TY - JOUR T1 - Cluster’s last stand JF - Gut JO - Gut SP - 773 LP - 774 VL - 53 IS - 5 AU - S C Howell AU - G D Eslick AU - N J Talley Y1 - 2004/05/01 UR - http://gut.bmj.com/content/53/5/773.2.abstract N2 - Guthrie and colleagues (Gut 2003;52:1616–22) described the results of cluster analysis in a patient sample with severe irritable bowel syndrome (IBS). Their analysis investigated a broad range of factors in addition to symptoms; these included psychosocial measures (psychiatric involvement, health service encounters, quality of life) and physiological parameters (rectal thresholds). The authors have demonstrated that severe IBS can be classified according to non-symptom characteristics and, in particular, according to the level of psychological distress, service encounters, and rectal sensitivity. They describe three groups which they labelled “distressed high utilisers,” “distressed low utilisers”, and “tolerant low utilisers.” The authors defend their analysis on clinical grounds and point to treatment implications for each of these … ER -