Largest Study to Date Indicates Doctors May Use IBS-D as a Blanket Diagnosis, Rather than Cite a Collection of Separate Medical Conditions
Findings: Accurate Diagnosis and Subsequent Treatment Results in 98 Percent Favorable Response
SUMMIT, NJ JANUARY 21, 2011 – A study published in the January issue of the peer-reviewed journal Medical Hypotheses finds that patients thought to have Diarrhea Predominant Irritable Bowel Syndrome (IBS-D) – a condition which affects up to 15 percent of the US population (35 million Americans) – may in fact have a different condition altogether.
According to the study, which examined 303 patients and is the largest single clinical retrospective study to date of patients presenting with IBS-D, 98 percent of participants were found to have a diagnosis different from the initial presentation of IBS-D. This study refutes the existence of IBS-D as a single medical entity and implies that this diagnosis is simply a catch-all diagnosis. The findings also revealed that 68 percent of the participants actually had conditions related to treatable bile acid induced diarrhea as a result of gallbladder dysfunction.
A dysfunctional gallbladder that produces an abnormal amount of bile causing chronic diarrhea can be very treatable, as opposed to IBS, for which physicians and patients often search for treatment to alleviate the discomfort, often to no avail. According to the study, once patients were accurately diagnosed, 98 percent experienced a favorable response to appropriate treatment. Favorable response was defined as a decrease in the number of bowel movements to less than three per day, sustained for at least three months with elimination of urgency and incontinence.
“Patients suffering from a diagnosis of IBS and functional diarrhea often endure a lifetime of discomfort, unease and frustration,” said Saad F. Habba, M.D., gastroenterologist at Overlook Hospital and the study author. “The results of this study demonstrate quite convincingly that many patients may needlessly be going through the physical and emotional pain of IBS and functional diarrhea when, in reality, they may be afflicted with something else that is easily treatable.”
IBS and Gallbladder Dysfunction
IBS is characterized by abdominal pain, bloating, constipation and/or diarrhea. Subtypes of IBS include IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), mixed IBS (IBS-M) and indeterminate or uncategorized IBS depending on the predominant stool pattern. About one third of IBS patients primarily suffer from diarrhea. There is no test to confirm IBS, meaning that it is essentially a “diagnosis of exclusion,” and the difficulty in successfully treating IBS has long been a frustration for physicians and their patients.
Of those patients in Dr. Habba’s study determined to have a condition other than IBS, 41 percent (124 patients) were found to have Habba Syndrome, a relatively new entity relating dysfunctional gallbladder with chronic diarrhea , which is successfully treated with bile acid binding agents. The gallbladder stores bile produced by the liver and when healthy, aids and controls the amount of bile necessary for digestion. In patients with gallbladder dysfunction or no gallbladder, the bile passes straight through to the small intestine causing functional diarrhea. Dr. Habba made the correlation between chronic diarrhea and a dysfunctional gallbladder in his original research, published in 2000 in the American Journal of Gastroenterology.
According to Christine Labisi, age 40, who participated in Dr. Habba’s study, “I spent over a decade living with what I thought was IBS and, as a result, my life became one of shelter and seclusion. Having learned that I actually have Habba Syndrome that is easily treatable has dramatically improved the quality of my life.”
Twenty three percent of the study subjects were diagnosed with post cholecystectomy diarrhea, eight percent had lactose intolerance, and seven percent had microscopic colitis.
About The Study
Three hundred and three patients over the age of 18 with a previous diagnosis of IBS and chronic diarrhea were reviewed retrospectively in a solo gastroenterology private practice over a period of eight years. Chronic diarrhea is defined by at least three loose bowel movements per day over a minimum of two months. Response was defined as less than three bowel movements per day sustained for at least three months with elimination of urgency and incontinence.
About Saad Habba, MD
Dr. Saad Habba has devoted the past 33 years to gastroenterology. He is a member of the gastroenterology department at Atlantic Health’s Overlook Hospital and has extensive national and international experience in teaching, lecturing and conducting research. Prior to joining Overlook Hospital, Dr. Habba served as the director of gastrointestinal endoscopy at University of Medicine and Dentistry of New Jersey – New Jersey Medical School, Newark, where he received the Distinguished Achievement Award. He received his medical degree from the Royal College of Surgeons in Dublin, Ireland, and completed his residency and fellowship in gastroenterology at St. Laurence’s Hospital in Dublin and at UMDNJ. He is extensively published in several domestic and international peer reviewed journals and has co-authored a chapter in Conn’s Current Therapy, a textbook of medicine. He has the distinction of holding the U.S. patent for proprietary methodology on regeneration of the liver. Dr. Habba is on the “2007 ‘America's Top Physicians’” list by the Consumers Research Council of America.
About Overlook Hospital
Overlook Hospital, part of Atlantic Health, is a 504-bed not-for-profit community hospital with more than 1,200 attending physicians. In addition to a Center for Digestive Disorders, Overlook Hospital offers a Comprehensive Stroke Center, a Level IV Epilepsy Center and Brain Tumor Center, as well as programs in movement and memory disorders. Overlook offers state-of-the-art neuro-interventional radiology and the northeast’s first CyberKnife for the treatment of inoperable brain, spine and other tumors. The Frank and Mimi Walsh Maternity Center boasts 24 private mother/baby rooms and a Level III Community Neonatal Intensive Care Unit with the largest pediatric surgery group in New Jersey.