Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 7, 2013; 19(9): 1466-1471
Published online Mar 7, 2013. doi: 10.3748/wjg.v19.i9.1466
Five-year follow-up of 263 cases of functional bowel disorder
Yu-Rong Tang, Ping Wang, Rui Yin, Jian-Xin Ge, Guo-Pin Wang, Lin Lin
Yu-Rong Tang, Ping Wang, Rui Yin, Jian-Xin Ge, Guo-Pin Wang, Department of Gastroenterology, Nanjing Jiangbei People’s Hospital, Medical School, Southeast University, 552 Geguan Road, Nanjing 210048, Jiangsu Province, China
Yu-Rong Tang, Lin Lin, Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China
Author contributions: Tang YR and Wang P analyzed the data and wrote the manuscript; Lin L designed the research and approved the final paper; Yin R collected and input the data; Ge JX and Yin R analyzed the data; Wang GP approved the final paper.
Supported by The Open Project Program of the Jiangsu Key Laboratory of Molecular and Functional Imaging, No. PYZX 2011016; and the Medical Science and Technology Development Foundation of Nanjing Department of Health, No. YKK11199
Correspondence to: Lin Lin, PhD, Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China. lin9100@yahoo.com.cn
Telephone: +86-25-83718836 Fax: +86-25-68136920
Received: November 2, 2012
Revised: December 19, 2012
Accepted: January 11, 2013
Published online: March 7, 2013
Processing time: 130 Days and 6.9 Hours
Abstract

AIM: To determine the mortality associated with functional bowel disorders (FBDs) and their possible relationship with organic bowel disease.

METHODS: Patients who satisfied the Rome III criteria for FBD (retrospective diagnosis) were followed up by telephone interview and/or outpatient review at 5 years after their first attendance. The patients were divided into the following groups: irritable bowel syndrome, functional abdominal bloating, functional constipation, functional diarrhea and unspecified FBD. The survival of the FBD patients overall and of those with each FBD were compared with data obtained from the Guangzhou population in 2005. The incidences of colonic cancer overall and for each FBD were compared with data from the Chinese population obtained from 56 cancer registries in 19 provinces of the country in 2008.

RESULTS: Two hundred and sixty-three patients were followed-up. Five patients died, which was not significantly different from the expected survival rate. No differences in mortality among the FBDs were found. There were nine cases of organic bowel disease: three colonic cancers and six colonic polyps. The incidence of colonic cancer in FBD patients was higher than that in the general Chinese population (0.23% vs 0.03%, P < 0.05). There were significant differences in the incidence of colonic cancer among the FBDs (0/134, 0/24, 2/29, 1/66, 0/10, respectively, P < 0.05); functional constipation was the most common. The incidence of colonic polyps was similar among the FBDs. The baseline age of patients who died was greater than that of those who survived (66.60 ± 6.84 years vs 45.14 ± 10.34 years, P < 0.05). The baseline age of patients who had colonic cancer or polyps during follow-up was greater than that of those without colonic cancer or polyps (60.33 ± 1.53 years vs 45.38 ± 10.62 years; 54.50 ± 6.47 years vs 45.34 ± 10.68 years, P < 0.05).

CONCLUSION: FBDs do not increase the risk of death. The incidence of colonic cancer in patients with FBDs may be increased, especially in those with functional constipation and in the elderly.

Keywords: Functional bowel disorders; Follow-up; Mortality; Colonic cancer; Colonic polyps