Increased Risk for Irritable Bowel Syndrome After Acute Diverticulitis

被引：88

作者：

Cohen, Erica ^{[1
]}

Fuller, Garth ^{[2
]}

Bolus, Roger ^{[2
,3
]}

Modi, Rusha ^{[1
,2
]}

Vu, Michelle ^{[1
]}

Shahedi, Kamyar ^{[2
]}

Shah, Rena ^{[3
]}

Atia, Mary ^{[1
]}

Kurzbard, Nicole ^{[3
]}

Sheen, Victoria ^{[3
]}

Agarwal, Nikhil ^{[1
,2
,3
]}

Kaneshiro, Marc ^{[1
]}

Yen, Linnette ^{[5
]}

Hodgkins, Paul ^{[5
]}

Erder, M. Haim ^{[5
]}

Spiegel, Brennan ^{[1
,2
,3
,4
]}

机构：

[1] VA Greater Los Angeles Healthcare Syst, Dept Gastroenterol, Los Angeles, CA USA

[2] UCLA VA Ctr Outcomes Res & Educ, Los Angeles, CA USA

[3] Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Los Angeles, CA 90095 USA

[4] UCLA Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA USA

[5] Shire Pharmaceut, Wayne, PA USA

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2013年 / 11卷 / 12期

关键词：

Outcome; Colon; Inflammatory Disorder; Functional Gastrointestinal Disease; INTESTINAL BACTERIAL OVERGROWTH; DISEASE; PATTERNS; COMORBIDITY; MANAGEMENT; PERCEPTION; RIFAXIMIN; COLON;

D O I：

10.1016/j.cgh.2013.03.007

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BACKGROUND & AIMS: Individuals with diverticulosis frequently also have irritable bowel syndrome (IBS), but there are no longitudinal data to associate acute diverticulitis with subsequent IBS, functional bowel disorders, or related emotional distress. In patients with postinfectious IBS, gastrointestinal disorders cause long-term symptoms, so we investigated whether diverticulitis might lead to IBS. We compared the incidence of IBS and functional bowel and related affective disorders among patients with diverticulitis. METHODS: We performed a retrospective study of patients followed up for an average of 6.3 years at a Veteran's Administration medical center. Patients with diverticulitis were identified based on International Classification of Diseases, 9th revision codes, selected for the analysis based on chart review (cases, n = 1102), and matched with patients without diverticulosis (controls, n = 1102). We excluded patients with prior IBS, functional bowel, or mood disorders. We then identified patients who were diagnosed with IBS or functional bowel disorders after the diverticulitis attack, and controls who developed these disorders during the study period. We also collected information on mood disorders, analyzed survival times, and calculated adjusted hazard ratios. RESULTS: Cases were 4.7-fold more likely to be diagnosed later with IBS (95% confidence interval [CI], 1.6-14.0; P = .006), 2.4-fold more likely to be diagnosed later with a functional bowel disorder (95% CI, 1.6 -3.6; P < .001), and 2.2-fold more likely to develop a mood disorder (CI, 1.4-3.5; P < .001) than controls. CONCLUSIONS: Patients with diverticulitis could be at risk for later development of IBS and functional bowel disorders. We propose calling this disorder postdiverticulitis IBS. Diverticulitis appears to predispose patients to long-term gastrointestinal and emotional symptoms after resolution of inflammation; in this way, postdiverticulitis IBS is similar to postinfectious IBS.

引用

页码：1614 / 1619

页数：6

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