title: Systematic review: Abdominal and pelvic surgery in patients with irritable bowel syndrome.
abstract: OBJECTIVE
  To systematically review research on the prevalence of abdominal and pelvic surgery in patients with irritable bowel syndrome.
  
  
  METHODS
  Computer searches of MEDLINE, EMBASE and Current Contents were performed independently by both investigators to identify appropriate studies. Primary study selection criteria included: (i) population-based samples of adult irritable bowel syndrome patients; (ii) the use of appropriate symptom-based criteria to identify irritable bowel syndrome patients; and (iii) comparison of the prevalence of abdominal and pelvic surgery in irritable bowel syndrome patients vs. control populations. Secondary analysis was performed on published studies of referral populations and case series.
  
  
  RESULTS
  Two population-based studies met the primary study selection criteria and revealed an increased prevalence of surgery in irritable bowel syndrome patients vs. controls for cholecystectomy (4.6% vs. 2.4%, respectively; odds ratio, 1.9; 95% confidence interval, 1.2-3.2) and hysterectomy (18% vs. 12%, respectively; odds ratio, 1.6; 95% confidence interval, 1.1-2.2). Secondary analysis revealed an increased prevalence of appendectomy and other abdominal and pelvic surgery in irritable bowel syndrome patients.
  
  
  CONCLUSIONS
  Irritable bowel syndrome is associated with a disproportionately high prevalence of abdominal and pelvic surgery, but most studies exhibit sub-optimal study design and do not define the factors causing the increased prevalence of surgery in these patients.
authors.affiliation: Division of Gastroenterology, University of Michigan School of Medicine, Ann Arbor, 48109, USA. whasler@umich.edu
authors.forename: W L
authors.initials: WL
authors.lastname: Hasler
authors.forename: P
authors.initials: P
authors.lastname: Schoenfeld
mesh_terms: D000005:Abdomen / Q000601:surgery*; D003109:Colonic Diseases, Functional / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010388:Pelvis / Q000601:surgery*; D015995:Prevalence