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Dr. Lamm's weekly review of relevant articles and research

There is an increasing amount of information available about the gut.  Here are a few informative articles you may find valuable.


IBS not linked to colon cancer

IBS not linked to colon cancer

SOURCE: University of Michigan Health System and American Journal of Gastroenterology

ANN ARBOR, Mich. March 9, 2010 -- Patients with irritable bowel syndrome (IBS) are at no greater risk of polyps, colon cancer, or inflammatory bowel diseases than healthy people, according to new research published in the American Journal of Gastroenterology.

“Patients and doctors get nervous about the symptoms of irritable bowel syndrome (IBS),” says William D. Chey, MD, University of Michigan Medical School, Ann Arbor, Michigan. “This study should reassure doctors and patients that typical IBS symptoms are not indicators of a more serious disease.”

Dr. Chey was lead author on the IBS study, the largest prospective evaluation of colonoscopy findings in patients with irritable bowel syndrome. The case-control study compared the prevalence of colonic lesions in 466 patients with suspected IBS and 451 controls.

The IBS group had a significantly lower prevalence of adenomas (7.7% vs 26.1%, P < .0001) and diverticulosis (8.8% vs 21.3%, P < .0001) compared with the control group. The most common lesions among this group were hemorrhoids (18.2%), polyps (14.6%), and diverticulosis (8.8%).

Patients with IBS often undergo colonoscopies because physicians are particularly concerned about missing colorectal cancer or inflammatory bowel diseases like ulcerative colitis or Crohn’s disease, Dr. Chey explains. Roughly one-quarter of all colonoscopies performed in the United States are for IBS-related symptoms.

This research shows that it is unnecessary to order colonoscopies for patients with IBS, unless they show alarming symptoms like unexplained weight loss or anaemia, bleeding from the GI tract, or have a family history of colon cancer, inflammatory bowel disease, or celiac disease, says Dr. Chey.

“Lay people and doctors overuse colonoscopies, which are very expensive procedures, in patients with typical IBS symptoms and no alarm features. Of course, patients over the age of 50 years or who have alarm features should undergo colonoscopy to screen for polyps and colon cancer.” Dr. Chey says.

Dr. Chey’s research also showed that 2.5% of IBS patients older than >=45 years had an unusual disease called microscopic colitis, compared with 1.5% among the control group. Microscopic colitis can masquerade as IBS in patients with diarrhoea and is important to diagnose because it is treated differently than IBS, he says.

SOURCE: University of Michigan Health System and American Journal of Gastroenterology

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