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Increased Prevalence of Irritable Bowel Syndrome in Patients With Gastroesophageal Reflux

Pimentel, Mark M.D., F.R.C.P.C; Rossi, Federico M.D.; Chow, Evelyn J. B.A.; Ofman, Joshua M.D., M.P.H.; Fullerton, Steven M.D.; Hassard, Phillip M.D., F.R.C.P.C; Lin, Henry C. M.D.

Journal of Clinical Gastroenterology: March 2002 - Volume 34 - Issue 3 - p 221-224
Alimentary Tract: Clinical Research

Goals To determine the prevalence of irritable bowel syndrome (IBS) in subjects with gastroesophageal reflux disease (GERD) compared with non-GERD controls.

Study Two hundred subjects were identified from a list of Cedars-Sinai Medical Foundation patients and gastroenterology motility practice subjects with and without a potential diagnosis of GERD. All subjects were then evaluated independently by two blinded physicians who were asked to identify subjects with GERD based on taking a history (gold standard). A follow-up questionnaire was later mailed to patients. This questionnaire included Rome I criteria for IBS. The prevalence of IBS was compared between GERD and non-GERD subjects. Finally, to further strengthen the method, a retrospective review of all subjects' charts was conducted to identify patients who had had 24-hour pH tests, and the prevalence of IBS was determined in this subgroup.

Results Of the 200 subjects, 90 (45%) patients returned the questionnaire. After excluding subjects with IBD and incomplete questionnaires, there were 84 subjects (35 with GERD) included in the analysis. Of the 35 GERD subjects, 25 (71%) were Rome I criteria positive for IBS, whereas only 17 of the 49 (35%) non-GERD subjects had IBS (odds ratio = 54.7, CI = 1.7–13.5, p < 0.01). In 11 of the GERD subjects a 24-hour pH study was available and confirmed GERD. Of these 11 subjects, 7 (64%) met Rome I criteria for IBS.

Conclusion There is a higher prevalence of IBS in subjects with GERD compared with subjects without GERD.

From the GI Motility Program, Department of Medicine, Cedars-Sinai Medical Center, CSMC Burns & Allen Research Institute, Los Angeles, California; and the School of Medicine, University of California, Los Angeles, Los Angeles, California, U.S.A.

Submitted April 24, 2001.

Accepted August 8, 2001.

Address correspondence and reprint requests to Dr. Mark Pimentel, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 770W, Los Angeles, CA 90048, U.S.A. E-mail:

© 2002 Lippincott Williams & Wilkins, Inc.