Background Irritable bowel syndrome (IBS) is a functional bowel disease that cannot be explained with an organic pathology, characterized by change in bowel habits and abdominal pain that relaxes with defecation. It is well known that IBS has an increased association with psychosomatic illnesses such as depression, anxiety, chronic fatigue syndrome and fibromyalgia. Similarly, publications are available in the literature that IBS has also an increased association with chronic, painful inflammatory pathologies such as rheumatoid arthritis and systemic lupus erythematosus. And also ankylosing spondylitis (AS) is a chronic inflammatory disease of the axial skeleton, that is characterized by new bone formation can eventually cause ankylosis and limitation of motion and disability. Accordingly, we aimed to assess the prevalence of IBS in patients with AS.
Methods The study was conducted at a university hospital rheumatology clinic and 113 consecutive patients with AS according to the modified New York criteria were included. Patients demographics, clinic and laboratory data were recorded. Functional status was evaluated with BASFI (Bath Ankylosing Spondylitis Functional Index), health quality with ASQOL (Ankylosing Spondylitis Health Quality) and disease activity with BASDAI (Bath Ankylosing Spondylitis Activity Index).
Then all patients were questioned with diagnosis of IBS and type according to ROME III criteria. The mean and standard deviation values for continuous variables were given. Categorical variables were expressed as percentage. While Mann-Whitney U test was used for comparison of continuous variables between two groups, chi-square test was used for categorical variables. P<0.05 was considered statistically significant.
Results Clinical and demographic characteristics of the patients are given in the table. Prevalence of IBS in patients with AS was found to be 30.1%. The distribution of types of IBS is following; 38% alternating diarrhea and constipation type, 23% constipation dominant type, 21% diarrhea dominant type and 18% mixed type. Frequency of IBS was found to be significantly higher in higher disease activity group (BASDAI>4) and in patients treated with biologic agents. (p values <0.001, 0.017, respectively). Prevalence of IBS between the sexes was found to be significantly higher in female patients (p: 0.031).
Conclusions IBS; when compared to the normal population was found to be higher (%30) in patients with AS. In a similar manner to the community, frequency of IBS is significantly higher in female patients, although AS is more frequent in male patients. As a result, in patients with AS, especially with high disease activity, gastroenterological complaints should be questioned; and the diagnosis of IBS should not be ignored in the treatment process.
Disclosure of Interest None declared