Tags

Type your tag names separated by a space and hit enter

Comorbidity in irritable bowel syndrome.
Am J Gastroenterol 2007; 102(12):2767-76AJ

Abstract

BACKGROUND

Comorbid nongastrointestinal symptoms account for two-thirds of excess health-care costs in irritable bowel syndrome (IBS).

OBJECTIVES

To determine whether IBS patients are at greater risk for specific comorbid disorders versus showing a general tendency to overreport symptoms; whether patients with inflammatory bowel disease (IBD) show patterns of comorbidity similar to IBS; whether comorbidity is explained by psychiatric disease; and whether excess comorbidity occurs in all IBS patients.

METHODS

All 3,153 patients in a health maintenance organization with a diagnosis of IBS in 1994-1995 were compared to 3,153 age- and gender-matched controls, and to 571 IBD patients. All diagnoses in a 4-yr period beginning 1 yr before their index visit were categorized as gastrointestinal, psychiatric, or nongastrointestinal somatic. Nongastrointestinal somatic diagnoses were further divided into symptom-based versus biological marker-based diagnoses.

RESULTS

Forty-eight of 51 symptom-based and 16 of 25 biomarker-based diagnoses were significantly more common in IBS versus controls. However, there were no unique associations. Bacterial, viral, and fungal infections and stroke were among diagnoses made more frequently in IBS. IBD patients were similar to controls. Greater somatic comorbidity was associated with concurrent psychiatric diagnosis. Only 16% of IBS patients had abnormally high numbers of comorbid diagnoses.

CONCLUSIONS

Comorbidity in IBS is due to a general amplification of symptom reporting and physician consultation rather than a few unique associations; this suggests biased symptom perception rather than shared pathophysiology. Comorbidity is influenced by, but is not explained by, psychiatric illness. Excess comorbidity is present in only a subset of IBS patients.

Authors+Show Affiliations

Center for Functional GI and Motility Disorders at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7555, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17900326

Citation

Whitehead, William E., et al. "Comorbidity in Irritable Bowel Syndrome." The American Journal of Gastroenterology, vol. 102, no. 12, 2007, pp. 2767-76.
Whitehead WE, Palsson OS, Levy RR, et al. Comorbidity in irritable bowel syndrome. Am J Gastroenterol. 2007;102(12):2767-76.
Whitehead, W. E., Palsson, O. S., Levy, R. R., Feld, A. D., Turner, M., & Von Korff, M. (2007). Comorbidity in irritable bowel syndrome. The American Journal of Gastroenterology, 102(12), pp. 2767-76.
Whitehead WE, et al. Comorbidity in Irritable Bowel Syndrome. Am J Gastroenterol. 2007;102(12):2767-76. PubMed PMID: 17900326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comorbidity in irritable bowel syndrome. AU - Whitehead,William E, AU - Palsson,Olafur S, AU - Levy,Rona R, AU - Feld,Andrew D, AU - Turner,Marsha, AU - Von Korff,Michael, Y1 - 2007/09/26/ PY - 2007/9/29/pubmed PY - 2008/2/22/medline PY - 2007/9/29/entrez SP - 2767 EP - 76 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 102 IS - 12 N2 - BACKGROUND: Comorbid nongastrointestinal symptoms account for two-thirds of excess health-care costs in irritable bowel syndrome (IBS). OBJECTIVES: To determine whether IBS patients are at greater risk for specific comorbid disorders versus showing a general tendency to overreport symptoms; whether patients with inflammatory bowel disease (IBD) show patterns of comorbidity similar to IBS; whether comorbidity is explained by psychiatric disease; and whether excess comorbidity occurs in all IBS patients. METHODS: All 3,153 patients in a health maintenance organization with a diagnosis of IBS in 1994-1995 were compared to 3,153 age- and gender-matched controls, and to 571 IBD patients. All diagnoses in a 4-yr period beginning 1 yr before their index visit were categorized as gastrointestinal, psychiatric, or nongastrointestinal somatic. Nongastrointestinal somatic diagnoses were further divided into symptom-based versus biological marker-based diagnoses. RESULTS: Forty-eight of 51 symptom-based and 16 of 25 biomarker-based diagnoses were significantly more common in IBS versus controls. However, there were no unique associations. Bacterial, viral, and fungal infections and stroke were among diagnoses made more frequently in IBS. IBD patients were similar to controls. Greater somatic comorbidity was associated with concurrent psychiatric diagnosis. Only 16% of IBS patients had abnormally high numbers of comorbid diagnoses. CONCLUSIONS: Comorbidity in IBS is due to a general amplification of symptom reporting and physician consultation rather than a few unique associations; this suggests biased symptom perception rather than shared pathophysiology. Comorbidity is influenced by, but is not explained by, psychiatric illness. Excess comorbidity is present in only a subset of IBS patients. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17900326/Comorbidity_in_irritable_bowel_syndrome_ L2 - http://Insights.ovid.com/pubmed?pmid=17900326 DB - PRIME DP - Unbound Medicine ER -