The DOI matches its Crossref record; 181 of the 181 references it cites were found in a registry or an index.
Systematic review of the comorbidity of irritable bowel syndrome with other disorders: What are the causes and implications?
Abstract
Background & aims Comorbid or extraintestinal symptoms occur frequently with irritable bowel syndrome and account for up to three fourths of excess health care visits. This challenges the assumption that irritable bowel is a distinct disorder. The aims of this study were to (1) assess comorbidity in 3 areas: gastrointestinal disorders, psychiatric disorders, and nongastrointestinal somatic disorders; and (2) evaluate explanatory hypotheses.Methods The scientific literature since 1966 in all languages cited in Medline was systematically reviewed.Results Comorbidity with other functional gastrointestinal disorders is high and may be caused by shared pathophysiological mechanisms such as visceral hypersensitivity. Psychiatric disorders, especially major depression, anxiety, and somatoform disorders, occur in up to 94%. The nongastrointestinal nonpsychiatric disorders with the best-documented association are fibromyalgia (median of 49% have IBS), chronic fatigue syndrome (51%), temporomandibular joint disorder (64%), and chronic pelvic pain (50%).Conclusions Multivariate statistical analyses suggest that these are distinct disorders and not manifestations of a common somatization disorder, but their strong comorbidity suggests a common feature important to their expression, which is most likely psychological. Some models explain the comorbidity of irritable bowel with other disorders by suggesting that each disorder is the manifestation of varying combinations of interacting physiological and psychological factors. An alternative hypothesis is that the irritable bowel diagnosis is applied to a heterogeneous group of patients, some of whom have a predominantly psychological etiology, whereas others have a predominantly biological etiology, and that the presence of multiple comorbid disorders is a marker for psychological influences on etiology.
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In the citing paper
“it is becoming increasingly understood how psychological co-morbidity may have an impact on gastrointestinal function, [30, 31, 32, 33] and vice versa, [34, 35]”
From Efficacy of psychological therapies for irritable bowel syndrome: systematic review and network meta-analysis (2020) · cites this paper as [32]
In the citing paper
“Many IBS patients have at least one co-morbid somatic complaint and many meet diagnostic criteria for other functional disorders.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“Studies of IBS among patients with chronic fatigue syndrome have reported a prevalence ranging from 35-92%.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“Many IBS patients have at least one co-morbid somatic complaint and many meet diagnostic criteria for other functional disorders.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“The studies are consistent in their finding that the overlap among these disorders is greater than expected based on their separate prevalence rates.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“In addition, patients with more than 1 disorder have greater disease severity, higher rates of psychopathology, and more severely impaired health-related quality of life than those with only 1 disorder.4”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“There is substantial overlap between IBS and other FGID, such as functional dyspepsia.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“Studies of IBS among CFS patients have reported a prevalence ranging from 35-92%34-38 with a median of 51%.4”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“In summary, many IBS patients have at least 1 co-morbid somatic complaint and many of them meet diagnostic criteria for other gastrointestinal and extraintestinal functional disorders.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [4]
In the citing paper
“Furthermore, in the systemic review, Whitehead et al. (20) reported that between a quarter and a third of patients with IBS meet the criteria for somatization disorder, which is much higher than in the normal population.”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [20]
In the citing paper
“It is well known that psychological and psychiatric comorbidity is common among patients with IBS (17,20,40).”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [20]
In the citing paper
“The definition of PPPD paralleled work in other areas of medicine where functional disorders (e.g., the functional gastrointestinal disorders [25, 91] and fibromyalgia [93, 94]) were defined by their core physical symptoms and not associated psychological features.”
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Mearin, F. (2006) · Digestion · doi:10.1159/000089777 · Cited by 13
Tegaserod: a new 5-HT4agonist in the treatment of irritable bowel syndrome
Tack, J. F., & Corsetti, M. (2002) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.3.8.1211 · Cited by 13
“However, each of these mechanisms is only present in a subset of IBS patients and symptom pattern and severity are likely to be determined by many factors [2].”
BackgroundPractical Considerations for Recognizing and Managing Severe Irritable Bowel Syndrome
Harris, L. A., & Heitkemper, M. M. (2012) · Gastroenterology Nursing · doi:10.1097/sga.0b013e31823ff0e8 · Cited by 12
Four years Follow-up of Patients with Irritable Bowel Syndrome
Rusu, F., & Dumitrascu, D. L. (2015) · Romanian Journal of Internal Medicine · doi:10.1515/rjim-2015-0009 · Cited by 12
Yang, C., Wu, M., Lin, M., & Wei, J. C. (2020) · EClinicalMedicine · doi:10.1016/j.eclinm.2020.100383 · Cited by 14
“Studies have highly associated IBS and fibromyalgia, and suggest common pathogenetic mechanism [29,30].”
BackgroundCarroccio, A., Soresi, M., Chiavetta, M., Blasca, F. L., Compagnoni, S., Giuliano, A., Fayer, F., Mandreucci, F., Castellucci, D., Seidita, A., et al. (2021) · Nutrients · doi:10.3390/nu13061971 · Cited by 12
Development and Validation of the Gastrointestinal Unhelpful Thinking Scale (GUTs)
Knowles, S. R., Apputhurai, P., Burgell, R., & Keefer, L. (2022) · Gastroenterology Nursing · doi:10.1097/sga.0000000000000644 · Cited by 13
Qualitative Validation of a Novel VR Program for Irritable Bowel Syndrome: A VR1 Study
Spiegel, B. M. R., Liran, O., Gale, R., Khalil, C., Makaroff, K. E., Chernoff, R. A., Raber, T. R., Chang, B. W., Pichetshote, N., & Rezaie, A. R. (2022) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001641 · Cited by 12
“High school graduate or equivalent 7 (1)”
The Irritable Bowel Syndrome: How Stress Can Affect the Amygdala Activity and the Brain-Gut Axis
Bonaz, B. L., Sonia Pellissier, A., Sinniger, V., Clarençon, D., Peinnequin, A., & Canini, F. (2012) · InTech eBooks · doi:10.5772/52066 · Cited by 12
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Diagnostic Stringency and Healthcare Needs in Patients with Biliary Dyskinesia
Aggarwal, N., & Bielefeldt, K. (2013) · Digestive Diseases and Sciences · doi:10.1007/s10620-013-2719-5 · Cited by 12
Assesment of Psychiatric Symptoms and Co-morbidities in Patients with Irritable Bowel Syndrome
Sertbaş, Y., Belli, H., Pişkinpaşa, N., Ural, C., Akbudak, M., Sertbaş, M., & Öncü, F. (2012) · West Indian Medical Journal · doi:10.7727/wimj.2012.166 · Cited by 12
Influence of experimentally induced anxiety on rectal sensorimotor function in healthy humans
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Darwinian Dyspepsia: An Extraordinary Scientist, an Ordinary Illness, Great Dignity
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“Furthermore, his non-gastrointestinal symptoms are consistent with comorbid extraintestinal somatization, a frequent accompaniment of IBS (”
BackgroundGastrointestinal and Hepatic Disease in Fibromyalgia
Schatz, R. A., & Moshiree, B. (2017) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2017.09.009 · Cited by 13
Tanaka, Y., Kanazawa, M., Kano, M., Tashiro, M., & Fukudo, S. (2018) · PLoS ONE · doi:10.1371/journal.pone.0199698 · Cited by 12
Norlin, A., Faresjö, Å., Falk, M., Jones, M. P., & Walter, S. (2019) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2019.01.015 · Cited by 12
Celiac disease in Iranian irritable bowel syndrome patients; a systematic review and meta-analysis.
Azami, M., Badfar, G., Abangah, G., & Mahmoudi, L. (2019) · Gastroenterology and hepatology from bed to bench. · Cited by 12
Are patients with polycystic ovary syndrome more prone to irritable bowel syndrome?
Kałużna, M., Kompf, P., Wachowiak-Ochmańska, K., Moczko, J., Królczyk, A., Janicki, A., Szapel, K., Grzymisławski, M., Ruchała, M., & Ziemnicka, K. (2022) · Endocrine Connections · doi:10.1530/ec-21-0309 · Cited by 14
“Moreover, those with concomitant somatic diseases may experience more severe IBS symptoms, lower QoL and more anxiety and depressive symptoms than IBS individuals with no comorbidities (43).”
Role of psychiatric disorders and irritable bowel syndrome in asthma patients
Yılmaz, A. T., Cumurcu, B. E., Taşlıyurt, T., Şahan, A. G., Üstün, Y., & Etikán, Í. (2011) · Clinics · doi:10.1590/s1807-59322011000400012 · Cited by 12
Rifaximin Therapy of Irritable Bowel Syndrome
Koo, H. L., Sabounchi, S., Huang, D. B., & DuPont, H. L. (2012) · Clinical Medicine Insights Gastroenterology · doi:10.4137/cgast.s7382 · Cited by 12
Reséndiz-Figueroa, F., Ortiz-Garrido, O., Pulido, D., Arcila-Martínez, D., & Schmulson, M. J. (2008) · PubMed · Cited by 12
Chen, J., Chen, Z. X., Ma, L., Liang, Q., Jia, W. P., Pan, Z., Zeng, Y., & Jiang, B. H. (2014) · Biomedical Chromatography · doi:10.1002/bmc.3180 · Cited by 12
Chandler, H. K., Ciccone, D. S., MacBride, R., & Natelson, B. H. (2008) · Disability and Rehabilitation · doi:10.1080/09638280701500109 · Cited by 12
“The prevalence of MUI reported in this study reflects the frequency with which diagnostic codes corresponding to FM, CFS, IBS, and subjective back pain were used to substantiate successful claims of work disability.”
BackgroundInfluentialHysterical Again: The Gastrointestinal Woman in Medical Discourse
Vidali, A. (2012) · Journal of Medical Humanities · doi:10.1007/s10912-012-9196-2 · Cited by 12
Olfactory and gustatory function in irritable bowel syndrome
Steinbach, S., Reindl, W., Kessel, C., Ott, R., Zahnert, T., Hundt, W., Heinrich, P., Saur, D., & Huber, W. (2009) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-009-1181-7 · Cited by 12
“Regarding IBS, there is a high prevalence of nongastrointestinal, functional diseases such as Wbromyalgia, chronic fatigue syndrome and psychological disorders (depression and anxiety) [ 31 , 32].”
BackgroundTreatment of functional diarrhea
Dellon, E. S., & Ringel, Y. (2006) · Current Treatment Options in Gastroenterology · doi:10.1007/s11938-006-0015-6 · Cited by 11
“As opposed to IBS, in which various physiologic factors, including serotonin imbalance [15], altered motility (and altered perceptions of motility) [16], visceral hypersensitivity [ 17 ], and alterations in inflammation [18] have been reported as contributing to the pathophysiology of the disorder, these factors have…”
BackgroundRao, C. D., Maiya, P. P., & Babu, M. A. (2014) · BMJ Open Gastroenterology · doi:10.1136/bmjgast-2014-000011 · Cited by 11
Kohen, R., Tracy, J. H., Haugen, E., Cain, K. C., Jarrett, M. E., & Heitkemper, M. M. (2016) · Biological Research For Nursing · doi:10.1177/1099800416633296 · Cited by 11
Kress, I. U., Paslakis, G., & Erim, Y. (2018) · Zeitschrift für psychosomatische Medizin und Psychotherapie · doi:10.13109/zptm.2018.64.1.4 · Cited by 11
Huchon, C., Aubry, G., Ploteau, S., & Fauconnier, A. (2018) · Gynécologie Obstétrique Fertilité & Sénologie · doi:10.1016/j.gofs.2018.02.022 · Cited by 11
Die Rolle Der Psychotherapie Beim Reizdarmsyndrom
Weibert, E., & Stengel, A. (2019) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/a-0829-6990 · Cited by 11
Funktionelle somatische Schmerzsyndrome?Nomenklatur
H�user, W., T�rp, J. C., Lempa, M., Wesselmann, U., & Derra, C. (2004) · Der Schmerz · doi:10.1007/s00482-004-0336-0 · Cited by 11
Metadata
- Authors
- Whitehead, W. E., Palsson, O., & Jones, K. R.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2002-04
- Volume
- 122
- Issue
- 4
- Pages
- 1140-1156
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2145558296
- Cited by
- 1,116
- References
- 180
- Citations by year
- 2026: 26 · 2025: 16 · 2024: 29 · 2023: 27 · 2022: 63 · 2021: 53 · 2020: 53 · 2019: 49 · 2018: 50 · 2017: 51 · 2016: 63 · 2015: 51 · 2014: 64 · 2013: 55 · 2012: 54
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK031369, R01 DK31369)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- irritable bowel syndrome, comorbidities, extraintestinal manifestations, functional gastrointestinal disorders, mental illness, depression, anxiety, somatoform disorders, fibromyalgia, chronic fatigue syndrome, temporomandibular disorders, chronic pelvic pain, visceral hypersensitivity, somatization, psychological etiology
- MeSH terms
- Mental Disorders, Colonic Diseases, Functional, Gastrointestinal Diseases, Humans, Psychophysiologic Disorders, Comorbidity
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