Three in Four People With IBS Also Have Functional Dyspepsia

Charlene Laino

October 14, 2003

Oct. 14, 2003 (Baltimore) — More patients than thought may suffer from multiple functional gastrointestinal disorders, according to researchers who found that nearly three quarters of people who suffer from irritable bowel syndrome (IBS) also have functional dyspepsia.

"Physicians need to realize that many patients seeking care for gastrointestinal symptoms are likely to have more than one clinical disorder," said lead researcher Ashok K. Tuteja, MD, from the Department of Gastroenterology at the University of Utah in Salt Lake City.

Dr. Tuteja presented the findings here on Monday at the 68th annual scientific meeting of the American College of Gastroenterology. About 1 in 10 American suffer from IBS and even more from dyspepsia, he said.

It has been suggested that dyspepsia and IBS represent the same disease entity — the so-called irritable gut, Dr. Tuteja said. As a result, he and colleagues undertook a study to determine how common each syndrome is and how much the two overlap.

The researchers followed 723 people who filled out questionnaires asking about their upper and lower gastrointestinal symptoms. Their ages ranged from 24 to 77 years (median, 47 years).

IBS was defined as having continuous or recurrent symptoms for three months or more in the previous 12 months. Symptoms included abdominal pain or discomfort that is relieved with defecation or associated with changes in stool, hard or loose stool, straining or urgency, and bloating.

Functional dyspepsia was defined as having upper abdominal pain or discomfort six months or more in the previous year.

Nearly 15% of the patients reported symptoms of dyspepsia: 6.2% reported ulcer-like dyspepsia, 6.1% reported dysmotility-like dyspepsia, and 9.4% reported reflux dyspepsia. Also, 8.9% of patients had IBS symptoms, and 6.2% reported both dyspepsia and IBS.

Of the patients with IBS, 70% also had functional dyspepsia and of subjects with dyspepsia, 43% also had IBS, the study showed.

The association between the two syndromes was much greater than that expected by chance (kappa = 0.48), Dr. Tuteja reported.

Both IBS and the overlap syndrome were more common in women, but these differences were not statistically significant (P > .27). There was no association between any of the disorders and alcohol or aspirin use (P > .19), the study showed.

The people who reported symptoms of both disorders or symptoms of IBS were much more likely to consult a physician about their problems than those with dyspepsia alone, Dr. Tuteja reported. Thirty-three percent of those with both dyspepsia and IBS symptoms visited a physician in the previous year compared with 17% of patients with dyspepsia alone and 31% with IBS alone.

Richard G. Locke, III, MD, associate professor of medicine at the Mayo Clinic in Rochester, Minnesota, said that physicians are increasingly recognizing that many patients will have symptoms of more than one gastric disorder.

The question, he said, is "should we be rearranging the deck? Are people who have IBS and dyspepsia somehow different than those who have only one or the other?"

As drugs targeting the molecular aberrations that cause gastric disorders are developed, knowing the answer to that question will become increasingly important, he said.

Kevin W. Olden, MD, associate professor of medicine in the Division of Gastroenterology at the Mayo Clinic in Scottsdale, Arizona, agreed. "Each person has different molecular changes. The patient with both IBS and dyspepsia will have a different molecular change than the person with just IBS or dyspepsia."

Understanding these molecular changes is the wave of the future, he said.

ACG 68th Annual Scientific Meeting: Abstract 301. Presented Oct. 13, 2003.

Reviewed by Gary D. Vogin, MD


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