Functional GI Disorders and IBD.
Inflammation of the gastrointestinal tract can produce motor and sensory dysfunction of the gut that persists even after the inflammation has resolved, said Dr. Irvine of McMaster University, Hamilton, Ont.
To assess the prevalence of functional gastrointestinal disorders in inflammatory bowel disease (IBD), Dr. Irvine and her associates recruited 228 consecutive IBD patients attending a clinic between May 1 and 1, 2000. Each patient completed a survey questionnaire that addressed demographic characteristics and disease activity.
Functional gastrointestinal disorders were classified according to Rome II criteria. Patients were considered to have active IBD if they had experienced a flare requiring a change in medication dosage or type within the previous year. The investigators then analyzed the association among demographic factors, functional disorders, and IBD.
Of the 228 patients, 162 had Crohn's disease, which was inactive in 69 patients. The remaining 66 had ulcerative colitis, which was inactive in 22. Only 10% of patients had no evidence of functional gastrointestinal disorders.
Among the patients with active IBD, 96% ad at least one functional disorder. The majority of patients with inactive disease--81%--also had at least one function disorder, Dr. Irvine said.
When compared with a general sample of the U.S. population, upper GI disorders were less prevalent in patients with inactive IBD. But the prevalence of lower GI disorders such as irritable bowel syndrome, fecal incontinence, and functional anorectal pain was higher, especially in patients with inactive Crohn's disease. Female sex, with an odds ratio of 4.12, was the strongest single predictor of a functional gastrointestinal disorder in a patient with inactive IBD.