicians considered irritable bowel syndrome to have improved, but improvement was minor. Diary data showed that, according to the type of symptom, improvement was small and quite different: diarrhoea in 19% of patients, abdominal pain frequency in 26%, constipation in 33% and abdominal pain intensity in 60%. Factors related to improvement at one year were: severe symptoms and poor health-related quality of life at first visit, irritable bowel syndrome-constipation, good improvement at 3 months, anxiety/depression, stress, symptoms related to meals and absence of comorbidity. By multivariate logistic regression, predictors were: severe basal symptoms and good improvement at 3 months (OR:CI 95%, 1.32:1.09-1.59 and 4.44:2.81-7.05).


CONCLUSIONS
At 1-year follow-up, half the patients and their physicians considered the irritable bowel syndrome to have had some improvement but, symptom diaries demonstrated that improvement was small and heterogeneous. Severe basal symptoms and improvement at 3 months were related to better prognosis.
Institute of Functional and Motor Digestive Disorders, Centro Médico Teknon, Barcelona, Spain. mearin@dr.teknon.es
F
F
Mearin
X
X
Badía
A
A
Balboa
J
J
Benavent
A M
AM
Caballero
E
E
Domínguez-Muñoz
V
V
Garrigues
J M
JM
Piqué
M
M
Roset
M
M
Cucala
M
M
Figueras
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D003248:Constipation / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D004415:Dyspepsia / Q000209:etiology; D005260:Female; D006356:Heartburn / Q000209:etiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000523:psychology / Q000628:therapy; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology