Table 1.
Summary of studies that have determined prevalence of irritable bowel syndrome-like symptoms in quiescent inflammatory bowel disease
| Ref. | Type | Sample size (CD/UC) | Criteria used to define IBD remission | Exclusions (IBD characteristics or previous surgery) | Criteria used to define IBS | IBD-IBS prevalence n (%) |
| Isgar et al[1] | Case-control | 98 (0/98) | Endoscopic remission, steroid-free | Not further specified | Manning | UC: 33 (33.7) |
| 98 non-IBD controls | ||||||
| Simrén et al[2] | Cross-sectional | 83 (40/43) | CD: Physician global assessment, endoscopic/radiological remission and normal inflammatory markers (Hb, ESR, CRP, platelets, albumin) UC: Endoscopic remission, no blood nor mucus, normal CRP | Stenotic CD | Gastrointestinal symptom questionnaire validated | 37 (44.6) |
| CD patients with > 2 surgeries | CD: 23 (57) | |||||
| UC: 14 (33) | ||||||
| Significant comorbidities | ||||||
| Zaman et al[43] | Cross-sectional | 55 (30/25) | Stable symptoms, no changes in medication for 3 mo | Not available | Rome II | 35 (63.6) |
| CD: 20 (66.7) | ||||||
| UC: 15 (60) | ||||||
| Minderhoud et al[44] | Case-control | 107 (34/73) | CD: CDAI < 150 | Significant comorbidities | Manning | Manning: 33 (30.8) |
| 66 non-IBD controls | UC: CAIUC < 10 | Rome II | CD: 8 (23.5) | |||
| UC: 25 (34.2) | ||||||
| Rome II: 37 (34.6) | ||||||
| CD: 14 (41.7) | ||||||
| UC: 23 (31.5) | ||||||
| Farrokhyar et al[45] | Cross-sectional | 149 (105/44) | No changes/addition of medication nor change dosage in the last year | Not further specified | Rome II | 31 (20.8) |
| CD: 27 (26) | ||||||
| UC: 4 (9.1) | ||||||
| Ansari et al[46] | Case-control | 50 (0/50) | Mayo score ≤ 2 (bleeding score = 0, endoscopic score 0-1) | Not further specified | Rome II | UC: 23 (46) |
| 100 non-IBD controls | ||||||
| Keohane et al[33] | Cross-sectional | 106 (62/44) | CD: CDAI < 150 | Not further specified | Rome II | 54 (50.9) |
| UC: UCAI ≤ 3 | CD: 37 (59.7) | |||||
| For both: physician’s global assessment, CRP < 10 mg/L, no use of steroids or biological agents in previous 6 mo | UC: 17 (38.6) | |||||
| Piche et al[48] | Cross-sectional | 92 (92/0) | CDAI < 150 for > 6 mo, endoscopic/radiologic remission (CDEIS < 6), normal inflammatory markers (CRP, Hb, ESR, platelets, albumin) | Stenosis | Rome III | CD: 42 (45.7) |
| CD patients with previous surgery | ||||||
| Recent corticoid use | ||||||
| Barratt et al[3] | Case-control | 276 (110/166) | CD: HBI < 5 | Not further specified | Rome II | 31 (11.2) |
| 348 non-IBD controls | UC: SCCAI < 5 | CD: 14 (12) | ||||
| UC: 17 (9) | ||||||
| Bryant et al[4] | Cross-sectional | 93 (47/43)1 | Physician’s global assessment using inflammatory markers, histological and endoscopic activity and clinical data | Not further specified | Rome III | 12 (12.9) (no CD/UC differentiation) |
| Jelsness-Jørgensen et al[49] | Cross-sectional | 89 (28/61) | CD: SCDAI < 4 | Not further specified | Rome II | Rome II: 21 (23.6) |
| UC: SCCAI < 3 | Rome III | CD: 6 (21.4) | ||||
| No current steroid treatment | UC: 15 (24.6) | |||||
| Rome III: 30 (33.7) | ||||||
| CD: 8 (28.6) | ||||||
| UC: 22 (36.1) | ||||||
| Kim et al[50] | Cross-sectional | 226 (107/119) | No changes on therapy in last year, normal limits of CRP, hemoglobin, no blood or mucus in stools for UC | CD with stenotic/penetrating phenotype | Rome III | 82 (36.3) |
| CD: 50 (46.7) | ||||||
| Previous surgery | UC: 32 (26.9) | |||||
| Berrill et al[5] | Cross-sectional | 97 (40/57) | CD: HBI < 5, CRP < 10 mg/L | Ileostomy, colostomy or total colectomy | Rome III | 31 (32) |
| UC: SCCAI < 3, CRP < 10 mg/L | CD: 13 (32.5) | |||||
| UC: 18 (31.6) | ||||||
| Jonefjäll et al[35] | Pro-spective | 94 (0/94) | Mayo ≤ 2 (endoscopic < 1) | Significant comorbidities | Rome II | UC: 25 (27) |
| No relapse during 3 mo before inclusion | ||||||
| Vivinus-Nébot et al[51] | Cross-sectional | 49 (31/18) | CD: CDAI < 150,CDEIS ≤ 4 | Stenotic or complicated CD | Rome III | 18 (36.7) |
| UC: UCAI ≤ 3, Mayo = 0 | CD: 11 (35.4) | |||||
| For both: physician’s global assessment, CRP < 10 mg/L, no use of steroids over the last year | Significant comorbidities | UC: 7 (38) | ||||
| Fukuba et al[52] | Case control | 172 (0/172) | CAI ≤ 4, CRP < 5 mg/L | Colectomy | Rome III | UC: 46 (26.7) |
| 330 non-IBD controls | ||||||
| Total | - | 1836 (726/1107)1 | - | - | - | Total: 567 (30.9) |
| CD: 259 (38.1)2 | ||||||
| UC: 296 (27.8)2 |
In the original article the numbers given by the authors do not add up to the total of patients and they do not specify if the rest correspond to undetermined colitis;
For the pooled prevalences in CD and UC, patients from study of Bryant et al have not been included as they do not state a differentiated IBS-IBD prevalence for CD and UC respectively. CD: Crohn’s disease; UC: Ulcerative colitis; IBD: Inflammatory bowel disease; IBS: Irritable bowel disease; CRP: C reactive protein; Hb: Haemoglobin; ESR: Erythrocyte sedimentation rate; CDAI: Crohn’s disease activity index; CAIUC: Clinical activity index for ulcerative colitis; UCAI: Ulcerative colitis activity index; CDEIS: Crohn’s disease endoscopic index of severity; HBI: Harvey-Bradshaw index; SCCAI: Simple clinical colitis activity index; SCDAI: Simple Crohn’s disease activity index; CAI: Colitis activity index.