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Empirically derived symptom sub‐groups correspond poorly with diagnostic criteria for functional dyspepsia and irritable bowel syndrome. A factor and cluster analysis of a patient sample
Author(s) -
Eslick G. D.,
Howell S. C.,
Hammer J.,
Talley N. J.
Publication year - 2004
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01805.x
Subject(s) - irritable bowel syndrome , medicine , constipation , nausea , vomiting , abdominal pain , gastroenterology , population , diarrhea , small intestinal bacterial overgrowth , environmental health
Summary Aim : To determine how clusters (groups) of patients with respect to symptoms compare with a clinical diagnosis in patients with irritable bowel syndrome and non‐ulcer dyspepsia. Methods : All patients who attended a gastroenterology practice at Nepean Hospital were included in the study. All patients received the previously validated Bowel Disease Questionnaire, and were independently assessed by the gastroenterologist. Factor analysis and a k ‐means cluster analysis were completed. Results : The study population comprised 897 patients [320 males (36%) and 577 females (64%)]. Factor analysis identified nine symptom factors: (1) diarrhoea; (2) constipation; (3) dysmotility; (4) dyspepsia/reflux; (5) nausea/vomiting; (6) bowel; (7) meal‐related pain; (8) weight loss; and (9) abdominal pain. A k ‐means cluster analysis identified seven distinct subject groups, which included an undifferentiated group: (1) diarrhoea; (2) meal‐related pain; (3) abdominal pain; (4) faecal indicators; (5) nausea/vomiting/weight loss; and (6) constipation. The majority of irritable bowel syndrome patients fitted into two cluster groups [diarrhoea (25%) and constipation (20%)], whereas those with non‐ulcer dyspepsia predominantly fitted into the undifferentiated cluster (34%) and the nausea/vomiting cluster (18%). Conclusion : This study supports the concept of symptom subgroups, including the subdivision of patients into diarrhoea‐ and constipation‐predominant irritable bowel syndrome.