title: Factors associated with poor therapeutic response in outpatients with irritable bowel syndrome: a multicenter study in Japan.
abstract: BACKGROUND
  Some patients with irritable bowel syndrome (IBS) show poor response to treatment. However, risk factors associated with poor therapeutic response have not been determined.
  
  
  METHODS
  This multicenter trial evaluated consecutive outpatients with IBS undergoing treatment for more than 1 month. Mental health status and physical function were evaluated using the Japanese version of the SF-8. Therapeutic response was evaluated using the IBS severity index-Japanese version (IBS-SIJ). Patients with IBS-SIJ scores ≥175 were defined as poor responders to treatment, whereas those with IBS-SIJ scores <175 were defined as good responders. The demographic and clinical characteristics of these two groups, along with medications, were compared.
  
  
  RESULTS
  The study enrolled 131 participants, 75 with IBS-SIJ scores ≥175-56 with IBS-SIJ scores <175. Multiple logistic regression analysis showed that female sex [odds ratio (OR) 2.67, 95 % confidence interval (CI) 1.19-5.97, p = 0.0167] and mental component summary (MCS) of the SF-8 <40 (OR 2.58, 95 % CI 1.12-5.97, p = 0.0263) were independent risk factors for poor therapeutic response in patients with IBS.
  
  
  CONCLUSIONS
  Lower MCS and female sex were risk factors for poor therapeutic response in patients with IBS. Ascertaining the mechanisms by which lower MCS and female sex are associated with poor therapeutic response in IBS may help design better treatments (Trial registration number: UMIN000016804).
authors.affiliation: Gastroenterology Division, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Yamada
authors.affiliation: Tsunoda Iin, Yokohama, Japan.
authors.forename: Seishi
authors.initials: S
authors.lastname: Tsunoda
authors.affiliation: Abe Clinic, Sagamihara, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Abe
authors.affiliation: Gastroenterology Division, Chigasaki Municipal Hospital, Chigasaki, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Uchida
authors.affiliation: Teraoka Clinic, Yokohama, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Teraoka
authors.affiliation: Gastroenterology Division, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Japan.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Gastroenterology Division, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawana
authors.affiliation: Department of Biostatistics and Epidemiology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Tagri
authors.affiliation: Hikari Clinic, Yokohama, Japan.
authors.forename: Noriomi
authors.initials: N
authors.lastname: Hosaka
authors.affiliation: Nagai Clinic, Yokohama, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Matsushima Clinic, Yokohama, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Nishino
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan. nakajima-tky@umin.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D007564:Japan; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011379:Prognosis; D011594:Psychometrics; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents
keywords: Irritable bowel syndrome; Mental health; Poor therapeutic response