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Increased prevalence of autoimmune diseases in functional gastrointestinal disorders: case–control study of 23 471 primary care patients
Author(s) -
Ford A. C.,
Talley N. J.,
Walker M. M.,
Jones M. P.
Publication year - 2014
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.12903
Subject(s) - medicine , irritable bowel syndrome , odds ratio , confidence interval , constipation , functional constipation , case control study , endocrine system , young adult , gastroenterology , hormone
Summary Background There is increasing evidence that impaired mucosal defence mechanisms are implicated in the pathogenesis of the functional gastrointestinal disorders ( FGID s), allowing inappropriate immune activation. Aim To test the hypothesis that an excess of autoimmune disorders among sufferers, using a large primary care database to examine this. Methods Cases were diagnosed with FGID s – irritable bowel syndrome ( IBS ), functional dyspepsia ( FD ), chronic idiopathic constipation ( CIC ), and multiple FGID s. Controls were those without FGID s. Prevalence of autoimmune disorders was compared between cases and controls using odds ratios ( OR s) and 95% confidence intervals ( CI s). Results We included 23 471 patients (mean age 51.4 years, 66.1% female). Prevalence of autoimmune disorders was greater among all FGID s, compared with controls without. In those with FD ( OR 1.35; 95% CI 1.12–1.63), CIC ( OR 1.75; 95% CI 1.11–2.75), or multiple FGID s ( OR 1.49; 95% CI 1.25–1.77) this was statistically significant after controlling for age and gender. Rheumatological autoimmune disorders were significantly more frequent in those with FD ( OR 1.44; 95% CI 1.15–1.80), CIC ( OR 1.84; 95% CI 1.08–3.13), or multiple FGID s ( OR 1.53; 95% CI 1.24–1.88), after controlling for age and gender. However, endocrine autoimmune disorders were no more frequent in those with FGID s, after controlling for age and gender. Conclusions In a large sample of primary care patients, there was a significantly higher prevalence of autoimmune disorders among those with FD , CIC , or multiple FGID s not explained by differences in age or gender. We were unable to control for concomitant drug use, which may partly explain this association.