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Comorbidity of irritable bowel syndrome in general practice

Findings in the most recent Alimentary Pharmacology and Therapeutics support the hypothesis that structured assessment of comorbid somatic symptoms might identify subgroups with different aetiology and needs of treatment

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Somatic comorbid symptoms might identify irritable bowel syndrome patients with different aetiologies and needs of treatment.

Dr Vanvik and colleagues from Norway undertook a study to measure comorbid symptoms in patients with irritable bowel syndrome in general practice.

In addition, the researchers explored characteristics of patients with low, intermediate and high somatic comorbidity.

In this prospective study, the research team recruited a total of 208 of 278 consecutive patients with irritable bowel syndrome (Rome II) in 9 general practices.

Researchers distributed questionnaires that assessed 22 comorbid symptoms (subjective health complaint inventory), psychosocial factors including psychological distress (Symptom Check list-10) and quality of life (Short form-12).

The research team used subjective health complaint data from 1240 adults (controls) as reference material.

Patients with low, intermediate and high somatic comorbidity were identified by a somatic comorbidity score (17 subjective health complaint items).

Health care seeking was assessed after 69 months.

Somatic comorbidity score correlates with psychological distress
Alimentary Pharmacology and Therapeutics

The researchers found that patients with irritable bowel syndrome (67% females, mean age 50) reported 20 of 22 comorbid symptoms significantly more frequent than controls.

In addition, the team noted that the somatic comorbidity score correlated with psychological distress.

The researchers found that patients with high somatic comorbidity reported higher levels of mood disorder, health anxiety and neuroticism than those with low and intermediate somatic comorbidity.

In addition, the research team observed that patients with high somatic comorbidity also reported higher levels of adverse life events, reduced quality of life and increased health care seeking.

Dr Vandvik concluded, "Our findings support the hypothesis that structured assessment of comorbid somatic symptoms might identify subgroups with different aetiology and needs of treatment."

Alimentary Pharmacology & Therapeutics; 2004: 20 (10): 1195
13 December 2004

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