Biliary events and an increased risk of new onset irritable bowel syndrome: A population-based cohort study

Abstract

Background Prospective data are lacking to determine if irritable bowel syndrome (IBS) is a risk factor for cholecystectomy, or if biliary disease and chole- cystectomy predisposes to the development of IBS. Aim To test the hypothesis that IBS and biliary tract disease are associated. Methods Validated symptom surveys sent to cohorts of Olmsted County, MN, (1988-1994) with follow-up in 2003. Medical histories were reviewed to determine any 'biliary events' (defined by gallstones or cholecystectomy). Analyses examined were: (i) time to a biliary event post-initial survey and separately and (ii) risk of IBS (Rome II) in those with vs. without a prior biliary event. Results A total of 1908 eligible subjects were mailed a follow-up survey. For analysis (i) of the 726 without IBS at initial survey, 44 (6.1%) had biliary events during follow up, in contrast to 5 of 93 (5.4%) with IBS at initial survey (HR 0.8, 95% CI 0.3-2.1). For analysis (ii) of the 59 subjects with a biliary event at initial survey, 10 (17%) reported new IBS on the follow-up survey, while in 682 without a biliary event up to 1.5 years prior to the second survey, 58 (8.5%) reported IBS on follow- up (OR = 2.2, 95% CI 1.1-4.6, P = 0.03). Conclusion There is an increased risk of new IBS in community subjects who have been diagnosed as having a biliary event.