- Fecal Incontinence
|Overlap of Irritable Bowel Syndrome and Functional Dyspepsia in the Clinical Setting: Prevalence and Risk Factors
von Wulffen M1,2,3, Talley NJ4, Hammer J2,3,5, McMaster J1,2,3, Rich G1,2,3, Shah A1,2,3, Koloski N1,2,4, Kendall BJ1,2,3, Jones M6, Holtmann G7,8,9,10. Dig Dis Sci. 2018 Oct 27. doi: 10.1007/s10620-018-5343-6. [Epub ahead of print]
1 Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia.
2 Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
3 Translational Research Institute, Brisbane, QLD, Australia.
4 Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia.
5 Medical University of Vienna, Vienna, Austria.
6 Department of Psychology, Macquarie University, Sydney, NSW, Australia.
7 Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, 199 Ipswich Rd, Woolloongabba, Brisbane, QLD, 4102, Australia. email@example.com.
8 Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia. firstname.lastname@example.org.
9 Translational Research Institute, Brisbane, QLD, Australia. email@example.com.
10 Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia. firstname.lastname@example.org.
BACKGROUND: According to Rome IV criteria, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are distinct functional gastrointestinal disorders (FGID); however, overlap of these conditions is common in population-based studies, but clinical data are lacking.
AIMS: To determine the overlap of FD and IBS in the clinical setting and define risk factors for the overlap of FD/IBS.
METHODS: A total of 1127 consecutive gastroenterology outpatients of a tertiary center were recruited and symptoms assessed with a standardized validated questionnaire. Patients without evidence for structural or biochemical abnormalities as a cause of symptoms were then categorized based upon the symptom pattern as having FD, IBS or FD/IBS overlap. Additionally, this categorization was compared with the clinical diagnosis documented in the integrated electronic medical records system.
RESULTS: A total of 120 patients had a clinical diagnosis of a FGID. Based upon standardized assessment with a questionnaire, 64% of patients had FD/IBS overlap as compared to 23% based upon the routine clinical documentation. In patients with severe IBS or FD symptoms (defined as symptoms affecting quality of life), the likelihood of FD/IBS overlap was substantially increased (OR = 3.1; 95%CI 1.9-5.0) and (OR = 9.0; 95%CI 3.5-22.7), respectively. Thus, symptom severity for IBS- or FD symptoms were significantly higher for patients with FD/IBS overlap as compared to patients with FD or IBS alone (p all < 0.01). Age, gender and IBS-subtype were not associated with overlap.
CONCLUSION: In the clinical setting, overlap of FD and IBS is the norm rather than the exception. FD/IBS overlap is associated with a more severe manifestation of a FGID.