Overlap between irritable bowel syndrome and common gastrointestinal diagnoses: a retrospective cohort study of 29,553 outpatients in Germany

Abstract

Background Irritable bowel syndrome (IBS) represents the most common functional disorder of the gastrointestinal tract. Many patients with IBS display complex gastrointestinal (GI) symptoms leading to overlapping diagnosis of IBS and other GI diseases in many patients. Methods Using the Disease Analyzer database (IQVIA) featuring patients treated within 2010 and 2019 within 1240 general practices in Germany, we analyzed the prevalence of common GI diseases within 12 months prior to and after the first diagnosis of IBS. Results 65,569 patients with an initial diagnosis of IBS were included into the analysis. Out of these, 29,553 patients had an observation time of at least 12 months prior to the first IBS diagnosis and at least 12 months after the first IBS diagnosis. Mean age was 48.8 (SD: 18.4) years, 65.0% were female. Notably, 16,164 (55%) of these patients had at least one preexisting diagnosis of another GI diseases within 12 months prior to the first IBS diagnosis. Most common overlapping diagnoses were intestinal infectious diseases (26%), gastritis/ duodenitis (21%), diseases of the esophagus (15%), non-infectious enteritis or colitis (7.4%), functional dyspepsia (6%) and ulcers (1.0%). Additionally, 12,048 (41%) received one of these diagnosis within 12 months after the first IBS diagnosis. Conclusion Our data provide evidence for a high overlap between IBS and other GI diagnoses. Moreover, we show that IBS is frequently diagnosed in patients with preexisting GI diseases, potentially putting into question the validity of IBS diagnosis at least in some cases.

Upper gastrointestinal endoscopic findings in functional constipation and irritable bowel syndrome diagnosed using the Rome IV criteria: a cross-sectional survey during a medical check-up in Japan

“…Meanwhile, duodenitis and other components of erosive gastritis, such as raised erosion and depressive erosion, were also significantly associated with IBS. Consistent with our results, Loosen et al reported that the most common overlapping GI diagnoses with IBS are intestinal infectious diseases, gastritis/duodenitis, esophageal diseases, FD, and other diseases of the stomach and duodenum in subjects with IBS using the disease analyzer database in Germany [ 26 ]. There are reports demonstrating the dysbiosis of mucosa-associated microbiota in duodenum in subjects with IBS [ 27 , 28 ], suggesting that altered duodenal microbiota can be one of the causes of duodenitis in subjects with IBS.…”

Impactos da Síndrome do Intestino Irritável associada à ansiedade e depressão na qualidade de vida da população

“…Nesse caso, o tratamento mais eficaz é o acompanhamento psicológico, pois o estresse é visto como causador principal dessas doenças, principalmente dos distúrbios esofágicos. (Loosen et al, 2022) (Nedelcut et al,2018) De modo geral, conclui-se que existe uma relação significativa entre SII, doenças alérgicas, ansiedade e depressão.…”

Is there a link between appendicitis and the risk of diverticular disease?: a large German cohort study

“…Earlier research has demonstrated that the panel of German practices represented in the Disease Analyzer database is an accurate reflection of both GPs and specialty practices in Germany [ 19 ]. Notably, this database has been previously employed in studies concentrating on gastrointestinal disorders [ 20 , 21 ].…”