• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of gutGutView this articleSubmit a manuscriptReceive email alertsContact usBMJ
Gut. Dec 1998; 43(6): 770–774.
PMCID: PMC1727355

Irritable bowel syndrome, gastro-oesophageal reflux, and bronchial hyper-responsiveness in the general population

Abstract

Background—Associations have been shown between irritable bowel syndrome (IBS) and gastro-oesophageal reflux, between gastro-oesophageal reflux and asthma, and more recently between IBS and bronchial hyper-responsiveness (BHR).
Aims—To explore the inter-relations between these conditions.
Subjects—A randomly selected community sample of 4432adults.
Methods—A validated postal symptom questionnaire investigating the associations between IBS, gastro-oesophageal reflux symptoms, and symptomatic BHR.
Results—3169 questionnaires (71.7% response) returned by 1451 men and 1718 women were analysed. One year prevalences, in men and women respectively, of IBS were 10.5% and 22.9%, of dyspepsia 26.3% and 25.25%, of gastro-oesophageal reflux symptoms 29.4% and 28.2%, of BHR 13.2% and 14.6%, and of chronic bronchitis 8.3% and 4.9%. Logistic regression showed independent associations between IBS and BHR, gastro-oesophageal reflux symptoms, and dyspepsia. There was no significant independent association between IBS and chronic bronchitis. In men and women the odds ratio with 95% confidence interval (CI) for IBS and gastro-oesophageal reflux symptoms was 2.6 (2.1-3.1; p<0.001) and for IBS and BHR 2.1 (1.7-2.7; p<0.001). These associations held on stratifying for sex and consultation behaviour. IBS, gastro-oesophageal reflux symptoms, and bronchial hyper-responsiveness occurred more frequently together than expected, 2.5% (95% CI 2.41-2.57) of the sample having all three conditions compared with an expected prevalence of 0.7% (95% CI 0.66-0.71). The conditions were independently associated with each other.
Conclusions—These observations may indicate the presence of an underlying disorder producing symptoms in gastrointestinal and respiratory systems.

Keywords: irritable bowel syndrome; asthma; dyspepsia; gastro-oesophageal reflux; epidemiology

Full Text

The Full Text of this article is available as a PDF (105K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Jones R, Lydeard S. Irritable bowel syndrome in the general population. BMJ. 1992 Jan 11;304(6819):87–90. [PMC free article] [PubMed]
  • Jones R, Lydeard S. Prevalence of symptoms of dyspepsia in the community. BMJ. 1989 Jan 7;298(6665):30–32. [PMC free article] [PubMed]
  • Kettell J, Jones R, Lydeard S. Reasons for consultation in irritable bowel syndrome: symptoms and patient characteristics. Br J Gen Pract. 1992 Nov;42(364):459–461. [PMC free article] [PubMed]
  • Jones RH, Lydeard SE, Hobbs FD, Kenkre JE, Williams EI, Jones SJ, Repper JA, Caldow JL, Dunwoodie WM, Bottomley JM. Dyspepsia in England and Scotland. Gut. 1990 Apr;31(4):401–405. [PMC free article] [PubMed]
  • Mays EE. Intrinsic asthma in adults. Association with gastroesophageal reflux. JAMA. 1976 Dec 6;236(23):2626–2628. [PubMed]
  • Boyle JT, Tuchman DN, Altschuler SM, Nixon TE, Pack AI, Cohen S. Mechanisms for the association of gastroesophageal reflux and bronchospasm. Am Rev Respir Dis. 1985 May;131(5):S16–S20. [PubMed]
  • Mansfield LE, Stein MR. Gastroesophageal reflux and asthma: a possible reflex mechanism. Ann Allergy. 1978 Oct;41(4):224–226. [PubMed]
  • White AM, Stevens WH, Upton AR, O'Byrne PM, Collins SM. Airway responsiveness to inhaled methacholine in patients with irritable bowel syndrome. Gastroenterology. 1991 Jan;100(1):68–74. [PubMed]
  • Toelle BG, Peat JK, Salome CM, Mellis CM, Woolcock AJ. Toward a definition of asthma for epidemiology. Am Rev Respir Dis. 1992 Sep;146(3):633–637. [PubMed]
  • Burney PG, Chinn S, Britton JR, Tattersfield AE, Papacosta AO. What symptoms predict the bronchial response to histamine? Evaluation in a community survey of the bronchial symptoms questionnaire (1984) of the International Union Against Tuberculosis and Lung Disease. Int J Epidemiol. 1989 Mar;18(1):165–173. [PubMed]
  • Manning AP, Thompson WG, Heaton KW, Morris AF. Towards positive diagnosis of the irritable bowel. Br Med J. 1978 Sep 2;2(6138):653–654. [PMC free article] [PubMed]
  • Schindlbeck NE, Ippisch H, Klauser AG, Müller-Lissner SA. Which pH threshold is best in esophageal pH monitoring? Am J Gastroenterol. 1991 Sep;86(9):1138–1141. [PubMed]
  • Klauser AG, Schindlbeck NE, Müller-Lissner SA. Symptoms in gastro-oesophageal reflux disease. Lancet. 1990 Jan 27;335(8683):205–208. [PubMed]
  • Talley NJ, Weaver AL, Tesmer DL, Zinsmeister AR. Lack of discriminant value of dyspepsia subgroups in patients referred for upper endoscopy. Gastroenterology. 1993 Nov;105(5):1378–1386. [PubMed]
  • Burney P, Chinn S. Developing a new questionnaire for measuring the prevalence and distribution of asthma. Chest. 1987 Jun;91(6 Suppl):79S–83S. [PubMed]
  • Burney PG, Britton JR, Chinn S, Tattersfield AE, Papacosta AO, Kelson MC, Anderson F, Corfield DR. Descriptive epidemiology of bronchial reactivity in an adult population: results from a community study. Thorax. 1987 Jan;42(1):38–44. [PMC free article] [PubMed]
  • Whitehead WE, Winget C, Fedoravicius AS, Wooley S, Blackwell B. Learned illness behavior in patients with irritable bowel syndrome and peptic ulcer. Dig Dis Sci. 1982 Mar;27(3):202–208. [PubMed]
  • Kennedy T, Jones R. Development of a postal health status questionnaire to identify people with dyspepsia in the general population. Scand J Prim Health Care. 1995 Dec;13(4):243–249. [PubMed]
  • Fletcher CM, Peto R, Tinker CM. A comparison of the assessment of simple bronchitis (chronic mucus hypersecretion) by measurements of sputum volume and by standardized questions on phlegm production. Int J Epidemiol. 1974 Dec;3(4):315–319. [PubMed]
  • Fleming DM. Morbidity registration and the fourth general practice morbidity survey in England and Wales. Scand J Prim Health Care Suppl. 1993;2:37–41. [PubMed]
  • Collins SM. Is the irritable gut an inflamed gut? Scand J Gastroenterol Suppl. 1992;192:102–105. [PubMed]

Figures and Tables

Figure 1
Observed prevalences and (expected prevalences).

Articles from Gut are provided here courtesy of BMJ Group

Formats: