IDDF2023-ABS-0173 Towards a new paradigm for the diagnostic of irritable bowel syndrome: a case study of the use of the raid-dx test

Abstract

Background

Retrospective review of the use of RAID-Dx, a test for the positive diagnosis of irritable bowel syndrome (IBS) through a faecal microbial signature. Data are presented by the Gastroenterology Department at the Hospital Universitari de Girona Dr. Josep Trueta – Institut d’Assistència Sanitària in the Girona area (Spain).

Methods

Observational, retrospective study with patients that meet ROME III/IV criteria for IBS who undergo the RAID-Dx test. A total of 34 patients were included (40.5±14.7 years, 60% women).

Results

The suspected diagnosis consisted of 7 IBS-diarrheal (20.6%), 12 IBS-mixed (35.3%), 4 IBS-constipation (11.8%), 5 IBS-undefined (14.7%), 3 IBS-post diverticulitis (8.9%), 1 dyspepsia (2.9%), and 1 with gastroesophageal reflux (2.9%). The RAID-Dx results showed that 58.8% of the patients presented a diagnosis compatible with IBS. 76.5% of patients showed some altered markers; the most affected was E. coli (44.1%), followed by A. muciniphila (32.4%). The results allowed to confirm the initial diagnostic suspicion in 67.7% of the cases, and a different diagnosis was reached in 81.1% of the remaining. Thus, the RAID-Dx assisted 94.1% of the diagnoses. Once the test was performed, 70.6% did not require additional diagnostic tests, starting treatment in 94.1% of cases. Treatments for patients diagnosed with IBS included I3.1 (30.3%), Bifibran (soluble fibre) (15.2%), compared with 17.4% I3.1, 30.4% Spiraxin, and 17.4% received a specific diet when obtained an incompatible diagnosis. Throughout the study, clinical improvement was observed after treatment in 76.5% of cases (52.9% total, 23.5% partial), of which 81.8% had obtained a positive diagnosis for IBS. On average, 78% of patients had received more than 4 visits before their referral to specialist care, specifically 5.7 visits for the group not compatible with IBS and doubling to 11.7 visits in patients with IBS. After performing the test, 87.5% of the patients had between 1 and 3 visits until hospital discharge.

Conclusions

The use of RAID-Dx could optimize the diagnosis of IBS and rationalize the use of healthcare resources by avoiding additional tests, shortening the time of diagnosis, and accelerating access to appropriate treatment.