Many Patients Have Dual Gastric Woes
Some Indigestion or Irritable Bowel Sufferers Likely to Have Both Ailments
Oct. 14, 2003 (Baltimore) -- It's a double whammy.
Doctors report that nearly three-fourths of people who suffer from irritable bowel syndrome also have indigestion.
Indigestion, also known as dyspepsia, is a disorder with no specific cause characterized by mid-abdominal pain, bloating, and difficulty in digesting. Indigestion usually accompanies meals and can be confused with the symptoms of an ulcer. It brings a ton of misery, preventing people from working, even keeping social engagements. It accounts for a large majority of physical complaints seen in a general practitioner's office.
Irritable bowel syndrome, or IBS, also causes gas, bloating, and abdominal pain. But in the case of IBS, the bowel is affected, which is also called the large intestine. About 1 in 10 Americans suffer from chronic IBS, even more from indigestion.
The new research, presented this week at the 68th Annual Scientific Meeting of the American College of Gastroenterology, looks at the association between these two disorders.
It has been suggested that indigestion and irritable bowel syndrome represent the same disease entity -- the so-called irritable gut, according to study presenter Ashok K. Tuteja, MD, of the department of gastroenterology at the University of Utah in Salt Lake City.
As a result, he and colleagues undertook a study to determine how common each syndrome is and how much the two overlap.
The researchers surveyed 723 people who filled out questionnaires asking about their gastrointestinal symptoms. Nearly 15% reported symptoms of indigestion, 8.9% had IBS symptoms, and 6.2% reported both indigestion and IBS.
Of the patients with IBS, 70% also had functional indigestion, and of subjects with indigestion, 43% also had IBS, the study showed.
"This was much greater overlap than we expected and much more than could be attributed to chance," Tuteja says.
The people who reported symptoms of both disorders or symptoms of IBS alone were much more likely to consult a doctor about their problems than those with indigestion alone, the study showed. Thirty-three percent of those with both indigestion and IBS symptoms went to the doctor in the previous year, compared with only 4% of patients with indigestion alone and 25% with IBS alone.
How to Treat Both?
Richard G. Locke III, MD, associate professor of medicine at the Mayo Clinic in Rochester, Minn., says that doctors are increasingly recognizing that many patients will have symptoms of more than one gastric disorder.
The question, he says, is, "should we be rearranging the deck? Are people who have IBS and dyspepsia somehow different than those who have only one or the other?"
As newer drugs are being developed that target the molecular differences that cause gastric diseases, knowing the answer to that question will become increasingly important, he says.
Kevin W. Olden, MD, associate professor of medicine in the division of gastroenterology at the Mayo Clinic in Scottsdale, Ariz., agrees. "Each person has different molecular changes. The patient with both IBS and dyspepsia will have a different molecular change than the person with just IBS or dyspepsia."
Understanding these molecular changes is the wave of the future, he says.