Nutrient drink test: A promising new tool for irritable bowel syndrome diagnosis

Table 1 Baseline abdominal symptoms in control subjects and IBS patients

	Control	IBS	P value
GER	0.4 ± 0.7	1.4 ± 1.4	0.05
Abdominal pain	0.4 ± 0.5	3.4 ± 1.7	0.001
Dyspepsia	0.7 ± 0.5	2.9 ± 1.4	0.001
Diarrhea	0.3 ±0.7	3.1 ± 1.9	0.001
Constipation	0.2 ± 0.4	2.4 ± 1.5	0.001
IBSSS score	37.3 ± 36.0	275.3 ± 115.6	0.001

Scores of symptoms in the 4 wk prior to drink testing, derived from the screening questionnaires, expressed as coefficients of each domain in the GSRS and the sum of IBSSS questionnaire variables (mean ± SD). GSRS: Gastrointestinal symptoms rating scale; GER: Gastro-esophageal reflux; IBSSS: Irritable bowel severity scoring system.

Table 2 Baseline psycho-social and quality of life markers in control subjects and IBS patients

	Control	IBS	P value
Somatization1	0.4 ± 0.4	1.8 ± 1.1	0.001
Obsession1	0.3 ± 0.3	1.2 ± 0.7	0.004
Interpersonal sensitivity1	0.2 ± 0.3	0.7 ± 0.7	0.05
Depression1	0.3 ± 0.4	1.5 ± 1.3	0.01
Anxiety1	0.2 ± 0.3	1.1 ± 0.8	0.005
Hostility1	0.2 ± 0.2	0.5 ± 0.6	0.09
Phobic anxiety1	0.1 ± 0.2	0.8 ± 1.0	0.05
Paranoid ideation1	0.2 ± 0.2	0.6 ± 0.5	0.025
Psychoticism1	0.1 ± 0.2	0.5 ± 0.5	0.013
Positive global symptoms1	17.2 ± 13.3	46.0 ± 21.7	0.002
Distress index1	1.2 ± 0.2	1.9 ± 0.6	0.002
HAD anxiety	3.6 ± 2.0	11.1 ± 4.8	0.000
HAD depression	1.5 ± 1.5	6.7 ± 5.4	0.01
HAD score	5.1 ± 2.6	17.8 ± 9.6	0.000
Physical score2	55.0 ± 5.0	37.4 ± 11.7	0.000
Mental score2	53.9 ± 6.0	42.3 ± 11.6	0.001

Psycho-social and quality of life data for the 4 wk prior to drink test, derived from the coefficient of each domain (¹SCL-90-R; HAD; and

²SF-12). Every questionnaire has its own statistical tools to evaluate the outcomes[18-20]. SCL-90-R: Symptom checklist-90-R; HAD: Hospital anxiety and depression scale; SF-12: Short form 12; IBS: Irritable bowel syndrome.

Table 3 Global dyspepsia score after the high nutrient drink test in control subjects and IBS patients

HN drink-individual symptoms assessed for the global dyspepsia score		Time in min
Symptom	Group	0	5	10	15	20	25	30	45	60	120
Satiety	IBS	0.3	1.3	2.1	2.6	3	3.4	3.8	4.5	4.2	2.8
	Controls	0.3	1.2	1.7	2.4	3	3.3	3.7	4.1	3.2	1.6
Nausea1	IBS	0.3	0	0	0.1	0.2	0.2	0.2	0.3	1.1	0.7
	Controls	0	0	0.1	0.1	0.1	0.2	0.2	0.2	0	0
Epigastric distension1	IBS	0.6	0.8	1.1	1.3	1.7	1.9	2.7	3.2	3.4	2.6
	Controls	0.2	0.1	0.4	0.5	0.6	0.6	0.8	0.9	0.9	0.6
Epigastric pain	IBS	0.1	0.1	0	0	0.1	0.2	0.5	0.5	0.5	0.5
	Controls	0	0	0	0	0	0	0	0	0	0
Heartburn	IBS	0	0.1	0.2	0.3	0.4	0.5	0.5	0.4	0.1	0.1
	Controls	0	0	0	0	0	0	0	0	0	0
Regurgitation1	IBS	0	0	0	0.1	0.2	0.3	0.3	0.6	1	0.7
	Controls	0	0	0	0	0	0	0	0	0	0

Mean scores of IBS patients and controls for individual upper GI symptoms in the first 120 min after the HN drink.

¹Variables reached significant differences. Bold number: Time points reaching significant differences. IBS: Irritable bowel syndrome; HN: High nutrient; GI: Gastrointestinal.

Table 4 General gastrointestinal symptoms after the high nutrient drink test in control subjects and IBS patients

HN drink-global symptoms		Time in h
Symptom	Group	0	1	2	4	6	8	10	12	24
Heartburn	IBS	0	0.3	0.2	0	0.1	0.1	0	0	0.1
	Controls	0	0	0	0	0	0	0.1	0.1	0
Regurgitation1	IBS	0.1	1	0.8	0.1	0.5	0.6	0.4	0.2	0.4
	Controls	0	0	0	0	0	0	0	0	0
Abdominal distension1	IBS	0	2.7	2.3	1.3	1.3	1.3	1.3	1.2	1.3
	Controls	0	0.6	0.4	0	0	0	0	0	0
Abdominal pain	IBS	0	0.7	0.4	0.3	0.1	1.1	0	0	0.5
	Controls	0	0.2	0.1	0.1	0	0.1	0	0	0.4

Mean scores of IBS patients and controls for individual general GI symptoms in the first 24 h after the HN drink.

¹Variables reached significant differences. Bold number: Time points reaching significant differences. IBS: Irritable bowel syndrome; HN: High nutrient; GI: Gastrointestinal.