Overlap between irritable bowel syndrome and functional dyspepsia including subtype analyses.
OBJECTIVE
Coexistent gastrointestinal symptom profiles and prevalence or associated factors for the overlap between each functional dyspepsia (FD) and irritable bowel syndrome (IBS) group remain unclear. Thus, the aim of the present study was to evaluate the clinicodemographic features of FD, IBS, and IBS-FD overlap and assess the risk factors thereof, including subtype and genetic polymorphisms for IBS-FD.


METHODS
Consecutive patients were enrolled from the outpatient Gastroenterology clinics of Bundang Seoul National University Hospitals in Korea. All gastrointestinal symptoms occurring at least once per week in the previous 3 months were recorded. Diagnostic criteria of functional gastrointestinal disorders were based on the Rome III criteria. Risk factors including genetic polymorphisms of 5-HTTLPR and ADRA2A 1291 G alleles and CCK-1R intron 779T>C were assessed using a multivariate logistic regression model.


RESULTS
A total of 632 subjects (278 control subjects, 308 FD, 156 IBS, and 110 who met the criteria for both FD and IBS) were included in this study. Patients with IBS-FD overlap had more severe symptoms (such as bloating, nausea, vomiting, hard or lumpy stools, defecation straining, and a feeling of incomplete bowel movement) and higher depression scores compared with non-overlap patients. Single/divorced or widowed marital status, nausea, bloating, and a feeling of incomplete emptying after bowel movements were independent risk factors for IBS-FD overlap among IBS patients. In contrast, young age, depression, bloating, and postprandial distress syndrome were positively associated with IBS-FD overlap among FD patients. 5-HTTLPR L/L was a risk factor for the co-occurrence of IBS-C among FD patients (OR: 12.47; 95% CI: 2.00-77.75; P = 0.007).


CONCLUSIONS
Bloating was a risk factor for IBS-FD overlap. Patients with postprandial distress syndrome have a higher risk of coexisting IBS, particularly constipation-dominant IBS.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
Yoon Jin
YJ
Choi
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.|Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
Nayoung
N
Kim
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
Hyuk
H
Yoon
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
Cheol Min
CM
Shin
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.|Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
Young Soo
YS
Park
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.|Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
Jin-Wook
JW
Kim
Department of Gastroenterology, Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Gunpo, South Korea.
Yong Sung
YS
Kim
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.|Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
Dong Ho
DH
Lee
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
Hyun Chae
HC
Jung
D000328:Adult; D000367:Age Factors; D000483:Alleles; D019742:Chemokines, CC / Q000235:genetics; D015897:Comorbidity; D003863:Depression; D004415:Dyspepsia / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics*; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011110:Polymorphism, Genetic; D015995:Prevalence; D018341:Receptors, Adrenergic, alpha-2 / Q000235:genetics; D012307:Risk Factors; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics
C547768:ADRA2A protein, human; C414047:CCL28 protein, human; D019742:Chemokines, CC; D018341:Receptors, Adrenergic, alpha-2; C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins
bloating; depression; functional dyspepsia; irritable bowel syndrome