IBD often misdiagnosed

One in ten people with inflammatory bowel disease (IBD) in the UK might be misdiagnosed, according to researchers who followed 20,193 patients and 201,393 controls for a median of 5.2 years.

IBD patients were three times more likely to have been previously diagnosed with irritable bowel syndrome (IBS) (15.2%) than controls (5.0%). Using a broader definition that includes antispasmodic prescriptions, 29.6% and 9.1% of IBD patients and controls might have been previously diagnosed with, or treated for, IBS. Histories of IBS were more common in Crohn's disease (34.9% versus 8.7% of controls) than ulcerative colitis (25.2% versus 9.2%); females (35.9% versus 12.6% of female controls) than males (22.8% versus 5.3%); and IBD patients less than 50 years of age (31.3% versus 7.8% of age-matched controls) than older people (27.4% versus 10.7%). Both IBS and IBD can cause symptoms such as diarrhoea, abdominal cramping and pain. Specific alarm symptoms – such as bloody stools, weight loss or fever – are often absent in early IBD. The authors have advocated faecal calprotectin testing (a marker of gastrointestinal inflammation) to help distinguish IBD from IBS. Nurses should refer patients with alarming symptoms of non-IBS diseases.