title: Prevalence of irritable bowel syndrome-like symptoms in ulcerative colitis patients with clinical and endoscopic evidence of remission: prospective multicenter study.
abstract: OBJECTIVE
  Irritable bowel syndrome (IBS)-like symptoms are often found in ulcerative colitis (UC) patients in remission. However, the prevalence of those symptoms in UC patients with endoscopic evidence of remission shown by mucosal healing remains unknown.
  
  
  METHODS
  IBS diagnosis was evaluated by questionnaire results according to the Rome III criteria. Clinical remission was assessed by clinical activity index (CAI), whereas endoscopic remission was evaluated by endoscopic index (Matts grade).
  
  
  RESULTS
  We enrolled 172 patients in clinical remission (CAI ≤ 4), after excluding 36 for incomplete questionnaire results or nonremission findings, as well as 330 control subjects. Of the 172 UC patients, 46 (26.7%) met the Rome III criteria, which was a significantly higher rate as compared with the controls (4.8%). The prevalence rate of IBS-like symptoms in UC patients with endoscopic remission findings (Matts grade ≤2) was 25.6%, which was similar to that of those with clinical remission. When endoscopic remission was defined as Matts grade 1, the prevalence rate of IBS-like symptoms was decreased to 15.4%, although the prevalence rate remained higher than that of the control subjects.
  
  
  CONCLUSIONS
  The prevalence of IBS-like symptoms in UC patients with clinical and endoscopic remission findings was significantly higher than that of control subjects. Furthermore, the prevalence rate in patients with complete endoscopic remission was decreased. These findings suggest that residual low-grade inflammation may influence the presence of IBS-like symptoms in UC patients in remission.
authors.affiliation: Department of Internal Medicine II, Shimane University School of Medicine , Shimane , Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Fukuba
authors.forename: Shunji
authors.initials: S
authors.lastname: Ishihara
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Tada
authors.forename: Naoki
authors.initials: N
authors.lastname: Oshima
authors.forename: Ichiro
authors.initials: I
authors.lastname: Moriyama
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yuki
authors.forename: Kousaku
authors.initials: K
authors.lastname: Kawashima
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kushiyama
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Fujishiro
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000150:complications*; D003113:Colonoscopy; D003248:Constipation / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: IBS-like symptoms; clinical remission; endoscopic remission; ulcerative colitis