Symptoms compatible with irritable bowel syndrome (IBS) may co-exist in patients with inflammatory bowel disease (IBD), presenting a clinical dilemma for physicians.
Drs Stephen Halpin and Alexander Ford and colleagues from the United Kingdom conducted a systematic review and meta-analysis to examine this issue.
The team searched MEDLINE, EMBASE, and EMBASE Classic to identify cross-sectional surveys or case-control studies reporting the prevalence of symptoms meeting diagnostic criteria for IBS in 50 or more unselected adult IBD patients.
The research team identified 3,045 articles.
|The pooled prevalence for IBS in all IBD patients was 39%|
|American Journal of Gastroenterology|
The researchers identified 13 studies, containing 1,703 patients that were eligible.
The pooled prevalence for IBS in all IBD patients was 39%, with an odds ratio compared with controls of 5.
In IBD patients in remission, the odds ratio was 4.4.
For IBD patients with active disease, the team noted the pooled prevalence of IBS was 44%, compared with 35% in those felt to be in remission.
The researchers noted that the prevalence in patients with Crohn's disease was higher than in those with ulcerative colitis.
Drs Halpin and Ford conclude, "Symptoms compatible with IBS were significantly higher in patients with IBD compared with non-IBD controls, even among those felt to be in remission."
"IBS-type symptoms were also significantly more common in Crohn's disease than in ulcerative colitis patients, and in those with active disease."
"Management strategies for IBD patients with symptoms suggestive of IBS are required."