MONTREAL – Non-GI symptoms can help distinguish irritable bowel syndrome from inflammatory bowel disease, Dr. Noel B. Hershfield said at the 13th World Congress of Gastroenterology.
Patients with irritable bowel syndrome (IBS) are more likely than patients with inflammatory bowel disease (IBD) to present with fatigue, depression/anxiety, and headache, as well as sleep loss for reasons not related to intestinal discomfort, Dr. Hershfield reported.
He reached these conclusions based on his survey of 400 patients who came to his outpatient clinic. All of the patients were younger than 50 years old.
Of the 200 patients with IBS, almost three-quarters had chronic fatigue syndrome, compared with one-quarter of the 200 patients with IBD, he said.
Nearly half of the IBS patients reported headaches, compared with less than a quarter of the patients with IBD. More than 40% of IBS patients had depression or anxiety; that figure was less than 10% for the IBD group, said Dr. Hershfield, a gastroenterologist at the University of Calgary (Alta.).
Of the IBS patents, 156 reported sleep disturbance not due to GI symptoms, compared with only 12 IBD patients. Conversely, only 2 IBS patients reported sleep disturbance due to gastrointestinal pain, compared with 179 IBD patients (Can. J. Gastroenterol. 2005;19:231–4).
“The object of this paper was to get physicians to take a better history, so they wouldn't have to do so many tests to prove IBS,” Dr. Hershfield said. “If you spend some time with them, you don't have to do very many tests to know that they have irritable bowel.”
Night sweats, sleep disturbance due to diarrhea and abdominal pain, and weight loss are symptoms that are associated with organic bowel disease. “People with IBD often have tremendous weight loss. … They can't eat, they don't absorb food properly, so they lose weight and all the things that go with that,” he said.
IBS patients, on the other hand, don't present with weight loss, anemia, and bleeding, Dr. Hershfield added.