# Extra-intestinal manifestations associated with irritable bowel syndrome: a twin



## eric (Jul 8, 1999)

FYIAliment Pharmacol Ther 2002 May;16(5):975-983 Books, LinkOut Extra-intestinal manifestations associated with irritable bowel syndrome: a twin study. Svedberg P, Johansson S, Wallander MA, Hamelin B, Pedersen NL. Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden, Department of Epidemiology, AstraZeneca R & D Molndal, Molndal, Sweden, Section of Preventive Cardiology, Sahlgrenska University Hospital, Goteborg University, Goteborg, Sweden, Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden, Gastrointestinal Therapy Area, AstraZeneca R & D Wilmington, PA, USA, Department of Psychology, University of Southern California, Los Angeles, CA, USA. BACKGROUND: Little is known about the role of genetic and environmental factors in irritable bowel syndrome. Various extra-intestinal manifestations are more prevalent in cases than in controls. Genetic effects may be important in the liability to develop functional bowel disorders. AIMS: To evaluate the associations of irritable bowel syndrome with several disorders co-morbid with the condition, using both a case-control design and a co-twin control design. METHODS: A sample of 850 Swedish twin pairs, aged 18-85 years, was contacted for a telephone interview. Through a diagnostic algorithm, 72 unrelated cases of irritable bowel syndrome and 216 age- and gender-matched controls were identified. Fifty-eight twin pairs discordant for irritable bowel syndrome were evaluated in co-twin analyses. RESULTS: Renal problems (odds ratio (OR)=3.3; confidence interval (CI), 1.3-8.2), obesity (OR=2.6; CI, 1.0-6.4), underweight in the past (OR=2.4; CI, 1.1-6.4), gluten intolerance (OR=9.0; CI, 1.4-60.1), rheumatoid arthritis (OR=3.2; CI, 1.1-9.4) and poor self-rated health (OR=1.8; CI, 1.0-3.2) were significantly associated with irritable bowel syndrome. In the co-twin analyses, the only factors maintaining significance were renal and recurrent urinary tract problems. CONCLUSIONS: The association between irritable bowel syndrome and renal and urinary tract problems does not reflect a genetic or familial mediation. Eating disorders in childhood represent a familial-environmental influence on irritable bowel syndrome, whereas the association with rheumatoid arthritis and perhaps gluten intolerance probably reflects genetic mediation. PMID: 11966507


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