Cargando…

Screening irritable bowel syndrome patients for symptoms predictive of Crohn's disease using the red flag score

BACKGROUND/AIMS: The diagnosis of inflammatory bowel disease (IBD) is often delayed due to misdiagnosing patients with irritable bowel syndrome (IBS), mostly because of the under-recognition of high-risk features. The red flag score (RFS) has been recently developed to identify patients with higher...

Descripción completa

Detalles Bibliográficos
Autores principales: Mosli, Mahmoud, Bamarhul, Mutaz, Alharbi, Abdulrahman, Shafei, Sohaib, Alharbi, Ahmad, Bamahfouth, Khalid, Jawa, Hani, Aljahdali, Emad, Bazaraa, Salim, Qari, Yousif
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539676/
https://www.ncbi.nlm.nih.gov/pubmed/28721976
http://dx.doi.org/10.4103/sjg.SJG_601_16
_version_ 1783254526249140224
author Mosli, Mahmoud
Bamarhul, Mutaz
Alharbi, Abdulrahman
Shafei, Sohaib
Alharbi, Ahmad
Bamahfouth, Khalid
Jawa, Hani
Aljahdali, Emad
Bazaraa, Salim
Qari, Yousif
author_facet Mosli, Mahmoud
Bamarhul, Mutaz
Alharbi, Abdulrahman
Shafei, Sohaib
Alharbi, Ahmad
Bamahfouth, Khalid
Jawa, Hani
Aljahdali, Emad
Bazaraa, Salim
Qari, Yousif
author_sort Mosli, Mahmoud
collection PubMed
description BACKGROUND/AIMS: The diagnosis of inflammatory bowel disease (IBD) is often delayed due to misdiagnosing patients with irritable bowel syndrome (IBS), mostly because of the under-recognition of high-risk features. The red flag score (RFS) has been recently developed to identify patients with higher risk of IBD rather than IBS. The aim of this study is to estimate the prevalence of high-risk features, according to the RFS, among patients diagnosed with IBS who would consequently be candidates for ileocolonoscopic evaluation. PATIENTS AND METHODS: Adult patients with IBS seen at the general medicine clinic were recruited and surveyed using the RFS. Clinical and demographic data were collected. The prevalence of high-risk features, defined as a RFS >5, was calculated. Logistic regression analysis was used to identify predictors of RFS >5. RESULTS: A total of 255 patients with IBS were recruited. The mean age was 30.6 years (±9.9 years); 71.4% of patients were women (182/255), and 90.2% were from Saudi Arabia (230/255). More than half of the patients we surveyed (51.4%) had not visited a gastroenterologist previously. The mean RFS was 6.6 (±3.6) and 54.9% of patients (140/255) scored more than 5 and accordingly were selected for further investigations. Statistical analysis identified no previous visits to a gastroenterologist as the only significant predictor of RFS >5 (OR = 2.2, 95% CI = 1.3–3.7, P = 0.003). CONCLUSIONS: More than half of the patients known to have IBS are candidates for further investigations to eliminate the possibility of IBD as a diagnosis according to the validated RFS. Patients who did not seek a specialized consultation with a gastroenterologist might be at a higher risk of being misdiagnosed as having IBS.
format Online
Article
Text
id pubmed-5539676
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-55396762017-08-14 Screening irritable bowel syndrome patients for symptoms predictive of Crohn's disease using the red flag score Mosli, Mahmoud Bamarhul, Mutaz Alharbi, Abdulrahman Shafei, Sohaib Alharbi, Ahmad Bamahfouth, Khalid Jawa, Hani Aljahdali, Emad Bazaraa, Salim Qari, Yousif Saudi J Gastroenterol Original Article BACKGROUND/AIMS: The diagnosis of inflammatory bowel disease (IBD) is often delayed due to misdiagnosing patients with irritable bowel syndrome (IBS), mostly because of the under-recognition of high-risk features. The red flag score (RFS) has been recently developed to identify patients with higher risk of IBD rather than IBS. The aim of this study is to estimate the prevalence of high-risk features, according to the RFS, among patients diagnosed with IBS who would consequently be candidates for ileocolonoscopic evaluation. PATIENTS AND METHODS: Adult patients with IBS seen at the general medicine clinic were recruited and surveyed using the RFS. Clinical and demographic data were collected. The prevalence of high-risk features, defined as a RFS >5, was calculated. Logistic regression analysis was used to identify predictors of RFS >5. RESULTS: A total of 255 patients with IBS were recruited. The mean age was 30.6 years (±9.9 years); 71.4% of patients were women (182/255), and 90.2% were from Saudi Arabia (230/255). More than half of the patients we surveyed (51.4%) had not visited a gastroenterologist previously. The mean RFS was 6.6 (±3.6) and 54.9% of patients (140/255) scored more than 5 and accordingly were selected for further investigations. Statistical analysis identified no previous visits to a gastroenterologist as the only significant predictor of RFS >5 (OR = 2.2, 95% CI = 1.3–3.7, P = 0.003). CONCLUSIONS: More than half of the patients known to have IBS are candidates for further investigations to eliminate the possibility of IBD as a diagnosis according to the validated RFS. Patients who did not seek a specialized consultation with a gastroenterologist might be at a higher risk of being misdiagnosed as having IBS. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5539676/ /pubmed/28721976 http://dx.doi.org/10.4103/sjg.SJG_601_16 Text en Copyright: © 2017 Saudi Journal of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mosli, Mahmoud
Bamarhul, Mutaz
Alharbi, Abdulrahman
Shafei, Sohaib
Alharbi, Ahmad
Bamahfouth, Khalid
Jawa, Hani
Aljahdali, Emad
Bazaraa, Salim
Qari, Yousif
Screening irritable bowel syndrome patients for symptoms predictive of Crohn's disease using the red flag score
title Screening irritable bowel syndrome patients for symptoms predictive of Crohn's disease using the red flag score
title_full Screening irritable bowel syndrome patients for symptoms predictive of Crohn's disease using the red flag score
title_fullStr Screening irritable bowel syndrome patients for symptoms predictive of Crohn's disease using the red flag score
title_full_unstemmed Screening irritable bowel syndrome patients for symptoms predictive of Crohn's disease using the red flag score
title_short Screening irritable bowel syndrome patients for symptoms predictive of Crohn's disease using the red flag score
title_sort screening irritable bowel syndrome patients for symptoms predictive of crohn's disease using the red flag score
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539676/
https://www.ncbi.nlm.nih.gov/pubmed/28721976
http://dx.doi.org/10.4103/sjg.SJG_601_16
work_keys_str_mv AT moslimahmoud screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT bamarhulmutaz screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT alharbiabdulrahman screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT shafeisohaib screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT alharbiahmad screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT bamahfouthkhalid screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT jawahani screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT aljahdaliemad screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT bazaraasalim screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore
AT qariyousif screeningirritablebowelsyndromepatientsforsymptomspredictiveofcrohnsdiseaseusingtheredflagscore