Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and Are Negatively Associated With Outcomes After Cholecystectomy: A Prospective, Multicenter, Observational Study (PERFECT - Trial)

Judith J de Jong; Carmen S S Latenstein; Djamila Boerma; Eric J Hazebroek; David Hirsch; Joost T Heikens; Joop Konsten; Fatih Polat; Marten A Lantinga; Cornelis J H M van Laarhoven; Joost P H Drenth; Philip R de Reuver

doi:10.1097/SLA.0000000000004453

Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and Are Negatively Associated With Outcomes After Cholecystectomy: A Prospective, Multicenter, Observational Study (PERFECT - Trial)

Judith J de Jong
, Carmen S S Latenstein
, Djamila Boerma
, Eric J Hazebroek
, David Hirsch
, Joost T Heikens
, Joop Konsten
, Fatih Polat
, Marten A Lantinga
, Cornelis J H M van Laarhoven
, Joost P H Drenth
, Philip R de Reuver

Department of Gastroenterology and Hepatology
Radboud University Medical Center
Department of Surgery
Radboud University Medical Centre
Antonius Hospital
Rijnstate
Radiotherapy Institute Arnhem, Arnhem, Netherlands
The Netherlands
Rivierenland Hospital
VieCuri Medical Centre
Cardioloog, Venlo, Netherlands
Canisius Wilhelmina Hospital

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To determine the prevalence of FD and IBS in patients eligible for cholecystectomy and to investigate the association between presence of FD/ IBS and resolution of biliary colic and a pain-free state.

SUMMARY BACKGROUND DATA: More than 30% of patients with symptomatic cholecystolithiasis reports persisting pain postcholecystectomy. Coexistence of FD/IBS may contribute to this unsatisfactory outcome.

METHODS: We conducted a multicenter, prospective, observational study (PERFECT-trial). Patients ≥18 years with abdominal pain and gallstones were included at 5 surgical outpatient clinics between 01/2018 and 04/2019. Follow-up was 6 months. Primary outcomes were prevalence of FD/IBS, and the difference between resolution of biliary colic and pain-free state in patients with and without FD/IBS. FD/IBS was defined by the Rome IV criteria, biliary colic by the Rome III criteria, and pain-free by an Izbicki Pain Score ≤10 and visual analogue scale ≤4.

RESULTS: We included 401 patients with abdominal pain and gallstones (assumed eligible for cholecystectomy), mean age 52 years, 76% females. Of these, 34.9% fulfilled criteria for FD/IBS. 64.1% fulfilled criteria for biliary colic and 74.9% underwent cholecystectomy, with similar operation rates in patients with and without FD/IBS. Postcholecystectomy, 6.1% of patients fulfilled criteria for biliary colic, with no significant difference between those with and without FD/IBS at baseline (4.9% vs 8.6%, P = 0.22). Of all patients, 56.8% was pain-free after cholecystectomy, 40.7% of FD/IBS-group vs 64.4% of no FD/IBS-group, P < 0.001.

CONCLUSIONS: One third of patients eligible for cholecystectomy fulfil criteria for FD/IBS. Biliary colic is reported by only a few patients postcholecys-tectomy, whereas nonbiliary abdominal pain persists in >40%, particularly in those with FD/IBS precholecystectomy. Clinicians should take these symptom-dependent outcomes into account in their shared decision-making process.

TRIAL REGISTRATION: The Netherlands Trial Register NTR-7307. Registered on 18 June 2018.

Original language	English
Pages (from-to)	e766-e772
Journal	Annals of surgery
Volume	275
Issue number	6
DOIs	https://doi.org/10.1097/SLA.0000000000004453
Publication status	Published - 1 Jun 2022
Externally published	Yes

Keywords

Abdominal Pain/epidemiology
Cholecystectomy
Colic/epidemiology
Dyspepsia/complications
Female
Gallstones/complications
Humans
Irritable Bowel Syndrome/complications
Male
Middle Aged
Prospective Studies

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de Jong, J. J., Latenstein, C. S. S., Boerma, D., Hazebroek, E. J., Hirsch, D., Heikens, J. T., Konsten, J., Polat, F., Lantinga, M. A., van Laarhoven, C. J. H. M., Drenth, J. P. H., & de Reuver, P. R. (2022). Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and Are Negatively Associated With Outcomes After Cholecystectomy: A Prospective, Multicenter, Observational Study (PERFECT - Trial). Annals of surgery, 275(6), e766-e772. https://doi.org/10.1097/SLA.0000000000004453

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title = "Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and Are Negatively Associated With Outcomes After Cholecystectomy: A Prospective, Multicenter, Observational Study (PERFECT - Trial)",

abstract = "OBJECTIVE: To determine the prevalence of FD and IBS in patients eligible for cholecystectomy and to investigate the association between presence of FD/ IBS and resolution of biliary colic and a pain-free state.SUMMARY BACKGROUND DATA: More than 30\% of patients with symptomatic cholecystolithiasis reports persisting pain postcholecystectomy. Coexistence of FD/IBS may contribute to this unsatisfactory outcome.METHODS: We conducted a multicenter, prospective, observational study (PERFECT-trial). Patients ≥18 years with abdominal pain and gallstones were included at 5 surgical outpatient clinics between 01/2018 and 04/2019. Follow-up was 6 months. Primary outcomes were prevalence of FD/IBS, and the difference between resolution of biliary colic and pain-free state in patients with and without FD/IBS. FD/IBS was defined by the Rome IV criteria, biliary colic by the Rome III criteria, and pain-free by an Izbicki Pain Score ≤10 and visual analogue scale ≤4.RESULTS: We included 401 patients with abdominal pain and gallstones (assumed eligible for cholecystectomy), mean age 52 years, 76\% females. Of these, 34.9\% fulfilled criteria for FD/IBS. 64.1\% fulfilled criteria for biliary colic and 74.9\% underwent cholecystectomy, with similar operation rates in patients with and without FD/IBS. Postcholecystectomy, 6.1\% of patients fulfilled criteria for biliary colic, with no significant difference between those with and without FD/IBS at baseline (4.9\% vs 8.6\%, P = 0.22). Of all patients, 56.8\% was pain-free after cholecystectomy, 40.7\% of FD/IBS-group vs 64.4\% of no FD/IBS-group, P < 0.001.CONCLUSIONS: One third of patients eligible for cholecystectomy fulfil criteria for FD/IBS. Biliary colic is reported by only a few patients postcholecys-tectomy, whereas nonbiliary abdominal pain persists in >40\%, particularly in those with FD/IBS precholecystectomy. Clinicians should take these symptom-dependent outcomes into account in their shared decision-making process.TRIAL REGISTRATION: The Netherlands Trial Register NTR-7307. Registered on 18 June 2018.",

keywords = "Abdominal Pain/epidemiology, Cholecystectomy, Colic/epidemiology, Dyspepsia/complications, Female, Gallstones/complications, Humans, Irritable Bowel Syndrome/complications, Male, Middle Aged, Prospective Studies",

author = "\{de Jong\}, \{Judith J\} and Latenstein, \{Carmen S S\} and Djamila Boerma and Hazebroek, \{Eric J\} and David Hirsch and Heikens, \{Joost T\} and Joop Konsten and Fatih Polat and Lantinga, \{Marten A\} and \{van Laarhoven\}, \{Cornelis J H M\} and Drenth, \{Joost P H\} and \{de Reuver\}, \{Philip R\}",

year = "2022",

month = jun,

day = "1",

doi = "10.1097/SLA.0000000000004453",

language = "English",

volume = "275",

pages = "e766--e772",

journal = "Annals of surgery",

issn = "0003-4932",

publisher = "Lippincott Williams and Wilkins",

number = "6",

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de Jong, JJ, Latenstein, CSS, Boerma, D, Hazebroek, EJ, Hirsch, D, Heikens, JT, Konsten, J, Polat, F, Lantinga, MA, van Laarhoven, CJHM, Drenth, JPH & de Reuver, PR 2022, 'Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and Are Negatively Associated With Outcomes After Cholecystectomy: A Prospective, Multicenter, Observational Study (PERFECT - Trial)', Annals of surgery, vol. 275, no. 6, pp. e766-e772. https://doi.org/10.1097/SLA.0000000000004453

Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and Are Negatively Associated With Outcomes After Cholecystectomy: A Prospective, Multicenter, Observational Study (PERFECT - Trial). / de Jong, Judith J; Latenstein, Carmen S S; Boerma, Djamila et al.
In: Annals of surgery, Vol. 275, No. 6, 01.06.2022, p. e766-e772.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and Are Negatively Associated With Outcomes After Cholecystectomy

T2 - A Prospective, Multicenter, Observational Study (PERFECT - Trial)

AU - de Jong, Judith J

AU - Latenstein, Carmen S S

AU - Boerma, Djamila

AU - Hazebroek, Eric J

AU - Hirsch, David

AU - Heikens, Joost T

AU - Konsten, Joop

AU - Polat, Fatih

AU - Lantinga, Marten A

AU - van Laarhoven, Cornelis J H M

AU - Drenth, Joost P H

AU - de Reuver, Philip R

PY - 2022/6/1

Y1 - 2022/6/1

N2 - OBJECTIVE: To determine the prevalence of FD and IBS in patients eligible for cholecystectomy and to investigate the association between presence of FD/ IBS and resolution of biliary colic and a pain-free state.SUMMARY BACKGROUND DATA: More than 30% of patients with symptomatic cholecystolithiasis reports persisting pain postcholecystectomy. Coexistence of FD/IBS may contribute to this unsatisfactory outcome.METHODS: We conducted a multicenter, prospective, observational study (PERFECT-trial). Patients ≥18 years with abdominal pain and gallstones were included at 5 surgical outpatient clinics between 01/2018 and 04/2019. Follow-up was 6 months. Primary outcomes were prevalence of FD/IBS, and the difference between resolution of biliary colic and pain-free state in patients with and without FD/IBS. FD/IBS was defined by the Rome IV criteria, biliary colic by the Rome III criteria, and pain-free by an Izbicki Pain Score ≤10 and visual analogue scale ≤4.RESULTS: We included 401 patients with abdominal pain and gallstones (assumed eligible for cholecystectomy), mean age 52 years, 76% females. Of these, 34.9% fulfilled criteria for FD/IBS. 64.1% fulfilled criteria for biliary colic and 74.9% underwent cholecystectomy, with similar operation rates in patients with and without FD/IBS. Postcholecystectomy, 6.1% of patients fulfilled criteria for biliary colic, with no significant difference between those with and without FD/IBS at baseline (4.9% vs 8.6%, P = 0.22). Of all patients, 56.8% was pain-free after cholecystectomy, 40.7% of FD/IBS-group vs 64.4% of no FD/IBS-group, P < 0.001.CONCLUSIONS: One third of patients eligible for cholecystectomy fulfil criteria for FD/IBS. Biliary colic is reported by only a few patients postcholecys-tectomy, whereas nonbiliary abdominal pain persists in >40%, particularly in those with FD/IBS precholecystectomy. Clinicians should take these symptom-dependent outcomes into account in their shared decision-making process.TRIAL REGISTRATION: The Netherlands Trial Register NTR-7307. Registered on 18 June 2018.

AB - OBJECTIVE: To determine the prevalence of FD and IBS in patients eligible for cholecystectomy and to investigate the association between presence of FD/ IBS and resolution of biliary colic and a pain-free state.SUMMARY BACKGROUND DATA: More than 30% of patients with symptomatic cholecystolithiasis reports persisting pain postcholecystectomy. Coexistence of FD/IBS may contribute to this unsatisfactory outcome.METHODS: We conducted a multicenter, prospective, observational study (PERFECT-trial). Patients ≥18 years with abdominal pain and gallstones were included at 5 surgical outpatient clinics between 01/2018 and 04/2019. Follow-up was 6 months. Primary outcomes were prevalence of FD/IBS, and the difference between resolution of biliary colic and pain-free state in patients with and without FD/IBS. FD/IBS was defined by the Rome IV criteria, biliary colic by the Rome III criteria, and pain-free by an Izbicki Pain Score ≤10 and visual analogue scale ≤4.RESULTS: We included 401 patients with abdominal pain and gallstones (assumed eligible for cholecystectomy), mean age 52 years, 76% females. Of these, 34.9% fulfilled criteria for FD/IBS. 64.1% fulfilled criteria for biliary colic and 74.9% underwent cholecystectomy, with similar operation rates in patients with and without FD/IBS. Postcholecystectomy, 6.1% of patients fulfilled criteria for biliary colic, with no significant difference between those with and without FD/IBS at baseline (4.9% vs 8.6%, P = 0.22). Of all patients, 56.8% was pain-free after cholecystectomy, 40.7% of FD/IBS-group vs 64.4% of no FD/IBS-group, P < 0.001.CONCLUSIONS: One third of patients eligible for cholecystectomy fulfil criteria for FD/IBS. Biliary colic is reported by only a few patients postcholecys-tectomy, whereas nonbiliary abdominal pain persists in >40%, particularly in those with FD/IBS precholecystectomy. Clinicians should take these symptom-dependent outcomes into account in their shared decision-making process.TRIAL REGISTRATION: The Netherlands Trial Register NTR-7307. Registered on 18 June 2018.

KW - Abdominal Pain/epidemiology

KW - Cholecystectomy

KW - Colic/epidemiology

KW - Dyspepsia/complications

KW - Female

KW - Gallstones/complications

KW - Humans

KW - Irritable Bowel Syndrome/complications

KW - Male

KW - Middle Aged

KW - Prospective Studies

U2 - 10.1097/SLA.0000000000004453

DO - 10.1097/SLA.0000000000004453

M3 - Article

C2 - 32889877

SN - 0003-4932

VL - 275

SP - e766-e772

JO - Annals of surgery

JF - Annals of surgery

IS - 6

ER -

de Jong JJ, Latenstein CSS, Boerma D, Hazebroek EJ, Hirsch D, Heikens JT et al. Functional Dyspepsia and Irritable Bowel Syndrome are Highly Prevalent in Patients With Gallstones and Are Negatively Associated With Outcomes After Cholecystectomy: A Prospective, Multicenter, Observational Study (PERFECT - Trial). Annals of surgery. 2022 Jun 1;275(6):e766-e772. doi: 10.1097/SLA.0000000000004453