TY - JOUR
T1 - Overlap of irritable bowel syndrome and functional dyspepsia in the clinical setting
T2 - prevalence and risk factors
AU - von Wulffen, Moritz
AU - Talley, Nicholas J.
AU - Hammer, Johann
AU - McMaster, Jessica
AU - Rich, Graeme
AU - Shah, Ayesha
AU - Koloski, Natasha
AU - Kendall, Bradley J.
AU - Jones, Mike
AU - Holtmann, Gerald
PY - 2019/2
Y1 - 2019/2
N2 - 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.
AB - 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.
KW - functional gastrointestinal disorders
KW - functional dyspepsia
KW - irritable bowel syndrome
KW - symptom severity
UR - http://www.scopus.com/inward/record.url?scp=85055940880&partnerID=8YFLogxK
U2 - 10.1007/s10620-018-5343-6
DO - 10.1007/s10620-018-5343-6
M3 - Article
VL - 64
SP - 480
EP - 486
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
SN - 0163-2116
IS - 2
ER -