Increased prevalence of irritable bowel syndrome in patients with bronchial asthma

Received 28 December 2001; accepted 27 May 2002.

Abstract

Irritable bowel syndrome (IBS) is one of the most common diseases of the gastrointestinal tract. IBS may represent a primary disorder of gastrointestinal motility, accompanied with motor dysfunction in various extraintestinal sites. Recent studies suggest that IBS is associated with bronchial hyper-responsiveness and bronchial asthma might be more prevalent in IBS patients than in control subjects. The aim of our study was to assess the prevalence of IBS in a cohort of asthmatic patients. We evaluated 150 patients with bronchial asthma (71 males and 79 females, aged 45.1±14.9 years) and two control groups including 130 patients with other pulmonary disorder and 120 healthy subjects. All subjects enrolled (asthmatic and controls) completed the Greek version of the Bowel Disease Questionnaire (BDQ). BDQ is a, previously validated, self-report instrument to measure gastrointestinal symptoms. Diagnosis of IBS was based on Rome II criteria. The IBS prevalence was significantly higher in asthmatics (62/150, 41.3%) than in subjects with other pulmonary disorders (29/130, 22.3%,P <0.001) and healthy ones (25/120, 20.8%, P<0.001). For all subjects studied, the prevalence of IBS was significantly higher in females (78/214, 36.4%) than in males (38/186, 20.4%, P<0.001). The IBS prevalence in asthmatic males was 29.5% vs. 15.2% in male patients with other pulmonary disorders (P=0.002) and 14.2% in male healthy subjects (P=0.002). The IBS prevalence in asthmatic females was 51.8% vs. 28.1% in females patients with other pulmonary disorders (P<0.001) and 26.5% in females healthy subjects (P<0.001). None of the asthma medications were associated with increased or decreased likelihood of IBS. We conclude that patients with bronchial asthma have an increased prevalence of IBS. Further studies are needed to clarify the potential pathogenetic mechanisms underlying the association between IBS and asthma.

Keywords: bronchial asthma, irritable bowel syndrome, autonomic nervous system.

No full text is available. To read the body of this article, please view the PDF online.

Article Outline

• Abstract

• References

• Copyright

References

REFERENCES

1. 1 Drossman DA, LI Z, Andruzzi E. US householder survey of functional GI disorders prevalence, sociodemography and health impact. Dig Dis Sci. 1993;13:1569–1580.

2. 2 Evehart JE, Renault PF. Irritable bowel syndrome in office-based practice in the United States. Gastroenterology. 1991;100:998–1005. Abstract

3. 3 Talley NJ, Gabriel SE, Harmsen WS, Zinsmeister AR, Evans RW. Medical costs in community subjects with irritable bowel syndrome. Gastroenterology. 1995;109:1736–1741. Abstract | Full-Text PDF (603 KB) | CrossRef

4. 4 Olden KW, Schuster MM. Irritable bowel syndrome. In: Feldman M, Scharschmidt BF, Sleisenger MH editor. Gastrointestinal and Liver Disease. Pathophysiology, Diagnosis, Management. Philadelphia: WB Saunders; 1998;p. 1536–1547.

5. 5 Smart HL, Nicholson DA, Atkinson M. Gastroesophageal reflux in the irritable bowel syndrome. Gut. 1986;27:1127–1131. MEDLINE | CrossRef

6. 6 Whorwell PJ, Cloter C, Smith CL. Oesophageal motility in the irritable bowel syndrome. Gut. 1986;27:1127–1131. MEDLINE | CrossRef

7. 7 Kellow JE, Philips SF. Altered small bowel motility in irritable bowel syndrome is correlated with symptoms. Gastroenterology. 1987;92:1885–1893. Abstract | Full-Text PDF (1109 KB)

8. 8 Whorwell PJ, Mc Callum M, Creed FH, Roberts CT. Noncolonic features of irritable bowel syndrome. Gut. 1986;27:37–40. MEDLINE | CrossRef

9. 9 Walker EA, Katon WJ, Roy-Byrne PP, Jemelka RP, Russo J. Histories of sexual victimization in patients with irritable bowel syndrome or inflammatory bowel disease. Am J Psychiatr. 1993;150:1502–1506.

10. 10 Veale D, Kavanagh G, Fielding JF, Fitzgerald O. Primary fibromyalgia and the irritable bowel syndrome: different expressions of a common pathogenetic process. Br J Rheumatol. 1991;30:220–222. MEDLINE

11. 11 White AM, Stephens WH, Upton AR. Airway responsiveness to inhaled metacholine in patients with irritable bowel syndrome. Gastroenterology. 1991;100:68–74. Abstract | Full-Text PDF (754 KB)

12. 12 Kennedy TM, Jones RH, Hungin A PS, O' Flanagan H, Kelly P. Irritable bowel syndrome, gastro-oesophageal reflux and bronchial hyper-responsiveness in the general population. Gut. 1998;43:770–774. MEDLINE

13. 13 Yazar A, Atis S, Konca K. Respiratory symptoms and pulmonary functional changes in patients with irritable bowel syndrome. Am J Gastroenterol. 2001;96:1511–1516. MEDLINE | CrossRef

14. 14 American Thoracic S ociety. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am Rev Respir Dis. 1987;136:225–244. MEDLINE

15. 15 Talley NJ, Phillips SF, Melton LJ, Wiltgen C, Zinsmeister AR. A patient questionnaire to identify bowel disease. Ann Int Med. 1989;11:671–674.

16. 16 Talley NJ, Zinsmeister AR, Van Duke C, Melton LJ. Epidemiology of colonic symptoms and the irritable bowel syndrome. Gastroenterology. 1991;101:927–934. Abstract | Full-Text PDF (794 KB)

17. 17 Talley NJ, O' Keefe EA, Zinsmeister AR, Melton IL. Prevalence of irritable bowel syndrome in the elderly: a population based study. Gastroenterology. 1992;102:1259–1268. Abstract | Full-Text PDF (856 KB)

18. 18 Neri M, Laterza F, Howell S. Symptoms discriminate irritable bowel syndrome from organic gastrointestinal diseases and food allergy. Eur J Gastroenterol Hepatol. 2000;12:981–988. CrossRef

19. 19 Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut. 1999;45:S43–S47.

20. 20 Thompson WG, Heaton KW, Smyth GT, Smyth C. Irritable bowel syndrome in general practice: prevalence, characteristics and referral. Gut. 2000;46:78–82. MEDLINE | CrossRef

21. 21 Minton NA, Henry JA. Acute and chronic human toxicity of theophylline. Hum Exp Toxicol. 1996;15:478–481.

22. 22 Buchman AL. Side effects of corticosteroid therapy. J Clin Gastroenterol. 2001;33:289–294. MEDLINE | CrossRef

23. 23 Kellow JE, Gill RC, Wingate DL. Prolonged ambulant recordings of small bowel motility demonstrate abnormalities in the irritable bowel syndrome. Gastroenterology. 1990;98:1208–1218. Abstract

24. 24 Wallis RM, Napier CM. Muscarinic antagonists in development for disorders of smooth muscle function. Life Sci. 1999;64:395–401. MEDLINE | CrossRef

25. 25 Smart HL, Atkinson M. Abnormal vagal function in irritable bowel syndrome. Lancet. 1987;1:475–478. MEDLINE

26. 26 Jartti T. Asthma, asthma medication and autonomic nervous system function. Clin Physiol. 2001;21:260–269. MEDLINE | CrossRef

27. 27 Alexander JA, Hunt LW, Patel AM. Prevalence, pathophysiology and treatment of patients with asthma and gastroesophageal reflux disease. Mayo Clin Proc. 2000;75:1055–1063. MEDLINE

28. 28 Harding SM, Sontag SJ. Asthma and gastroesophageal reflux. Am J Gastroenterol. 2000;95:S23–S32. MEDLINE | CrossRef

29. 29 Lodi U, Harding SM, Coghlan HC, Guzzo MR, Walker LH. Autonomic regulation in asthmatics with gastroesophageal reflux. Chest. 1997;111:65–70. MEDLINE | CrossRef

9th Department of Pulmonary Medicine, “SOTIRIA” Chest Diseases Hospital, Athens, Greece

f1 Correspondence should be addressed to: Anastasios Roussos, 20 Ierosolimon St, P.O.: 11252, Athens, Greece. E-mail: roumar26@yahoo.com

PII: S0954-6111(01)91409-X

doi:10.1053/rmed.2001.1409

13 of 18