Irritable Bowel Linked to High Surgery Rates

People with irritable bowel syndrome (IBS) — a disease of unknown origin involving abdominal pain and diarrhea — are more likely than other people to undergo several types of surgery, including gallbladder removal and appendectomy, a new study shows.

People with irritable bowel syndrome (IBS) — a disease of unknown origin involving abdominal pain and diarrhea — are more likely than other people to undergo several types of surgery, including gallbladder removal and appendectomy, a new study shows. Many of these operations are probably unnecessary, according to a related editorial. The findings, which appear in the medical journal Gastroenterology, are based on a study of nearly 90,000 subjects who completed medical and lifestyle questionnaires. Of the six surgeries studied, gallbladder removal, appendectomy, hysterectomy, and back surgery were all significantly more common among IBS patients than among other subjects, note Dr. George F. Longstreth, from Kaiser Medical Center in San Diego, California, and Dr. Janis F. Yao, from the Permanente Medical Group in Pasadena, California. The strongest link was with gallbladder removal, which was twice as common among patients with IBS as those without the condition. By contrast, rates for coronary artery surgery and peptic ulcer surgery were similar for subjects with and without IBS, the report indicates. “Although it is impossible to know how much of the surgical predisposition we identified resulted from misdiagnosis, consideration of our findings with those of other studies suggests that diagnostic error is an important factor,” the researchers note. In a related editorial, Dr. Nicholas J. Talley, from the Mayo Clinic in Rochester, Minnesota, comments that follow-up “data on the indications and outcomes of surgery in IBS is now needed.” He adds that “whether the excess surgery in IBS is cause or effect, unnecessary surgery must be avoided and gastroenterology (doctors) should take responsibility for actions to protect the public.” (Source: Reuters Health, Gastroenterology, June 2004.)