Biliary events and an increased risk of new onset irritable bowel syndrome: a population‐based cohort study

Abstract

Background Prospective data are lacking to determine if IBS a risk factor for cholecystectomy, or if biliary disease and cholecystectomy predisposes to the development of IBS. Methods Validated symptom surveys sent to cohorts of Olmsted County, MN, (1988–1994) with follow-up in 2003. Medical histories were reviewed to determine any “biliary events” (defined by gallstones or cholecystectomy). Analyses examined: 1) time to a biliary event post initial survey and separately, 2) risk of IBS (Rome II) in those with vs. without a prior biliary event. Results 1908 eligible subjects mailed a follow-up survey. For aim 1) of the 726 without IBS at initial survey, 44 (6.1%) had biliary events during follow up, in contrast to 5 of 93 (5.4%) with IBS at initial survey (HR 0.8, 95% CI 0.3-2.1). For aim 2) of the 59 subjects with a biliary event at initial survey, 10 (17%) reported new IBS on the follow-up survey, while in 682 without a biliary event up to 1.5 years prior to the second survey, 58 (8.5%) reported IBS on follow-up (OR=2.2, 95% CI 1.1-4.6, p=0.03). Conclusion There is an increased risk of new IBS in community subjects who have been diagnosed as having a biliary event.

Family history of mental illness or alcohol abuse and the irritable bowel syndrome

“…Subjects with IBS and controls were selected from a cohort of responders to a population based symptom survey conducted as part of a longitudinal natural history study [16]. The research was approved by the Institutional Review Board of Mayo Clinic.…”

“…In 2003, a new study questionnaire (see below) and an explanatory letter were mailed to a random sample of subjects who had been mailed a prior survey [16]. Reminder letters were mailed at 2, 4 and 7 weeks.…”

Optimal management of constipation associated with irritable bowel syndrome

“… 66 The clearest example of the role played by diagnostic imaging is represented by pelvic or abdominal US performed in patients reporting abdominal pain with biliary features and rise of liver enzymes, since the overlap between IBS and gall stones is a well-known entity. 67 However, physicians should be prudent in the evaluation of gallbladder US findings in IBS, and radiological assessment should be limited to patients with typical meal-provoked symptoms. Little attention in literature has been paid regarding the application of barium enema or CT colonography in IBS; the American College of Gastroenterology guidelines suggest that patients with IBS requiring further investigations should undergo colonoscopy rather than barium enema or CT colonography, because of their inability to perform random biopsies.…”

The gastroenterological symptoms and the quality of life of the patients during the late postoperative period following cholecystectomy for the treatment of cholelithiasis

“…Некоторые авторы полагают, что в большинстве случаев после ХЭ такой симптом, как диарея, явля ется проявлением функциональных нарушений же лудочнокишечного тракта (ЖКТ), а именно син дрома раздраженного кишечника (СРК), а его появ ление непосредственно связано с проведенным опе ративным вмешательством [12,13]. Так, в недавней работе, проведенной в Румынии, представлены ре зультаты обследования пациентов с симптомами боли и диспепсии после удаления желчного пузыря.…”