title: An Initial Attack of Urinary Stone Disease Is Associated with an Increased Risk of Developing New-Onset Irritable Bowel Syndrome: Nationwide Population-Based Study.
abstract: BACKGROUND
  The neurotransmitter pathways in irritable bowel syndrome (IBS) and urinary stone attacks are both related to serotonin, and each disease may be influenced by viscero-visceral hyperalgesia. However, the relationship between urinary tract stone disease and IBS has never been addressed. We aimed to investigate the risk of suffering new-onset IBS after an initial urinary stone attack using a nationwide database.
  
  
  METHODS
  A study group enrolled a total of 13,254 patients who were diagnosed with an initial urinary stone attack; a comparison group recruited 39,762 matched non-urinary stone participants during 2003 and 2007. We followed each patient for 3 years to determine new-onset IBS. We also used Cox proportional hazards models to analyze the risk of IBS between the study and comparison groups after modified by demographics, residence, patient characteristics and personal histories.
  
  
  RESULTS
  The occurrence rates of IBS were 3.3% (n = 440) and 2.6% (n = 1,034) respectively in the study and comparison groups. A covariate-adjusted hazard ratio (HR) of IBS in the study group that was 1.28 times greater (HR = 1.29, 95% CI, 1.15-1.44) than that in the comparison group was showed in the stratified Cox proportional analysis. The adjusted HRs of IBS did not decrease after considering demographics and past histories. The majority of IBS (30.5%) occurred within the first 6 months after the stone attack.
  
  
  CONCLUSIONS
  Patients with an initial urinary stone attack are at increased risk of developing new-onset IBS. The HRs of IBS did not decrease even after adjusting for patient demographics and past histories. Most importantly, 30.5% of IBS occurred within the first 6 months after the urinary stone attack.
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Wei-Yuan
authors.initials: WY
authors.lastname: Lei
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.|Department of Biological Science and Technology of Biochemical Engineering, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Jr-Hau
authors.initials: JH
authors.lastname: Wu
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Fei-Hung
authors.initials: FH
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Cheng
authors.initials: C
authors.lastname: Hsu Chen
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Chin-Fu
authors.initials: CF
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yan-Ren
authors.initials: YR
authors.lastname: Lin
authors.affiliation: Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan, Taoyuan, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Han-Ping
authors.initials: HP
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014545:Urinary Calculi / Q000150:complications* / Q000453:epidemiology