Overlap of irritable bowel syndrome and functional dyspepsia in the clinical setting

prevalence and risk factors

Moritz von Wulffen, Nicholas J. Talley, Johann Hammer, Jessica McMaster, Graeme Rich, Ayesha Shah, Natasha Koloski, Bradley J. Kendall, Mike Jones, Gerald Holtmann*

*Corresponding author for this work

    Research output: Contribution to journalArticle

    21 Citations (Scopus)


    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.

    Original languageEnglish
    Pages (from-to)480-486
    Number of pages7
    JournalDigestive Diseases and Sciences
    Issue number2
    Publication statusPublished - Feb 2019


    • functional gastrointestinal disorders
    • functional dyspepsia
    • irritable bowel syndrome
    • symptom severity

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