A CASE-CONTROL STUDY TO EXAMINE ANY ASSOCIATION BETWEEN IDIOPATHIC DETRUSOR INSTABILITY AND GASTROINTESTINAL-TRACT DISORDER, AND BETWEEN IRRITABLE-BOWEL-SYNDROME AND URINARY-TRACT DISORDER

Objective To assess whether there are common malfunctions (e.g. of the autonomic nervous system and smooth muscle) that underlie disorders o f the urinary and gastrointestinal tracts by determining whether there is an increased prevalence (i) of urinary symptoms in patients with i rritable bowel syndrome (IBS) and (ii) of gastrointestinal symptoms in patients with idiopathic detrusor instability (IDI). Patients and met hods Questionnaires were sent to patients with a diagnosis of IBS or I DI who were seen in the Departments of Gynaecology, Gastroenterology a nd Urology at the John Radcliffe and Churchill Hospitals, Oxford, duri ng the 3 year period 1993-1995. The questionnaires were also distribut ed to control patients who were recruited from the day-surgery unit of the Churchill Hospital, Of 236 questionnaires sent out, 168 replies w ere analysed; 64 from patients with IBS, 49 from patients with detruso r instability and 55 from controls. The questionnaire included questio ns about micturition and defecatory behaviour (frequency, regularity, urgency, continence, pain, and ease in passing urine and stools). Resu lts Patients with IBS were more likely to experience certain urinary s ymptoms than controls (nocturia, urgency and some forms of urinary urg e incontinence) and patients with IDI were as likely as patients with IBS to experience gastrointestinal symptoms more frequently than contr ols. Control patients showed an unexpectedly high probability of exper iencing many of the gastrointestinal and urinary symptoms. Conclusions The frequent occurrence of symptoms in control patients makes the sig nificance of the results less clear, but the association between certa in symptoms of urinary tract disorder and patients with IBS, and of sy mptoms of gastrointestinal tract disorder with patients with IDI, sugg ests that they may share some common underlying dysfunction.