A systematic review and meta-analysis on the prevalence of non-malignant, organic gastrointestinal disorders misdiagnosed as irritable bowel syndrome

Poon, Dennis, Law, Graham, Major, Giles and Andreyev, H. Jervoise N. (2022) A systematic review and meta-analysis on the prevalence of non-malignant, organic gastrointestinal disorders misdiagnosed as irritable bowel syndrome. Scientific Reports, 12 . p. 1949. ISSN 2045-2322

Full content URL: https://doi.org/10.1038/s41598-022-05933-1

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A systematic review and meta-analysis on the prevalence of non-malignant, organic gastrointestinal disorders misdiagnosed as irritable bowel syndrome
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Abstract

Introduction
Treatable gastrointestinal disorders in patients with symptoms typical for irritable bowel syndrome (IBS) may be overlooked. The prevalence of five gastrointestinal conditions - bile acid diarrhoea (BAD), carbohydrate malabsorption (CM), microscopic colitis (MC), pancreatic exocrine insufficiency (PEI) and small intestinal bacterial overgrowth (SIBO) was systematically assessed from studies including consecutive patients meeting diagnostic criteria for IBS.
Methods
4 databases were searched from 1978-2020. Studies were included if they evaluated the prevalence of these conditions in secondary healthcare setting. Estimated pooled rates were calculated and statistical heterogeneity between studies was evaluated using Q and I² statistics.
Results
Seven studies (n=597) estimated the pooled prevalence for BAD as 41% (95% CI 29-54). 17 studies (n=5,068) estimated that of MC as 3% (95% CI 2-4%). Two studies (n=478) suggested a rate of 4·6% (range: 1·8-6·1%) for PEI. Using breath testing, 26 studies (n=6,700) and 13 studies (n=3,415) estimated the prevalence of lactose and fructose malabsorption as 54% (95% CI 44-64%) and 43% (95% CI 23-62%); 36 studies (n=4,630) and 22 studies (n=2,149) estimated that of SIBO as 49% (95% CI 40-57%) with lactulose and 19% (95% CI 13-27%) with glucose. Rates of all conditions were significantly higher than in healthy controls.
Conclusion
A significant proportion of patients presenting to secondary care with IBS have an organic condition which may account for their symptoms. Failure to exclude such conditions will deny patients effective treatment.

Keywords:IBS
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science > School of Health & Social Care
ID Code:47647
Deposited On:08 Feb 2022 16:02

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