FYI
Irritable Bowel Syndrome Linked to High Rates of Various Surgeries
NEW YORK (Reuters Health) Jun 29 - Irritable bowel syndrome (IBS) is independently associated with high rates of cholecystectomy, appendectomy, hysterectomy, and back surgery, according to a report published in the June issue of Gastroenterology. Many of these operations were probably unnecessary, the author of a related editorial suggests.
The findings are based on a study of nearly 90,000 subjects who completed medical and lifestyle questionnaires. The questionnaire data was validated in a subgroup of 201 subjects for whom continuous medical records were available for at least 3 years.
Of the six surgeries studied, cholecystectomy, appendectomy, hysterectomy, and back surgery were all significantly more common among IBS patients than among other subjects, note Dr. George F. Longstreth, from Kaiser Medical Center in San Diego, California, and Dr. Janis F. Yao, from the Permanente Medical Group in Pasadena, California.
By contrast, rates for coronary artery surgery and peptic ulcer surgery were similar for subjects with and without IBS, the report indicates.
Multivariate analysis revealed that IBS was associated with 2.1-, 1.5-, 1.7-, and 1.2-fold increased risks of cholecystectomy, appendectomy, hysterectomy, and back surgery, respectively.
"Although it is impossible to know how much of the surgical predisposition we identified resulted from misdiagnosis, consideration of our findings with those of other studies suggests that diagnostic error is an important factor," the researchers note.
In a related editorial, Dr. Nicholas J. Talley, from the Mayo Clinic in Rochester, Minnesota, comments that "prospective data on the indications and outcomes of surgery in IBS is now needed." He adds that "whether the excess surgery in IBS is cause or effect, unnecessary surgery must be avoided and the gastroenterology community should take responsibility for actions to protect the public."
Gastroenterology 2004;126:1665-1673,1899-1903.
http://www.medscape.com/viewarticle/482168
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My website on IBS is www.ibshealth.com
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Irritable Bowel Syndrome Linked to High Rates
