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Cited by 85Gastrointestinal motility and disordersPsychosomatic Disorders and Their TreatmentsFibromyalgia and Chronic Fatigue Syndrome Research

Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes

Open access
Sperber, Ami D., Dekel, Roy·2010·Journal of Neurogastroenterology and Motility
DOI 10.5056/jnm.2010.16.2.113PMC PMC2879857
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Abstract

The irritable bowel syndrome (IBS) is the best known of the functional gastrointestinal tract disorders. Many IBS patients have at least one co-morbid somatic complaint and many meet diagnostic criteria for other functional disorders. Patients with IBS and another functional disorder, in comparison with patients with IBS only, have more severe IBS symptoms, a higher rate of psychopathology, greater impairment of quality of life, and more illness-related work absenteeism. Estimates of the prevalence of IBS in patients with fibromyalgia range from 30-35% to as high as 70%. Studies of IBS among patients with chronic fatigue syndrome have reported a prevalence ranging from 35-92%. The prevalence of IBS among patients with chronic fatigue syndrome is reported to be 14%. IBS patients with other co-morbid functional disorders appear to manifest a greater degree of somatization. It has been suggested that the presence of multiple co-morbid disorders may be a marker for psychological influences on etiology. This raises the question of whether the functional syndromes represent the same pathophysiological process, i.e., are the same entity that has been separated into different clinical entities because of medical sub-specialization, or are indeed separate disorders. While the answer to this question awaits further research, it would appear that most functional patients who meet formal diagnostic criteria for more than one functional disorder manifest one disorder clinically more that the others and seek consultation differentially for that set of symptoms.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review summarizes evidence that IBS frequently co-occurs with other functional gastrointestinal and extraintestinal disorders, and that patients with multiple functional disorders tend to have more severe symptoms, greater psychopathology, worse quality of life, and more work absenteeism. It discusses whether these overlapping syndromes represent one shared pathophysiological process or separate clinical entities, concluding that the question remains unresolved.

Key findings

  • Whitehead et al. found that 50% of IBS patients have at least one co-morbid somatic complaint, and many meet diagnostic criteria for other functional disorders; IBS patients with another functional disorder have more severe IBS symptoms, higher rates of psychopathology such as depression, anxiety and somatization, greater quality-of-life impairment, and more illness-related work absenteeism.
  • Overlap is substantial across functional disorders: IBS–functional dyspepsia overlap is reported at 15–42%, with an 8-fold increase in IBS prevalence among people with dyspepsia; in a Rome III study of 3,014 GI clinic patients, 24.8% of FD patients and 31.5% of IBS patients fulfilled criteria for the other disorder.
  • Extraintestinal associations are common: estimates of IBS prevalence in fibromyalgia range from 30–35% to as high as 70%; studies of IBS among chronic fatigue syndrome patients report prevalence from 35–92% with a median of 51%, while another report cites 14%; IBS prevalence in women with chronic pelvic pain ranges from 29–79%.
  • Psychiatric co-morbidity is also elevated: in a community sample of 2,005 adolescents and adults in Hong Kong, IBS prevalence was 5.4% and GAD prevalence 4.0%; the OR for IBS among respondents with GAD was 5.84, and the OR for GAD among respondents with IBS was 6.32 (both p < 0.001).

Methods

  • Narrative review of published literature on IBS co-morbidity with other functional gastrointestinal disorders, extraintestinal functional disorders, and psychological/psychiatric disorders.
  • Synthesizes findings from prior systematic reviews, meta-analyses, clinic-based studies, population-based studies, and selected abstracts; no primary data collection or new patient sample is reported.
  • Main analysis is qualitative synthesis of prevalence estimates, overlap rates, clinical severity, quality-of-life impact, and proposed shared pathophysiological mechanisms.

Limitations

  • The paper does not include a formal limitations section; it states that the question of whether functional disorders are one syndrome or many “awaits further research” and that “the jury is still out.”
  • Evident from the text: as a narrative review, it does not describe a systematic search strategy, inclusion criteria, or formal quality appraisal of included studies.
  • Evident from the text: cited prevalence estimates are highly heterogeneous, some evidence comes from abstracts, and psychiatric co-morbidity is noted to be particularly high in tertiary referral centers and lower in community settings, which may affect generalizability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.5056/jnm.2010.16.2.113

Cites

60 of 60 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

24 of 103 cited sources checked · 13 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    Studies of IBS among patients with chronic fatigue syndrome have reported a prevalence ranging from 35-92%.

    “Studies of IBS among patients with chronic fatigue syndrome have reported a prevalence ranging from 35-92%.”
    • Also stated in: § 2. Chronic fatigue syndrome · plain
      “Studies of IBS among CFS patients have reported a prevalence ranging from 35-92%34-38 with a median of 51%.4”
    Quote in the paperNot a substantial claim1 of 6 sources checked
    • cites [34] Goldenberg, 1990, Arthritis Rheum source
    • cites [35] Jones, 2001, Gastroenterology source
    • cites [36] Gomborone, 1996, J R Coll Physicians Lond source

      The paper’s opening section reports IBS in 63% of respondents from a chronic-fatigue self-help group, which falls within the claimed range. It does not report a 35–92% range, and the Methods state that participants were not screened for chronic fatigue syndrome specifically. (LLM, conf=0.89)

      Experimental — accuracy not yet measured
    • cites [37] Aaron, 2000, Arch Intern Med source
    • cites [38] Aaron, 2001, J Gen Intern Med

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [4] Whitehead, 2002, Gastroenterology source
    • Rests on an assumption: Diagnostic criteria for IBS and other functional disorders used across the cited studies identify comparable patient populations.
    • Rests on an assumption: Prevalence estimates from different studies and settings can be meaningfully compared to infer co-morbidity.
  • Premisecitation

    A high prevalence of overlap between IBS and functional dyspepsia has been consistently reported in numerous studies.

    “A high prevalence of overlap between these 2 conditions has been consistently reported in numerous studies.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [11] Ford, 2009, Clin Gastroenterol Hepatol source
    • Rests on an assumption: The functional disorders are distinct enough that their co-occurrence can be measured as overlap.
  • Premisecitation

    Two population based studies in the United States and the United Kingdom reported 25% and 19% overlap between IBS and GERD, respectively.

    “Two other population based studies in the United States and the United Kingdom reported 25% and 19% overlap between IBS and GERD, respectively.17,18”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [17] Locke, 2000, Mayo Clin Proc source
    • cites [18] Kennedy, 1998, Gut source

      The Results describe a UK community sample and confirm that IBS and gastro-oesophageal reflux symptoms coexist. They report reflux symptoms in 43.1% of people with IBS who had consulted a GP and 47.4% of those who had not, not a 19% overlap. This source is cited for the UK study, not the US study's 25% figure; page numbers are unavailable in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • Rests on an assumption: Diagnostic criteria for IBS and other functional disorders used across the cited studies identify comparable patient populations.
    • Rests on an assumption: Prevalence estimates from different studies and settings can be meaningfully compared to infer co-morbidity.
  • Premisecitation

    The concomitant presence of IBS or psychological distress in GERD patients predicted higher symptom ratings and lower quality of life before and after PPI treatment.

    “In addition, the concomitant presence of IBS or psychological distress in GERD patients predicted higher symptom ratings and lower quality of life before and after PPI treatment, making this subset of patients a therapeutic challenge.20”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [20] Nojkov, 2008, Aliment Pharmacol Ther source

      The ‘Impact of co-morbid PD on GERD symptoms and QoL’ section supports higher symptom burden and worse disease-specific quality of life before and after PPI therapy among patients with psychological distress. The ‘Impact of co-morbid IBS’ section supports higher symptoms and worse quality of life before treatment, but IBS was not associated with post-treatment symptom scores, and its lower post-treatment quality-of-life scores were not statistically significant. The claim overstates the post-treatment findings for IBS. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
  • Premisecitation

    Probably the most common association is the one between IBS and functional dyspepsia.

    “Probably the most common association is the one between IBS and functional dyspepsia (FD).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [11] Ford, 2009, Clin Gastroenterol Hepatol source

      The Discussion (page unavailable) reports substantial overlap between IBS and dyspepsia, and the Abstract (page unavailable) explains that many people with dyspepsia have functional dyspepsia. The paper does not compare this association with others or establish it as the most common, and its pooled estimate concerns dyspepsia rather than functional dyspepsia specifically. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • May combine two claims. 21
  • Classified as probably not a substantial claim. 6

  • May combine two claims.

    Premisecitation

    The OR for IBS was 5.84 among respondents with GAD compared to those without GAD and the OR for GAD was 6.32 for respondents with IBS compared to those without it (both, p < 0.001).

    “The OR for IBS was 5.84 among respondents with GAD compared to those without GAD and the OR for GAD was 6.32 for respondents with IBS compared to those without it (both, p < 0.001), showing considerable co-morbidity between these disorders.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [52] Lee, 2009, Aliment Pharmacol Ther source

      The “Comorbidity of GAD and IBS” section assigns the figures in the opposite direction: 5.84 is the relative risk of GAD among respondents with IBS, while 6.32 is the OR for IBS among respondents with GAD. Both are reported with P < 0.001, but the citing sentence reverses which figure applies to which comparison. (LLM, conf=0.92)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The various functional disorders have important characteristics in common, including epidemiology (female predominance), pathophysiology, diagnosis (symptom-based), the central role of the patient-physician relationship in therapy, and common therapeutic modalities.

    “The various functional disorders have important characteristics in common, including epidemiology (female predominance), pathophysiology (inflammation, hypersensitivity, impaired central processing of afferent sensory information, role of serotonin, psychological distress and somatization, and the role of stress and life events), diagnosis (symptom-based), the central role of the patient-physician”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [8] North, 2004, Clin Gastroenterol Hepatol source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [9] Miller, 2001, Ann Clin Psychiatry source
    • cites [10] North, 2007, World J Gastroenterol source

      The Introduction (page unavailable) says functional disorders are diagnosed from subjective symptoms. The Psychiatric Angle and treatment sections discuss psychological comorbidity, possible biological mechanisms, and the importance of physicians’ approach to IBS care. The copy does not establish female predominance or a shared set of pathophysiological features and therapeutic modalities across the various functional disorders. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    IBS and FD share a similar profile of patients (female predominance, high levels of psychological co-morbidities) and pathophysiologic mechanisms, mainly visceral hypersensitivity.

    “These 2 entities also share a similar profile of patients (female predominance, high levels of psychological co-morbidities) and pathophysiologic mechanisms, mainly visceral hypersensitivity.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [15] Gwee, 2006, World J Gastroenterol source

      The “Shared Common Pathophysiological Disturbances” and “Visceral hypersensitivity” sections support visceral hypersensitivity as a mechanism found in both FD and IBS. Our copy does not establish the claimed female predominance or high levels of psychological comorbidity in both patient groups (searched: female, psychological, and related terms). (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Most IBS patients do not have psychiatric illness per se but do manifest psychoform symptoms and somatoform complaints.

    “However, as discussed by North et al.10 most IBS patients do not have psychiatric illness per se but do manifest psychoform symptoms and somatoform complaints.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] North, 2007, World J Gastroenterol source

  • May combine two claims.

    Premisecitation

    In a community-based sample of 2,005 adolescents and adults from Hong Kong, the overall prevalence was 5.4% for IBS using the Rome III diagnostic criteria and 4.0% for GAD.

    “Lee et al.52 studied the co-morbidity of IBS and GAD in a community-based sample of 2,005 adolescents and adults from Hong Kong. They showed an overall prevalence of 5.4% for IBS using the Rome III diagnostic criteria and 4.0% for GAD.52”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [52] Lee, 2009, Aliment Pharmacol Ther source
    • Rests on an assumption: Diagnostic criteria for IBS and other functional disorders used across the cited studies identify comparable patient populations.
    • Rests on an assumption: Prevalence estimates from different studies and settings can be meaningfully compared to infer co-morbidity.

  • May combine two claims.

    Premisecitation

    Several studies have reported an increased prevalence of sexual dysfunction among IBS patients, including reduced sexual drive, increased dyspareunia, and more severe IBS symptoms following intercourse.

    “Several studies have reported an increased prevalence of sexual dysfunction among IBS patients, including reduced sexual drive,43 increased dyspareunia,39,44 and more severe IBS symptoms following intercourse.”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [43] Fass, 1998, Digestion source
    • cites [39] Walker, 1991, J Psychosom Obstet Gynaecol source
    • cites [44] Whorwell, 1986, Gut source

  • May combine two claims.

    Premisecitation

    SD was much more important than depression or anxiety, which are often considered as psychiatric associates of IBS.

    “In fact SD was much more important that depression or anxiety, which are often considered as psychiatric associates of IBS.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [8] North, 2004, Clin Gastroenterol Hepatol source

  • May combine two claims.

    Premisecitation

    North et al. reported a very high rate of non-gastrointestinal functional disorders in IBS patients, but significantly more so among those with somatization disorder (SD).

    “North et al.8 reported a very high rate of non-gastrointestinal functional disorders in IBS patients, but significantly more so among those with SD.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [8] North, 2004, Clin Gastroenterol Hepatol source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The prevalence of IBS among patients with chronic fatigue syndrome is reported to be 14%.

    “The prevalence of IBS among patients with chronic fatigue syndrome is reported to be 14%.”
    • Also stated in: § 2. Chronic fatigue syndrome · plain
      “The prevalence of IBS among patients with CFS is reported to be 14%.35”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Jones, 2001, Gastroenterology source
    • Rests on an assumption: Diagnostic criteria for IBS and other functional disorders used across the cited studies identify comparable patient populations.
    • Rests on an assumption: Prevalence estimates from different studies and settings can be meaningfully compared to infer co-morbidity.

  • May combine two claims.

    Premisecitation

    Nastaskin et al. reported that the overlap between IBS and GERD is significantly greater than their individual prevalence rates and the rates for each disorder would be significantly lower if individuals with overlap were removed from analyses.

    “Nastaskin et al.16 conducted a systematic review of the literature to assess associations between IBS and GERD. They reported that the overlap between them is significantly greater than their individual prevalence rates and the rates for each disorder would be significantly lower if individuals with overlap were removed from analyses.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Nastaskin, 2006, Dig Dis Sci source
    • Rests on an assumption: Diagnostic criteria for IBS and other functional disorders used across the cited studies identify comparable patient populations.
    • Rests on an assumption: Prevalence estimates from different studies and settings can be meaningfully compared to infer co-morbidity.

  • May combine two claims.

    Premisecitation

    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.

    “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”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Whitehead, 2002, Gastroenterology source

  • May combine two claims.

    Premisecitation

    Long-term follow ups of patients with IBS and FD demonstrate that over time patients with IBS develop FD symptoms and vice versa.

    “Furthermore long-term follow ups of patients with IBS and FD demonstrate that over time patients with IBS develop FD symptoms and vice versa.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Agreus, 1995, Gastroenterology source

  • May combine two claims.

    Interpretationown data

    Most functional patients who meet formal diagnostic criteria for more than one functional disorder manifest one disorder clinically more than the others and seek consultation differentially for that set of symptoms.

    “In our experience, patients who meet the diagnostic criteria for several functional disorders often manifest 1 disorder clinically much more that the others and seek consultation differentially for that set of symptoms.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisenone given

    FMS is considered a disorder of somatic hypersensitivity, while IBS is considered a disorder of visceral hypersensitivity.

    “FMS is considered a disorder of somatic hypersensitivity, while IBS is considered a disorder of visceral hypersensitivity.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Chang, 2003, Am J Gastroenterol source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The prevalence of CFS in the general population is reported to be 0.4%.

    “The prevalence of CFS in the general population is reported to be 0.4%.32”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Jason, 1999, Arch Intern Med source
    • Rests on an assumption: Diagnostic criteria for IBS and other functional disorders used across the cited studies identify comparable patient populations.
    • Rests on an assumption: Prevalence estimates from different studies and settings can be meaningfully compared to infer co-morbidity.

  • May combine two claims.

    Premisecitation

    The prevalence of any reported sexual dysfunction among male and female IBS patients was 40.6%, significantly higher than among controls (OR, 4.33; 95% CI, 2.69-7.25; p < 0.001).

    “The prevalence of any reported sexual dysfunction among male and female patients was 40.6%, which was significantly higher than among controls (OR, 4.33; 95% CI, 2.69-7.25; p < 0.001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Fass, 1998, Digestion source

  • May combine two claims.

    Premisecitation

    Among women with IBS with a sexual problem over the previous six months, 36% reported a decreased sexual drive, 32% reported dyspareunia, 32% reported that bowel symptoms directly prevented them from engaging in intercourse, and 15% reported that sexual dysfunction worsened directly in relation to the severity of their bowel problems.

    “Among women with IBS with a sexual problem over the previous six months, 36% reported a decreased sexual drive, 32% reported dyspareunia, 32% reported that bowel symptoms directly prevented them from engaging in intercourse, and 15% reported that sexual dysfunction worsened directly in relation to the severity of their bowel problems.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Fass, 1998, Digestion source

  • May combine two claims.

    Premisecitation

    Williams et al. studied 987 new patients referred to a CPP clinic and reported that 35% met the Rome I criteria for IBS, although IBS was not diagnosed previously in 40% of these patients.

    “Williams et al.41 studied 987 new patients referred to a CPP clinic and reported that 35% met the Rome I criteria for IBS, although IBS was not diagnosed previously in 40% of these patients.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Williams, 2005, Am J Obstet Gynecol source
    • Rests on an assumption: Diagnostic criteria for IBS and other functional disorders used across the cited studies identify comparable patient populations.

  • May combine two claims.

    Premisecitation

    The percentage of IBS patients with psychiatric disorders is particularly high among patients seen in tertiary referral centers and lower in IBS patients seen and treated in the community setting.

    “The percentage is particularly high among patients seen in tertiary referral centers and lower in IBS patients seen and treated in the community setting.49”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] Walker, 1992, Am J Med source

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationnone given

    In our experience, patients who meet the diagnostic criteria for several functional disorders often manifest 1 disorder clinically much more than the others and seek consultation differentially for that set of symptoms.

    “In our experience, patients who meet the diagnostic criteria for several functional disorders often manifest 1 disorder clinically much more that the others and seek consultation differentially for that set of symptoms.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Beard noted that patients with neurasthenia had additional symptoms including sleep difficulties, back pain, nervousness, anxiety, depression, headache, difficulty in concentrating, reduced sexual impulse, abdominal pain, bloating and excess gas, diarrhea, and lack of appetite.

    “He noted that these patients had additional symptoms including sleep difficulties, back pain, nervousness, anxiety, depression, headache, difficulty in concentrating, reduced sexual impulse, abdominal pain, bloating and excess gas, diarrhea, and lack of appetite.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] Beard, 1869, Bost Med Surg J source

  • May combine two claims.

    Premisecitation

    Patients with IBS and 1 or more other functional disorders, in comparison with patients with IBS only, have more severe IBS symptoms, a higher rate of psychopathology such as depression, anxiety and somatization, and a greater impairment of quality of life.

    “Patients with IBS and 1 or more other functional disorders, in comparison with patients with IBS only, have more severe IBS symptoms, a higher rate of psychopathology such as depression, anxiety and somatization, and a greater impairment of quality of life.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [6] Markowitz, 2001, Gastroenterology source
    • cites [7] Drossman, 1993, Dig Dis Sci source

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Our clinical impression is that many patients with more than 1 formal diagnosis do not consult multiple specialists, but concentrate on the physician who specializes in the symptoms that they suffer from in particular.

    “Our clinical impression is that many patients with more that 1 formal diagnosis do not consult multiple specialists, but concentrate on the physician who specializes in the symptoms that they suffer from in particular.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    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.

    “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.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4] Whitehead, 2002, Gastroenterology source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    The patients Beard described might be diagnosed today with CFS, or depending on the specialist that saw them, any of the other system-specific functional disorders.

    “The patients he described might be diagnosed today with CFS, or depending on the specialist that saw them, any of the other system-specific functional disorders.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [55] Beard, 1869, Bost Med Surg J source
25 of 25

  • The paper relies on this without support.

    Diagnostic criteria for IBS and other functional disorders used across the cited studies identify comparable patient populations.

    “Another study that used the Rome III criteria found, in 3,014 patients attending a GI clinic, that 24.8% of FD patients and 31.5% of IBS patients fulfilled the diagnostic criteria of the other disorder.12”
    “Lee et al.52 studied the co-morbidity of IBS and GAD in a community-based sample of 2,005 adolescents and adults from Hong Kong. They showed an overall prevalence of 5.4% for IBS using the Rome III diagnostic criteria and 4.0% for GAD.52”

  • The paper relies on this without support.

    Prevalence estimates from different studies and settings can be meaningfully compared to infer co-morbidity.

    “Estimates of the prevalence of IBS in patients with fibromyalgia range from 30-35% to as high as 70%.”
    “Studies of IBS among CFS patients have reported a prevalence ranging from 35-92%34-38 with a median of 51%.4”

  • The paper relies on this without support.

    The functional disorders are distinct enough that their co-occurrence can be measured as overlap.

    “There is substantial overlap between IBS and other FGID, such as functional dyspepsia.”
    “The studies are consistent in their finding that the overlap among these disorders is greater than expected based on their separate prevalence rates.”
3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting prevalence of IBS among patients with chronic fatigue syndrome

    Minor

    The paper gives a 35-92% range for IBS prevalence among patients with CFS, then reports 14% for the same population. The 14% figure falls outside the stated range.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 6

  1. Markowitz, 2001, Gastroenterology, 120, 105
  2. Ford, 2009, Clin Gastroenterol Hepatol
  3. Pace, 1997, Gastroenterology, 112, A802
  4. Gomborone, 1996, J R Coll Physicians Lond, 30, 512
  5. Aaron, 2001, J Gen Intern Med, 16, 24
  6. Palsson, 2002, Gastroenterology, 122, A501

Cited by

Sorted by citations

Related

Authors
Sperber, A. D., & Dekel, R.
Affiliations
  • Tel Aviv Sourasky Medical Center (IL)
  • Tel Aviv University (IL)
Corresponding author
Sperber, Ami D.
ORCID
Sperber, Ami D.
Venue
Journal of Neurogastroenterology and Motility
Publisher
The Korean Society of Neurogastroenterology and Motility
Published
2010-04-30
Volume
16
Issue
2
Pages
113-119
ISSN
  • 2093-0879 (ISSN-L)
  • 2093-0887
DOI
10.5056/jnm.2010.16.2.113
PMC
PMC2879857
OpenAlex
W1988415769
Semantic Scholar
4823b501140afcbfed9ad4cbbfcd74078e1e0212
Cited by
85
References
58
Citations by year
2026: 1 · 2025: 2 · 2024: 6 · 2023: 2 · 2022: 14 · 2021: 3 · 2020: 7 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 7 · 2014: 9 · 2013: 5 · 2012: 9
FWCI
4.91
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Journal of Neurogastroenterology and Motility (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by-nc)
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, functional gastrointestinal disorders, fibromyalgia, chronic fatigue syndrome, somatization, psychopathology, quality of life, absenteeism, IBS prevalence, pathophysiology

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-22.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-22.

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