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Published on: November 30, 2016
Comorbidity in irritable bowel syndrome.
William E Whitehead1, Olafur S Palsson, Rona R Levy
1Center for Functional GI and Motility Disorders at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7555, USA.
The American Journal of Gastroenterology
|September 29, 2007
Summary
Irritable bowel syndrome (IBS) patients often report more symptoms due to amplified perception, not unique conditions. Comorbidity is linked to psychiatric issues but affects only a subset of IBS patients.
Area of Science:
- Gastroenterology
- Psychiatry
- Epidemiology
Background:
- Nongastrointestinal symptoms contribute significantly to healthcare costs in irritable bowel syndrome (IBS).
- Understanding comorbidity patterns is crucial for managing IBS effectively.
Purpose of the Study:
- To investigate if IBS patients exhibit increased risk for specific comorbid disorders or a general tendency for symptom overreporting.
- To compare comorbidity patterns in IBS with those in inflammatory bowel disease (IBD) and assess the role of psychiatric conditions.
- To determine if excess comorbidity is a universal characteristic of all IBS patients.
Main Methods:
- A comparative study involving 3,153 IBS patients, 3,153 matched controls, and 571 IBD patients.
- Diagnosis categorization over a 4-year period into gastrointestinal, psychiatric, and nongastrointestinal somatic types.
- Nongastrointestinal somatic diagnoses were further classified into symptom-based and biomarker-based.
Main Results:
- A higher prevalence of numerous symptom-based and biomarker-based diagnoses was observed in IBS patients compared to controls.
- No unique diagnostic associations were identified; infections and stroke were more frequent in IBS.
- Greater somatic comorbidity correlated with concurrent psychiatric diagnoses, but only 16% of IBS patients showed high comorbidity numbers.
Conclusions:
- Comorbidity in IBS appears to stem from amplified symptom reporting and healthcare utilization, suggesting altered symptom perception rather than distinct pathophysiological links.
- Psychiatric illness influences, but does not fully explain, the observed comorbidity.
- Elevated comorbidity is not pervasive across all IBS patients, affecting only a specific subset.
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