Post infectious IBS: defining its clinical features and prognosis using an internet-based survey

Background: Gastrointestinal infection is an important risk factor for developing IBS. Our aim was to characterise postinfectious IBS (PI-IBS) compared to other IBS patients. Methods: An internet survey of IBS patients using Rome III diagnostic questionnaire, Hospital Anxiety & Depression Scale (HADS) and Patient Health Questionnaire-12 somatic symptom score (PHQ12-SS) documenting the mode of onset. Results: 7811 participants, 63.2% female of whom 1004 (13.3%) met criteria for PI-IBS. 70% of PI-IBS described sudden onset, 35% onset while travelling, 49.6% vomiting, 49.9 fever and 20.3% bloody diarrhoea. Compared to other IBS, PI-IBS was significantly associated with living in Northern Europe and North America, having a hysterectomy, not having an appendectomy, higher PHQ12-SS score and having more than one toilet in the family home. PI-IBS patients had more frequent stools. At 1 year recovery rate in PI-IBS and non-PI-IBS group was 19.7% and 22.2%, p=0.15. Recovery rates were lower for females (20.7%) versus males (38.8%), those with somatisation ( 23.0%) versus those without (33.2%) and living in North America or Northern Europe (21.1%) versus living elsewhere (33.9%) p=<0.001. Conclusion: PI-IBS accounts for around 13% of all IBS in this internet sample, with some distinctive features but a similar prognosis to the remainder

Cognitive Conflicts in Functional Gastrointestinal Disorders

The importance of psychological factors in functional gastrointestinal disorders (FGID) is well-stablished in the literature; however, cognitive factors have hardly been researched and, in particular, cognitive conflicts have not been explored for these disorders. The aim of this study is to compare the cognitive and symptomatic characteristics of a group of 66 FGID patients (33 diagnosed with irritable bowel syndrome and 33 with functional dyspepsia) with a control group of participants without FGID or psychopathological symptoms. Both groups were matched by sex and age. The evaluation of the clinical sample was carried out following the criteria of the DSM-IV-TR. The SCL 90-R, and also the Repertory Grid for the identification of cognitive conflicts (implicative dilemmas) and self-ideal discrepancy, were administered to both the clinical sample and the control group. Results showed that 85% of FGID patients met the criteria for one axis I disorder of the DSM-IV-TR, mainly anxiety and somatization disorders. Regarding axis II, 23% presented at least one personality disorder, the most common ones being those of avoidance and dependence. Regarding axis IV, the patients reported a higher number of problems relative to the primary support group. FGID patients showed greater symptoms compared to the control group on various SCL 90-R scales. On the other hand, FGID patients presented more implicative dilemmas than healthy controls, as well as lower self-esteem. No significant differences were observed depending on the type of FGID (irritable bowel syndrome or functional dyspepsia).La importancia de los factores psicológicos en los Trastornos Funcionales Digestivos (TFD) queda plasmada en la literatura, sin embargo, los factores cognitivos apenas se han investigado y en particular, los conflictos cognitivos nunca se han explorado en este tipo de trastornos. El objetivo de este estudio es comparar las características cognitivas y sintomáticas de un grupo de 66 pacientes con TFD (33 diagnosticados de Síndrome del Intestino Irritable y 33 de Dispepsia Funcional) en comparación con un grupo control de participantes sin síntomas de TFD ni psicopatológicos. Ambos grupos fueron apareados por sexo y edad. La evaluación de la muestra clínica se llevó a cabo siguiendo los criterios del DSM- IV-TR y tanto a la muestra clínica como al grupo control se les administró el SCL 90-R, y además la Técnica de la Rejilla para la identificación de los conflictos cognitivos (dilemas implicativos) y de la discrepancia yo-ideal. Los resultados mostraron que el 85% de TFD cumplía criterios para algún trastorno del eje I del DSM-IV-TR, principalmente trastornos de ansiedad y de somatización. Respecto al eje II, el 23% presentó por lo menos un trastorno de personalidad, siendo los más comunes los de evitación y dependencia. En cuanto al eje IV, los pacientes informaron de un mayor número de problemas relativos al grupo primario de apoyo. Los pacientes con TFD mostraron mayor sintomatología con respecto al grupo control en diversas escalas del SCL-90-R. Por otro lado, los pacientes con TFD presentaron más dilemas implicativos que los controles sano