Epidemiology of cholecystectomy and irritable bowel syndrome in a UK population

Background: Some patients with irritable bowel syndrome (IBS) may undergo unnecessary cholecystectomy. This paper describes the prevalence of cholecystectomy and IBS in a sample of British adults in Teesside. Associations between the two conditions and their relationship to consultation behaviour and socioeconomic status are described. The results are compared with those from Bristol in an attempt to determine the influence of service-related factors on the prevalence of cholecystectomy. Methods: A postal questionnaire was sent to 4432 adults aged 20-69 years registered with six general practices. The Standard Occupational Classification was used as a proxy for socioeconomic status. Results: In Teesside cholecystectomy was reported by 4.1 per cent of women and 1.3 per cent of men. Some 22.9 per cent of the women had IBS, and 10.5 per cent of men. Cholecystectomy was more common in patients with IBS (odds ratio 1.9 (95 per cent confidence interval 1.2-3.2); P < 0.01). The prevalence of cholecystectomy, of IBS and of consultation for symptoms of IBS was not influenced by socioeconomic status. Conclusion: Symptoms of IBS may cause diagnostic confusion and unproductive surgery. Cholecystectomy may cause IBS-like symptoms, a single underlying disorder may produce symptoms in both gastrointestinal and biliary tracts, or the associations might be due to a combination of these factors.