Skip to main content

Advertisement

Log in

Gastroesophageal reflux disease and irritable bowel syndrome: A common overlap syndrome

  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) are very common disorders in the general population. Symptoms of IBS are commonly encountered in GERD patients, and symptoms of GERD are not uncommon in IBS patients. GERD patients consistently report lower abdominal symptoms, which may be part of the spectrum of GERD symptoms. Alternatively, GERD and IBS may be two distinct manifestations of a similar underlying pathophysiologic process that can affect different levels of the gastrointestinal tract. Although the reason for the overlap observed between GERD and IBS remains to be elucidated, recent studies have demonstrated that GERD patients who also suffer from IBS-like symptoms perceive their GERD-related symptoms as more severe and are less likely to respond to antireflux treatment, as compared with those without IBS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Jones R, Lydeard S: Irritable bowel syndrome in the general population. BMJ 1992, 304:87–90.

    PubMed  CAS  Google Scholar 

  2. Hungin AP, Whorwell PJ, Tack J, Mearin F: The prevalence, patterns and impact of irritable bowel syndrome: an international survey of 40,000 subjects. Aliment Pharmacol Ther 2003, 17:643–650.

    Article  PubMed  CAS  Google Scholar 

  3. Locke GR III. Talley NJ, Fett SL, et al.: Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology 1997, 112:1448–1456.

    Article  PubMed  Google Scholar 

  4. Agreus L, Svardsudd K, Talley NJ, et al.: Natural history of gastroesophageal reflux disease and functional abdominal disorders: a population based study. Am J Gastroenterol 2001, 96:2905–2914.

    PubMed  CAS  Google Scholar 

  5. Locke GR III, Zinsmeister AR, Fett SL, et al.: Overlap of gastrointestinal symptom complexes in a US community. Neurogastroenterol Motil 2005, 17:29–34.

    Article  PubMed  Google Scholar 

  6. Pimentel M, Rossi F, Chow EJ, et al.: Increased prevalence of irritable bowel syndrome in patients with gastroesophageal reflux. J Clin Gastroenterol 2002, 23:221–224.

    Article  Google Scholar 

  7. Locke GR III, Zinsmeister AR, Talley NJ, et al.: Familial association in adults with functional gastrointestinal disorders. Mayo Clin Proc 2000, 75:907–912.

    Article  PubMed  Google Scholar 

  8. Kennedy TM, Jones RH, Hungin AP, et al.: Irritable bowel syndrome, gastro-oesophageal reflux, and bronchial hyperresponsiveness in the general population. Gut 1998, 43:770–774. One of the early reports about the overlap between GERD and IBS, using a population-based study.

    Article  PubMed  CAS  Google Scholar 

  9. Wong WM, Fass R: Extraesophageal and atypical manifestations of GERD.J Gastroenterol Hepatol 2004, 19(Suppl 3):S33-S43.

    Article  PubMed  Google Scholar 

  10. Talley NJ, Boyce P, Jones M: Identification of distinct upper and lower gastrointestinal symptom groupings in an urban population. Gut 1998, 42:690–695.

    Article  PubMed  CAS  Google Scholar 

  11. Smart HL, Nicholson DA, Atkinson M: Gastro-oesophageal reflux in the irritable bowel syndrome. Gut 1986, 27:1127–1131.

    PubMed  CAS  Google Scholar 

  12. Guillemot F, Ducrotte P, Bueno L: Prevalence of functional gastrointestinal disorders in a population of subjects consulting for gastroesophageal reflux disease in general practice. Gastroenterol Clin Biol 2005, 29:243–246.

    Article  PubMed  Google Scholar 

  13. Stanghellini V, Armstrong D, Monnikes H. et al.: Determination of ReQuest-based symptom thresholds to define symptom relief in GERD clinical studies. Digestion 2005, 71:145–141.

    Article  PubMed  Google Scholar 

  14. Zimmerman J: Irritable bowel, smoking and oesophageal acid exposure: an insight into the nature of symptoms of gastro-oesophageal reflux. Aliment Pharmacol Ther 2004, 20:1297–1303.

    Article  PubMed  CAS  Google Scholar 

  15. Bardhan KD, Stanghellini V, Armstrong D, et al.: Evaluation of GERD symptoms during therapy. Part I. Development of the new GERD questionnaire ReQuest. Digestion 2005, 69:229–237.

    Article  Google Scholar 

  16. Bardhan KD, Stanghellini V, Armstrong D, et al.: International validation of ReQuest in patients with endoscopy-negative gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2004, 20:891–898.

    Article  PubMed  CAS  Google Scholar 

  17. Fass R, Stanghellini V, Monnikes H, et al.: Baseline analysis of symptom spectrum in GERD clinical trial patients: Results from the ReQuest database. Gastroenterology 2006, 1304, (Suppl 2):A-629, #W1075. One of the largest studies evaluating reports of lower abdominal complaints among patients with GERD, using the ReQuest database.

    Google Scholar 

  18. Talley NJ, Dennis EH, Schettler-Duncan VA: Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol 2003, 98:2454–2459.

    Article  PubMed  Google Scholar 

  19. Zimmerman J: Extraintestinal symptoms in irritable bowel syndrome and inflammatory bowel diseases: nature, severity, and relationship to gastrointestinal symptoms. Dig Dis Sci 2003, 48:743–749.

    Article  PubMed  Google Scholar 

  20. Papatheodoridis GV, Karamanolis DG: Prevalence and impact of upper and lower gastrointestinal symptoms in the Greek urban general population. Scand J Gastroenterol 2005, 40:412–421.

    PubMed  CAS  Google Scholar 

  21. Raftopoulos Y, Papasavas P, Landreneau R: Clinical outcome of laparoscopic antireflux surgery for patients with irritable bowel syndrome. Surg Endosc 2004, 18:655–659.

    Article  PubMed  CAS  Google Scholar 

  22. Stanghellini V: ReQuest—the challenge of quantifying both esophageal and extra-esophageal manifestations of GERD. Best Pract Res Clin Gastroenterol 2004, 18(Suppl):27–30.

    Article  PubMed  Google Scholar 

  23. Nojkov B, Chey WD, Adlis S, Shaw M: Predictors of response to PPI therapy in patients with GERD: the influence of co-morbid IBS and psychological disease [abstract 416]. Gastroenterology 2005, 128:A61. An important abstract that demonstrates a higher symptom severity at baseline and a lower response to PPI therapy in GERD patients with IBS and psychological distress.

    Article  Google Scholar 

  24. Fass R, Shapiro M, Dekel R, Sewell J: Systematic review: proton-pump inhibitor failure in gastro-oesophageal reflux disease—where next? Aliment Pharmacol Ther 2005, 22:79–94.

    Article  PubMed  CAS  Google Scholar 

  25. Mertz H, Naliboff B, Munakata J, et al.: Altered rectal perception is a biological marker of patients with irritable bowel syndrome. Gastroenterology 1995, 109:40–52.

    Article  PubMed  CAS  Google Scholar 

  26. Trimble KS, Farouk R, Pryde A, et al.: Heightened visceral sensation in functional gastrointestinal disease is not site-specific. Evidence for a generalized disorder of gut sensitivity. Dig Dis Sci 1995, 40:1607–1613.

    Article  PubMed  CAS  Google Scholar 

  27. Costantini M, Sturniolo GC, Zaninotto G, et al.: Altered esophageal pain threshold in irritable bowel syndrome. Dig Dis Sci 1993, 38:206–212.

    Article  PubMed  CAS  Google Scholar 

  28. Dickman R, Fass R: Functional heartburn. Curr Treat Options Gastroenterol 2005, 8:285–291.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ronnie Fass MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dickman, R., Feroze, H. & Fass, R. Gastroesophageal reflux disease and irritable bowel syndrome: A common overlap syndrome. Curr Gastroenterol Rep 8, 261–265 (2006). https://doi.org/10.1007/s11894-006-0045-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11894-006-0045-1

Keywords

Navigation