Biliary events and an increased risk of new onset irritable bowel syndrome

Aliment Pharmacol Ther. 2008 Apr 13 [Epub ahead of print]

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

McNally MA, Locke GR, Zinsmeister AR, Schleck CD, Peterson J, Talley NJ. Mayo Clinic, Jacksonville FL and Rochester MN, USA.

Background: Prospective data are lacking to determine if IBS a risk factor for cholecystectomy, or if biliary disease and cholecystectomy predisposes to the development of IBS.

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: 1) time to a biliary event post initial survey and separately, 2) risk of IBS (Rome II) in those with vs. without a prior biliary event.

Results: 1908 eligible subjects mailed a follow-up survey. For aim 1) 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 aim 2) 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.