Marshall Centre, The University of Western Australia, Perth, Western Australia, Australia.
North Metropolitan Health Service, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Clin Transl Gastroenterol. 2019 Mar;10(3):e00017. doi: 10.14309/ctg.0000000000000017.
Irritable bowel syndrome (IBS) is a common and debilitating disorder estimated to affect approximately 11% of the world's population. Typically, IBS is a diagnosis of exclusion after patients undergo a costly and invasive colonoscopy to exclude organic disease. Clinician's and researchers have identified a need for a new cost-effective, accurate, and noninvasive diagnostic test for IBS.
Using a diagnostic case-control study, we explored the use of bowel sounds to characterize IBS with a view to diagnostic use. We recruited participants with an existing clinical diagnosis of IBS or healthy (asymptomatic) digestive systems. We recorded bowel sounds for 2 hours after fasting and then for 40 minutes after a standard meal.
We here report our results including our accuracy in characterizing IBS-related bowel sounds and differentiation between participants with IBS and healthy participants. Leave-one-out cross-validation of our model developed using the first 31 IBS and 37 healthy participants gave 90% sensitivity and 92% specificity for IBS diagnosis. Independent testing using the next 15 IBS and 15 healthy participants demonstrated 87% sensitivity and 87% specificity for IBS diagnosis.
These preliminary results provide proof of concept for the use of bowel sound analysis to identify IBS. A prospective study is needed to confirm these findings.
Our belt and model offer hope of a new approach for IBS diagnosis in primary practice. Combined with screening tests for organic disease, it would offer greater confidence to patients and could reduce the burden of unnecessary colonoscopies for health care systems and patients.
肠易激综合征(IBS)是一种常见且使人虚弱的疾病,据估计影响了约 11%的世界人口。通常,在患者接受昂贵且有创的结肠镜检查以排除器质性疾病后,IBS 才被诊断。临床医生和研究人员已经认识到需要一种新的具有成本效益、准确且非侵入性的 IBS 诊断测试。
我们使用诊断病例对照研究,探索使用肠鸣音来描述 IBS,以期用于诊断。我们招募了患有现有临床 IBS 诊断或健康(无症状)消化系统的参与者。我们在空腹后记录肠鸣音 2 小时,然后在标准餐后记录 40 分钟。
我们在此报告我们的结果,包括我们在描述 IBS 相关肠鸣音方面的准确性以及在 IBS 参与者和健康参与者之间的区分能力。使用前 31 名 IBS 参与者和 37 名健康参与者开发的模型进行的留一法交叉验证得出 90%的敏感性和 92%的特异性用于 IBS 诊断。使用下 15 名 IBS 参与者和 15 名健康参与者进行的独立测试显示,IBS 诊断的敏感性和特异性分别为 87%和 87%。
这些初步结果为使用肠鸣音分析来识别 IBS 提供了概念验证。需要进行前瞻性研究来证实这些发现。
我们的腰带和模型为 IBS 诊断提供了在初级实践中使用的新方法。结合对器质性疾病的筛查测试,它将为患者提供更大的信心,并可能减少医疗保健系统和患者进行不必要结肠镜检查的负担。