Studying the Overlap Between IBS and GERD: A Systematic Review of the Literature

Abstract

Evidence points to a significant overlap between irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD). In this study, we evaluate this overlap by conducting a systematic review of the literature. Six electronic databases from 1966 through January 2005 were screened by multiple search terms to identify all epidmiological evidence linking IBS and GERD. In addition, AGA meeting abstracts for 2003 and 2004 were also screened. All studies were validated by the authors and data extracted according to predefined criteria. As a separate search strategy, studies evaluating the prevalence of IBS and GERD in the general population were sought. These articles were obtained to compare the prevalence of IBS and GERD in the community to the degree of overlap. The search identified 997 original titles with 15 publications that fulfilled our eligibility criteria. Among the 15 studies, 7 determined the GERD maximum mean prevalence in patients already diagnosed with IBS to be 39.3% and the weighted mean 30.3%. The other 7 studies examined the prevalence of IBS in patients already diagnosed with GERD. The maximum mean prevalence of IBS in subjects with known GERD was 48.8% and the weighted mean 60.5%. Based on the prevalence of IBS (12.1%) and GERD (19.4%) in the community, the rate of IBS in the non-GERD community was calculated to be only 5.1%. There is a strong overlap between GERD and IBS that exceeds the individual presence of each condition. In the absence of GERD, IBS is relatively uncommon.

Heartburn and other related symptoms are independent of body mass index in irritable bowel syndrome

“…These results are very similar to those of a recent systematic review by Nas- (2). In our study we only analyzed the presence of heartburn according to the Rome II Modular Questionnaire but we did not rule out pathological gastroesophageal reflux to discriminate those subjects from the ones with functional heartburn, as precluded by the Rome II criteria (5).…”

“…In fact, a study reported that reflux symptoms were the most powerful predictors of extraintestinal manifestations in IBS (1). Furthermore, a recent systematic review of the literature found that the maximum mean prevalence of GERD in patients already diagnosed with IBS was 39% and the maximum mean prevalence of IBS in subjects with known GERD was 49%, exceeding the individual presence of each condition (2). Also, in a study aimed to assess the effect of IBS on the postoperative outcome of laparoscopic fundoplication, surprisingly, 81% of the GERD patients with IBS according to the Rome II criteria, no longer fulfilled criteria for IBS (3).…”

Evidence-based clinical practice guidelines for irritable bowel syndrome

“…Although data on patients who visit practitioners are lacking, data from a mass work place health-screening survey indicated that IBS patients show two times or more higher co-morbidity with GERD than non-IBS patients [163,164].…”

Irritable bowel syndrome subtypes: Clinical and psychological features, body mass index and comorbidities

“…Several studies have shown a considerable overlap of IBS with gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) (2,3). In addition, nongastrointestinal somatic disorders and psychiatric disorders occur frequently in IBS (4,5).…”