Physical and psychological co-morbidity in irritable bowel syndrome: a matched cohort study using the General Practice Research Database

Aliment Pharmacol Ther. 2006 Sep 1;24(5):879-86. doi: 10.1111/j.1365-2036.2006.03044.x.


Background: Irritable bowel syndrome is a common problem known to have a complex relationship with psychological disorders and other physical symptoms. Little information, however, is available concerning physical and psychological comorbidity in irritable bowel syndrome patients studied over an extended period.

Aim: To evaluate physical and psychological morbidity 2 years before and during 6 years after the time of diagnosis in incident cases of irritable bowel syndrome and control subjects.

Methods: A matched cohort study was implemented in 123 general practices using the General Practice Research Database. Irritable bowel syndrome cases (n = 1827) and controls (n = 3654) were compared for 2 years before and 6 years after diagnosis.

Results: The age-standardized incidence of irritable bowel syndrome in patients over 15 years of age was 1.9 per 1,000 in men and 5.8 per 1,000 in women. From 2 years before the date of diagnosis, more irritable bowel syndrome cases (13%) than controls (5%) consulted with depression or were prescribed antidepressant drugs. Consultation and prescription rates for anxiety were also higher before diagnosis, and both anxiety and depression remained prevalent up to 6 years after diagnosis. Asthma, symptoms of urinary tract infection, gall-bladder surgery, hysterectomy and diverticular disease were recorded more frequently in irritable bowel syndrome patients, who were also more likely than controls to be referred to hospital.

Conclusions: People who are diagnosed with irritable bowel syndrome experience more anxiety and depression and a range of physical problems, compared with controls; they are more likely to be referred to hospital.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Anxiety / epidemiology
  • Asthma / epidemiology
  • Cohort Studies
  • Comorbidity
  • Databases, Factual*
  • Depression / epidemiology
  • Diverticulum / epidemiology
  • Family Practice*
  • Female
  • Gallbladder Diseases / epidemiology
  • Hospitalization
  • Humans
  • Hysterectomy
  • Incidence
  • Irritable Bowel Syndrome / epidemiology*
  • Irritable Bowel Syndrome / psychology
  • Male
  • Middle Aged
  • Prevalence
  • Sex Distribution
  • United Kingdom / epidemiology
  • Urinary Tract Infections / epidemiology