Abstract
BackgroundIrritable 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.MethodsUsing 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.Results65,569 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.ConclusionOur 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.
Highlights
Irritable bowel syndrome (IBS) represents the most common functional disorder of the gastrointestinal tract
According to the current S3 guideline [3], irritable bowel syndrome (IBS) disease is present when all 3 items are met: (1) there are chronic symptoms, i.e., lasting longer than 3 months, which are referred to the intestine by the patient and the physician and are usually accompanied by changes in bowel movements; (2) the complaints should justify the patient seeking help and/or worrying about them and be so severe that the quality of life is relevantly impaired as a result; (3) there are no characteristic alterations for other clinical pictures which are probably responsible for these symptoms
Prevalence of preexisting GI diseases in patients diagnosed with IBS Using the Disease Analyzer database (IQVIA) featuring patients treated between 2010 and 2019 within 1240 general practices in Germany, we analyzed the prevalence of established GI disorders like intestinal infectious diseases, gastritis/duodenitis, esophagus diseases, functional dyspepsia, ulcers, noninfective enteritis and colitis as well as other diseases of the stomach within 12 months prior to and 12 months after the first IBS diagnosis
Summary
Irritable bowel syndrome (IBS) represents the most common functional disorder of the gastrointestinal tract. As early as 3000 years ago, Hippocrates described a patient with abdominal complaints, altered stool behavior, flatulence and urge to defecate [1]. According to the current S3 guideline [3], irritable bowel syndrome (IBS) disease is present when all 3 items are met: (1) there are chronic symptoms, i.e., lasting longer than 3 months (e.g., abdominal pain, flatulence), which are referred to the intestine by the patient and the physician and are usually accompanied by changes in bowel movements; (2) the complaints should justify the patient seeking help and/or worrying about them and be so severe that the quality of life is relevantly impaired as a result; (3) there are no characteristic alterations for other clinical pictures which are probably responsible for these symptoms. We analyzed the proportion of patients with a diagnosis of IBS who, within one year prior to the diagnosis of IBS, received a diagnosis of another gastrointestinal disease that is in principle capable of causing symptoms that fit IBS and might have precluded the diagnosis of IBS
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