Digestive Diseases and Sciences

, Volume 40, Issue 12, pp 2647–2655 | Cite as

Irritable bowel syndrome defined by factor analysis gender and race comparisons

  • Edward Taub
  • Jorge L. Cuevas
  • Edwin W. CookIII
  • Michael Crowell
  • William E. Whitehead
Intestinal Disorders, Inflammatory Bowel Disease, Immunology, and Microbiology


To examine the applicability across subgroups of the Manning criteria commonly used to diagnose the irritable bowel syndrome, a 22-item symptom questionnaire was administered to male and female African-American and Caucasian adults (N=1344). Principal components factor analysis with varimax rotation was used to identify symptom clusters. Consistent with the findings of a previous factor analytic study, three of the six Manning symptoms (loose stools and more frequent bowel movements with onset of pain, pain relieved by defecation) formed a cluster corresponding to the irritable bowel syndrome in all subgroups. It is concluded that: (1) The three core Manning symptoms have equal applicability to both genders and to African-Americans as well as to Caucasians. They are useful symptom criteria for the diagnosis of IBS when used in conjunction with medical evaluation. (2) Three of the six Manning symptoms rarely correlate with the others; if confirmed in patient samples, this would indicate that these three symptoms are not useful for making a diagnosis of the irritable bowel syndrome.

Key Words

irritable bowel syndrome Manning criteria Rome consensus criteria gas constipation symptom questionnaire factor analysis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Drossman DA, Thompson SG, Talley NJ, Funch-Jensen P, Janssens J, Whitehead WE: Identification of sub-groups of finctional gastrointestinal disorders. Gastroenterol Int 3:159–172, 1990.Google Scholar
  2. 2.
    Manning AP, Thompson WG, Heaton KW, Morris AF: Towards positive diagnosis of the irritable bowel. Br Med J 2:653–654, 1978Google Scholar
  3. 3.
    Smith RC, Greenbaum DS, Vancouver JB, Henry RC, Reinhart MA, Greenbaum RB, Dean HA, Mayle JE: Gender differences in Manning criteria in the irritable bowel syndrome. Gastroenterology 100:591–595, 1991Google Scholar
  4. 4.
    Talley NJ, Phillips SF, Melton IJ, Mulvihill C, Wiltgen C, Zinsmeister AR. Diagnostic value of the Manning criteria in irritable bowel syndrome. Gut 31:77–81, 1990Google Scholar
  5. 5.
    Kruis W, Thieme CH, Weinzierl M, Schussler P, Holl J, Paulus W: A diagnostic score for the irritable bowel syndrome. Gastroenterology 87:1–7, 1984Google Scholar
  6. 6.
    Thompson WG, Creed F, Drossman DA, Heaton KW, Mazzocca G: Functional bowel disease and functional abdominal pain. Gastroenterol Int 5:75–91, 1992Google Scholar
  7. 7.
    Whitehead WE, Crowell MD, Bosmajian L, Zonderman A, Costa PT Jr, Benjamin C, Robinson JC, Heller BR, Schuster MM: Existence of irritable bowel syndrome supported by factor analysis of symptoms in two community samples. Gastroenterology 98:336–340, 1990Google Scholar
  8. 8.
    Tabachnick BG, Fidell LS: Using Multivariate Statistics. New York, Harper and Row, 1989Google Scholar
  9. 9.
    Mulaik SA: The Foundation of Factor Analysis. New York, McGraw-Hill, 1972Google Scholar
  10. 10.
    Whitehead WE, Bosmajian L, Zonderman AB, Costa PT, Schuster MM: Symptoms of psychologic distress associated with irritable bowel syndrome. Gastroenterology 95:709–714, 1988Google Scholar
  11. 11.
    Whitehead WE, Holtkotter B, Enck P, Hoelzl R, Holmes KD, Anthony J, Shabsin HS, Schuster MM: Tolerance for rectosigmoid distention in irritable bowel syndrome. Gastroenterology 98:1187–1192, 1990Google Scholar
  12. 12.
    Heaton KW, O'Donnell LJD, Braddon FEM, Mountford RA, Hughes AO, Cripps PJ: Symptoms of irritable bowel syndrome in a British urban community: Consulters and nonconsulters. Gastroenterology 102:1962–1967, 1992Google Scholar
  13. 13.
    Drossman DA, Li Z, Andruzzi E, Temple RD, Talley NJ, Thompson WG, Whitehead WE, Janssens J, Funch-Jensen P, Corazziari E, Richter JE, Koch GG: US householder survey of functional GI disorders: Prevalence, sociodemography and health impact. Dig Dis Sci 38:1569–1580, 1993Google Scholar
  14. 14.
    Everhart JE, Go VLW, Johannes RS, Fitzsimmons SC, Roth HP, White LR: A longitudinal survey of self-reported bowel habits in the United States. Dig Dis Sci 34:1153–1162, 1989Google Scholar
  15. 15.
    Johanson JF, Sonnenberg A, Koch TR: Clinical epidemiology of chronic constipation. J Clin Gastroeterol 11:525–536, 1989Google Scholar
  16. 16.
    Johnson JD: Regional and ethnic distribution of lactose malabsorption: Adaptive and genetic hypothesis.In Lactose Digestion: Clinical and Nutritional Implications. DM Baige, TM Bayliss (eds). Baltimore, Johns Hopkins University Press, 1981, pp 11–22Google Scholar
  17. 17.
    Talley NJ, Zinsmeister AR, Van Dyke C, Melton IJ III: Epidemiology of colonic symptoms and the irritable bowel syndrome. Gastroenterology 101:927–934, 1991Google Scholar
  18. 18.
    Jones R, Lydeard S: Irritable bowel syndrome in the general population. Br Med J 304:87–90, 1992Google Scholar

Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Edward Taub
    • 1
    • 2
  • Jorge L. Cuevas
    • 1
    • 2
  • Edwin W. CookIII
    • 1
    • 2
  • Michael Crowell
    • 1
    • 2
  • William E. Whitehead
    • 1
    • 2
  1. 1.Department of PsychologyUniversity of Alabama at BirminghamBirmingham
  2. 2.Division of Digestive DiseasesUniversity of North Carolina, School of MedicineChapel Hill

Personalised recommendations