COMORBIDITIES IN COMORBIDITIES IN PATIENTS WITH PATIENTS WITH

IRRITABLE BOWEL IRRITABLE BOWEL SYNDROMESYNDROME

Natalia PriNatalia Prittcancan Alina Burianov,Gheata IrinaAlina Burianov,Gheata Irina

Doctor Melania MacarieDoctor Melania Macarie

Faculty of Medicine, UMPh Targu MureşFaculty of Medicine, UMPh Targu MureşDepartment of Gastroenterology I, Faculty of Medicine, UMPh Targu MureşDepartment of Gastroenterology I, Faculty of Medicine, UMPh Targu Mureş

IntroductionIntroduction

• Irritable bowel syndrome (IBS) is a symptom-based Irritable bowel syndrome (IBS) is a symptom-based diagnosisdiagnosis characterized by chronic abdominal pain, characterized by chronic abdominal pain, discomfort, bloatingdiscomfort, bloating,,andand alteration of bowel habits. alteration of bowel habits.

• As a functional gastrointestinal disorderAs a functional gastrointestinal disorder,, IBS has no IBS has no knownknown organiorganic cause.c cause.

• IBS can be classified as either diarrhea-predominant IBS can be classified as either diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), with (IBS-D), constipation-predominant (IBS-C), with alternating stool pattern (IBS-A) or pain-predominant.alternating stool pattern (IBS-A) or pain-predominant.

AimAim

  The aim of this study was to analyze comorbidities, which appear with greater frequency in patients diagnosed with IBS. We took in consideration the following areas:

• psychiatric disorders • other gastrointestinal disorders• metabolic disorders • cardiovascular disorders

Material and methodMaterial and method • We performed a retrospective study of 2459 patients

hospitalized in Gastroenterology Clinic of Targu Mures County

Clinical Emergency Hospital between 01.01.2012 -31.12.2013. • Almost everything about IBS is totally dependent on the

individual patient, therefore this syndrom can be nothing more than a mild discomfort or completely debilitating. Most people can control their symptoms with diet, stress management, and prescribed medications.

IBS PathophysiologyIBS Pathophysiology

Results:Results:

During the studied period there were diagnosed 73 (2.9 %) patients with IBS. People with IBS often suffer from other GI and non-GI conditions. All hospitalized patients who have been diagnosed with this syndrom had at least 2 comorbidities of the categories listed above.

91.70%

56.10%

36.90%27.90%

0

0.2

0.4

0.6

0.8

1

other GI Psyh CV MD

other GIPsyhCV MD

The average age of patients was 53.4 years, predomining

at females (ratio of F/M 2.2 /1) .

50

23

female (69%)

male (31%)

GI conditions such as gastritis, hiatal hernia , hepatic steatosis, disorders of biliary pathway, reflux esophagitis and hepatitis are more common in people with IBS than the general population.

hepatitis disorders ofbilliary pathway

gastritis hiatal hernia hepatic steatosis reflux esophagitis

4%

20.50%

64.30%

35.60%

26%

16.40%

Stress, Anxiety,Depression Stress, Anxiety,Depression and IBSand IBS

Regardless of whether they have IBS, people with anxiety tend to worry greatly about issues such as health, money, or careers, according to the Anxiety Disorders Association of America.High prevalence of psychiatric disorders in patients with IBS High prevalence of psychiatric disorders in patients with IBS sugest that the association of IBS and psychiatric disorders may sugest that the association of IBS and psychiatric disorders may be more fundamental than was previously believed.be more fundamental than was previously believed.

“While there are multiple factors leading to irritable bowel syndrome, there is a strong association with psychological disorders such as anxiety and depression. However, it is not always clear whether the anxiety or depression causes IBS or results from the IBS symptoms.” Dr Wang Yu Tien, Consultant, Department of Gastroenterology and Hepatology, Singapore General Hospital (SGH).

depression, 38.30%

schizophrenia, 5.40%

anxiety, 38.30%

Other associated conditions

26%

20.50%HCh

26%AHT

8.20%DM

17.80%ICD

4%Obesity

16.40%VD

0%

5%

10%

15%

20%

25%

30%

Cardiovascular disorders Metabolic disorders Osteoarticular disorders

CConclusionsonclusions::

People with IBS frequently have psychiatric disorders, gastritis, hiatal hernia, hepatic steatosis, disorders of biliary pathway and reflux esophagitis.

There is a strong link between IBS on one hand, and anxiety and depression on the other. However, it is unclear which one comes first.

IBS affects about twice as many women as men. IBS has no direct effect on life expectancy. It is,

however, a source of chronic pain, fatigue, and other symptoms and contributes to work absences.

Thank youThank you!!