P4067 - The Association of Irritable Bowel Syndrome With Improved Clinical Outcomes in Upper Gastrointestinal Bleeding

Binyamin R. Abramowitz, MD¹, Rahul Chaudhry, ², Selome F. Yewedalsew, MD³, Rachel R. Meier, BA⁴, Sushil Ahlawat, MD, MS, MBBS^3
1SUNY Downstate Health Sciences University, New York, NY; ²SUNY Downstate Health Sciences University, Woodbury, NY; ³SUNY Downstate Health Sciences University, Brooklyn, NY; ⁴Columbia University, New York, NY

Introduction: Irritable bowel syndrome (IBS) is the most common cause for referral to gastroenterologists and it affects up to 15% of the U.S. population. IBS has been shown to be an independent risk factor for poor outcomes in patients with other diseases such as inflammatory bowel disease (IBD). As literature on the topic is quite scarce, our study sought to evaluate outcomes of IBS patients hospitalized for upper gastrointestinal bleeding (UGIB) in an effort to identify and delineate a potential relationship between IBS and UGIB.

Methods: A retrospective study was conducted utilizing the 2020 National Inpatient Sample database. Patients aged 18 and above hospitalized with UGIB were identified using the International Classification of Disease 10th Revision (ICD-10) codes. Patients were then separated into two groups; those with a diagnosis of IBS and those without IBS. Demographic information as well as hospitalization outcome data was collected, analyzed, and compared across the two groups of patients.

Results: A total of 129,122 patients hospitalized with UGIB were identified, 1,319 of them had a comorbid diagnosis of IBS, while the other 127,803 patients were without a diagnosis of IBS. Patients with IBS were more likely to have shorter hospitalizations (5.2 vs 6.5 days, p< 0.001), decreased hospitalization costs ($59,940 vs $87,548, p< 0.001), and decreased mortality risk (3.0% vs 5.2%, p< 0.001). Patients with IBS were also less likely to experience sepsis, respiratory failure, and renal failure.

Discussion: Our data unexpectedly found IBS patients with UGIB to have better clinical outcomes than non-IBS patients with UGIB. Adherence to healthy lifestyle choices may be significantly contributing to these findings. IBS patients are recommended even more so than the average patient to engage in increased exercise, improve sleep hygiene, and implement dietary changes such as increased fiber, elimination of alcohol, and reduced FODMAP intake. Additionally, IBS patients have been shown to visit both primary care doctors as well as specialists at significantly higher rates than the average patient, keeping a closer eye on their health. As a result, IBS patients may have greater physiological fitness, and therefore, are less likely to decompensate when affected by an UGIB. Furthermore, increased use of proton pump inhibitors (PPI) by IBS patients may also contribute to our findings, as it has been shown that PPI use can decrease the severity of UGIB.


Disclosures:


Binyamin R. Abramowitz, MD¹, Rahul Chaudhry, ², Selome F. Yewedalsew, MD³, Rachel R. Meier, BA⁴, Sushil Ahlawat, MD, MS, MBBS³. P4067 - The Association of Irritable Bowel Syndrome With Improved Clinical Outcomes in Upper Gastrointestinal Bleeding, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.