Irritable bowel syndrome and the incidence of colorectal neoplasia: a prospective cohort study with community-based screened population in Taiwan

Abstract

Background:We aim to report the prevalence of irritable bowel syndrome (IBS) and elucidate the influence of IBS on the incidence of colorectal neoplasm through a community-screening-based, longitudinal follow-up study.Methods:We enroled 39 384 community residents aged 40 years or older who had participated in a community-based colorectal cancer-screening programme with an immunochemical faecal occult test since 1999. We followed a cohort that was free of colorectal neoplasm (excluding colorectal neoplasm at baseline) to ascertain the incident colorectal neoplasm through each round of screening and used a nationwide cancer registry. Information on IBS was obtained by linking this screened cohort with population-based health insurance claim data. Other confounding factors were also collected via questionnaire or biochemical tests.Results:The overall period prevalence of IBS was 23%, increasing from 14.7% for subjects aged 40–49 years to 43.7% for those aged 70 years and more. After controlling for age, gender and family history of colorectal cancer, screenees who had been diagnosed as having IBS exhibited a significantly elevated level (21% adjusted hazard ratio (HR)=1.21 (95% CI: 1.02–1.42)) of incident colorectal adenoma compared with those who had not been diagnosed with IBS. A similar finding was noted for invasive carcinoma; however, the size of the effect was of borderline statistical significance (adjusted HR=1.20 (95% CI: 0.94–1.53)).Conclusions:IBS led to an increased risk for incident colorectal neoplasm.

Irritable Bowel Syndrome between Molecular Approach and Clinical Expertise—Searching for Gap Fillers in the Oxidative Stress Way of Thinking

“…One of the most important issues to consider is inflammation mismatch between IBS and IBD due to the fact that IBS lies somewhere in the spectrum of functionality while IBD is more an organic disorder, argument sustained by a characteristic mucosal inflammation and symptomatology that do not certify endoscopic conclusions [68], identification of reliable biomarkers being a priority and a major step forward for the management of this disease. It would be unrealistic to expect that a single candidate biomarker could be the answer to all questions, which is why intestinal tissue was the perfect starting point to search novel biomarkers, the same logic also being viable for IBS by using urine, stool, and blood samples [88]. Calcium-signaling heterodimer, calprotectin, constituted the cornerstone for non-invasively testing for IBS.…”

“…An increased mucosal permeability could explain to some extent visceral hypersensitivity and interactions with enteric nervous system (ENS) that leads to an aggravated symptomatology in IBS [85]. Based on the aspects detailed earlier and results obtained in this context, IBS is not a precursor of colorectal cancer (CRC), data sustained after the analysis of variable cohorts in number (between 30,000 and 90,000 individuals) [86][87][88]. In this way, we find arguments in explaining the main difference between IBS and IBD in which the antioxidant system is impaired and inflammation escalades [98].…”

Risk of psychiatric disorders in irritable bowel syndrome-A nationwide, population-based, cohort study

“…Irritable bowel syndrome (IBS) is a functional bowel disorder characterised by chronic or recurrent abdominal pain associated with either relief or exacerbation by defecation, or a change in bowel habit . The consequences of IBS include the risk of other disorders or diseases, such as colorectal neoplasia, colorectal cancer, and other cancers, and asthma …”

Systematic review with meta‐analysis: the accuracy of diagnosing irritable bowel syndrome with symptoms, biomarkers and/or psychological markers

“…3 The pathogenesis of IBS is poorly understood and, as yet, no unifying structural or physiological cause has been identified. Furthermore, making a positive diagnosis of IBS is challenging as the symptoms often overlap with those of organic GI disease such as colorectal cancer, 4 inflammatory bowel disease, 5 bile acid malabsorption, 6 and coeliac disease. 7,8 Symptom-based diagnostic criteria were developed to aid in making a positive diagnosis of IBS and are the current gold standard, the latest iteration of these being the Rome III criteria.…”