Functional somatic illnesses in patients with functional bowel disorders. A cross-sectional cohort study in western Saudi Arabia, 2020, Khayyat

[Andy]

Objectives: To study the prevalence of functional gastrointestinal disorders (FGID) in Saudi patients with irritable bowel syndrome (IBS).

Methods: A cross-sectional study was conducted in patients with IBS treated at a private tertiary medical center in western Saudi Arabia between 2013 and 2017. We used ROME 3 criteria with data from the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire-9 (PHQ-9) depression scale, and International Classification of Headache Disorders (ICHD) to assess the prevalence of psychosomatic illness. Statistical analysis of frequency and statistical correlation was performed using Chi-square.

Results: The final analysis of 307 patients revealed a combined 425 diagnoses of psychosomatic illness, including diagnoses of headache in 104 patients (34%), migraine in 93 patients (30.5%), fibromyalgia in 169 patients (55%), and depression in 59 patients (19%). There was a statistically significant correlation between patients’ ages and diagnoses of joint pain and migraines.

Conclusion: Fibromyalgia and headache disorders were common in this cohort of Saudi patients with IBS. This coexistence of illness is partly explained by the functional nature of these illnesses. Collective efforts to provide multidisciplinary care is needed for these patients.

Open access, https://smj.org.sa/index.php/smj/article/view/smj.2020.2.24901/11887

 

[Hutan]

What a weird study.

The study participants had to be 15 years of age or older and present with abdominal symptoms of abdominal pain, diarrhea, or constipation that fulfilled the ROME 3 criteria for IBS. The inclusion required an absence of red flag symptoms (namely, anemia, weight loss, gastrointestinal bleeding such as hematemesis, melena or hematochezia, or family history of colorectal cancer). They had to present with complaints of headache or migraine, joint or muscular pain, or anxiety and depression.

The inclusion criteria were approximately:
1. abdominal symptoms that equalled IBS, with nothing suggesting another bowel-related diagnosis, and
2. at least one of: headache, migraine, joint or muscular pain, anxiety or depression (they termed these 'psychosomatic illness')

They then assessed the prevalence of each of the psychosomatic illnesses.

and then, if I have understood right, they concluded that psychosomatic illness is very common in patients with functional gastrointestinal disorders.

From the findings of this study, we can observe that there is a close relationship between functional gastrointestinal disorders and psychosomatic symptoms in our local patients.

Sometimes I am surprised anew at the stupidity. Unless I have got it wrong and it is me being stupid.

We have no idea how many IBS patients they had who had no 'psychosomatic symptoms', because they only selected patients who had psychosomatic symptoms for the study. So they can't conclude anything about how common psychosomatic illnesses are in their IBS patients. And 100% of their sample had one or more psychosomatic illness.

And that's even before we start considering whether a headache or a migraine or joint pain or the others are necessarily psychosomatic, or if the instruments they used to decide if someone had any of those conditions were accurate. Looking at the headache definitions for example, a person may have qualified as having headaches if they have had one. And presumably having IBS might mean that you exhibit a few anxious or depressed symptoms without necessarily having anxiety disorder or clinical depression.

Some nights this game feels like shooting fish in barrels.

 

[Trish]

Thanks for saving me the trouble of reading it, @Hutan!

So they selected patients with IBS plus X/Y/Z, then concluded a lot of patients with IBS have X/Y/Z.

Bizarre.

I was going to say how the f*** did that get past peer review, then checked to see who published it - a medical journal, so probably not peer reviewed. Probably not even read carefully.

 

[rvallee]

Let's break this down:

1. Here's a box with a label
2. Here's a bunch of objects that we selected and put in the box
3. Looks in the box, finds objects, concludes there is an association between the objects and the label

So the conclusion of this study is that if you put some objects in a box, you will find them in that box. Outstanding. It's typical of the level of quality in this field, just as devoid of substance. The execution simply doesn't have the decades of experience of using flowery language and mathemagics to give the illusion of a legitimate process.

The process in this field isn't science, it's persuasion. Those amateurs have a lot to learn from the pros.

 

[InfiniteRubix]

What a weird study.

Yup...