Comorbidity in Irritable Bowel Syndrome

Abstract

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.

Significant psychological morbidity occurs in irritable bowel syndrome: a case‐control study using a pharmacy reimbursement database

“…This suggests that significant psychological co-morbidity exists in IBS and is consistent with previously reported over-representation of depression and anxiety in IBS. 13,15,16 This study provides longitudinal data on psychological co-morbidity in IBS, using prescribing as a surrogate and this relationship has been assessed longitudinally only once before. 16 This study also provides new information about the prescribing of antipsychotic and hypnosedative drugs with IBS medicines implying that psychological conditions other than depression and anxiety may also be over-represented in IBS.…”

“…12 A number of studies have examined the prevalence of depression and anxiety in IBS. [13][14][15][16][17][18][19][20][21][22] Limitations of these studies include selection bias, disparate diagnostic criteria for IBS, depression and anxiety and assessing psychological traits as opposed to psychiatric diagnosis. Using a validated, well-characterized pharmacy reimbursement database and drug prescribing as a surrogate marker for psychological and IBS diagnosis, we examined the co-existence of psychological comorbidity in IBS in the community and evaluated the persistence of psychological co-morbidity over time.…”

A biomarker panel and psychological morbidity differentiates the irritable bowel syndrome from health and provides novel pathophysiological leads

“…In addition, subjects were required to experience active IBS symptoms more than twice a week in the month prior to enrolment and be free of comorbidities reported to be highly prevalent in individuals with IBS, 33 including major psychiatric disorders, as well as other nongastrointestinal functional disorders such as fibromyalgia, chronic fatigue and chronic pelvic pain. Subjects were assigned to the different subgroups of diarrhoea-predominant (IBS-D), constipation-predominant (IBS-C) or mixed IBS (IBS-M) based on predominant bowel habit according to the Rome III subtype table and scored by the Bristol Stool Form Scale, which was asked over a 3-month recall period.…”

Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult

“…The overlapping of IBS with other FBDs (such as FC or functional diarrhea), other functional digestive extraintestinal disorders (such as functional dyspepsia or functional heartburn), or other non-digestive disorders (such as fibromyalgia or interstitial cystitis) is very common (12,13).…”

“…In a meta-analysis (128), the use of TCAs or SSRIs generally improved distension, pain, and stool consistency in patients with IBS, with a NNT of 4 for both medications (95% CI: 3-6; 4 for TCAs with a 95% CI of 3-8, and 3.5 for SSRIs with a 95% CI of [2][3][4][5][6][7][8][9][10][11][12][13][14]. However, TCAs should not be used against IBS-C because of their increased constipation effect.…”