Esophageal disorders in patients with irritable bowel syndrome

Abstract

Aim.To study the whole range of esophageal disorders in patients with irritable bowel syndrome (IBS) using high-tech methods.
 Materials and methods.102 IBS patients (47 males, mean age 40.8, diagnosis of IBS was established according to Rome III criteria) with esophageal symptoms (heartburn, belching, globus sensation and noncardiac chest pain) were examined in gastroenterology department. All patients underwent endoscopy, with biopsies if required, X-ray examination of upper gastrointestinal tract; 24-hour pH-impedance monitoring;13C-urea breath test. Evaluation of esophageal symptoms was carried out on the basis of Rome IV criteria.
 Results.21 (20.6%) individuals had esophagitis (ERD). According to 24-hour pH-monitoring data, 7 of them had overlap between GERD and functional esophageal disorders (FED). 27 (26.5%) individuals had nonerosive reflux disease (NERD). In 54 (52.9%) individuals endoscopy and pH-impedance monitoring data did not differ from normal, suggesting this group as group of patients with FED. There was no significant difference for age, sex and IBS subtypes in GERD, NERD and FED groups.
 Conclusion.Comorbid esophageal disorders in patients with IBS are different and represented by organic diseases, FED and overlap between them. Methods such as 24-h pH-impedance measurement and esophageal manometry should be used to assess comorbid esophageal disorders in IBS patients.

The overlap between gastroesophageal reflux disease and irritable bowel syndrome: an updated systematic review

“…Among the studies that reported the presence of GERD among IBS patients, pourhoseingholi et al reported the highest prevalence rate, being 74.7% GERD patients among 18,180 patients with IBS. 16 On the other hand, the lowest prevalence rate of patients with GERD among an IBS population was found to be 20.6%, however, the sample size was limited being 102 only as reported by Morozova et al 25 Another four studies have also reported the prevalence of GERD symptoms among patients with IBS. A large study by El Slahy et al reported that 66% of their 1489 IBS patients were diagnosed with GERD.…”

“…1820 At baseline, three studies included patients with GERD, six included patients with IBS, while seven included patients with non-specified GERD or IBS to study the correlation as to their primary outcome. [15][16][17][18][21][22][23][24][25][26][27][28][29][30] Almost all studies were cross-sectional in design while only two studies were RCTs. 27,30 All of the studies were published between 2011 and 2020 as presented in Table 2, together with other baseline characteristics and outcomes.…”

“…Only three of the included studies used the 24-h pH monitoring for the assessment of gastric juice activity. 19,20,25 This test was previously considered the most sensitive laboratory test in diagnosing GERD and related gastro-esophageal lesions.…”

“…We also noticed that studies with IBS baseline populations recorded the highest prevalence overlap rates which might also raise questions about whether IBS has a role in developing GERD more than GERD does on IBS, however, this also was not within the scope of this review and further studies are needed. 16,[18][19][20]24,25…”