Original Contribution | Published:

Genetic Influences in Irritable Bowel Syndrome: A Twin Study

The American Journal of Gastroenterology volume 100, pages 13401344 (2005) | Download Citation

Subjects

Abstract

BACKGROUND:

Aggregation of symptoms of abdominal pain or bowel disturbance has been described in the families of patients with irritable bowel syndrome (IBS). This may be due to environmental factors, including learned responses to abdominal symptoms or a genetic contribution to the etiology of IBS.

OBJECTIVES:

To determine the relative contribution of genetic factors to IBS by evaluating IBS symptoms in monozygotic (MZ) and dizygotic (DZ) twins.

METHODS:

A total of 4,480 unselected twin pairs identified from a national volunteer twin register were asked to complete a validated questionnaire. IBS was defined by the Rome II criteria.

RESULTS:

A total of 5,032 subjects replied (56% response rate). One thousand eight hundred seventy complete twin pairs were evaluable; 888 MZ pairs (82 male pairs, mean age 51, SD 13 (range 19–81) yr) and 982 DZ pairs (69 male pairs, age 52, SD 13 (20–82) yr). The prevalence of IBS was 17% in MZ and 16% in DZ twins. There was no significant difference in casewise concordance rates between the MZ and DZ twins (28% vs 27%, p= NS). Logistic regression analysis revealed that decreasing age and increasing psychosomatic score were independently associated with IBS. Multifactorial liability threshold modeling suggested that a combination of unique and shared environmental factors provided the best model for IBS. In contrast, somatization was shown to be moderately heritable.

CONCLUSION:

Genetic factors are of little or no influence on IBS where the predominant influences appear to be environmental.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

    , , , et al. Symptoms of irritable bowel syndrome in a British urban community: Consulters and nonconsulters. Gastroenterology 1992;102: 1962–1967.

  2. 2.

    , . Irritable bowel syndrome in the general population. BMJ 1992;304: 87–90.

  3. 3.

    , . Physical symptom severity, psychological and social dysfunction in a series of outpatients with irritable bowel syndrome. J Psychosom Res 1990;34: 483–491.

  4. 4.

    , , . Clinical economics review: Irritable bowel syndrome. Aliment Pharmacol Ther 1997;11: 1019–1030.

  5. 5.

    , , , et al. Householder survey of functional gastrointestinal disorders: Prevalence, sociodemography and health impact. Dig Dis Sci 1993;38: 1569–1580.

  6. 6.

    , , , et al. Familial association in adults with functional gastrointestinal disorders. Mayo Clin Proc 2000;75: 907–912.

  7. 7.

    , , , et al. Familial aggregation of irritable bowel syndrome: A prospective study. Gut 2003;52: 1703–1707.

  8. 8.

    , , , et al. Evidence of genetic contribution to functional bowel disorder. Am J Gastroenterol 1998;93: 1311–1317.

  9. 9.

    , , , et al. Irritable bowel syndrome in twins: Heredity and social learning both contribute to etiology. Gastroenterology 2001;121: 799–804.

  10. 10.

    , , , et al. Functional bowel disorders and functional abdominal pain. Gut 1999;45(suppl II):43–47.

  11. 11.

    , . The St Thomas' Adult UK Twin Registry. Twin Res 2002;5: 440–443.

  12. 12.

    , , , et al. Genetic influences on osteoarthritis in women: A twin study. BMJ 1996;312: 940–944.

  13. 13.

    , . The inheritance of scholastic abilities in a sample of twins. Ascertainments of the sample and diagnosis of zygosity. Ann Hum Genet 1975;39: 213–218.

  14. 14.

    , , , et al. Psychometric properties of the SUNYA revision of the psychosomatic symptom checklist. J Behav Med 1984;7: 247–257.

  15. 15.

    . Generalisability and assumptions of twin studies. In: Spector TD, Sneider H, Macgregor AJ, eds. Advances in twin and sib-pair analysis. Greenwich Medical Media: London, 2000.

  16. 16.

    . Practical approaches to account for bias and confounding in twin data. In: Spector TD, Sneider H, Macgregor AJ, eds. Advances in twin and sib-pair analysis. Greenwich Medical Media: London, 2000.

  17. 17.

    , . Methodology for genetic studies of twins and families. Kluwer Academic Publishers: Dordrecht, 1992.

  18. 18.

    , , . Heritability of respiratory sinus arrythmia: Dependency on task and respiration rate. Psychophysiology 1997;34: 317–328.

  19. 19.

    . Introduction to quantitive genetics. Longman Scientific and Technical: Harlow, 1989.

  20. 20.

    , , , et al. Logistic regression analysis of twin data: Estimation of parameters of the multifactorial liability-threshold model. Behaviour Genetics 1994;24: 229–238.

  21. 21.

    Intercooled Stata for Windows 95. (version 5.0). College Station, Texas, USA: Statacorp, 1997.

  22. 22.

    . Mx: statistical modelling (4th edn.). Department of Psychiatry, Medical College of Virginia, Richmond: VA, 1997.

  23. 23.

    , , , et al. British Society of Gastroenterology guidelines for the management of the irritable bowel syndrome. Gut 2000;47(suppl II):1–19.

  24. 24.

    , , , et al. A twin-family study of self-report symptoms of panic-phobia and somatization. Behav Genet 1995;25: 499–515.

  25. 25.

    , , , et al. The association of irritable bowel syndrome and somatization disorder. Ann Clin Psychiatry 2001;13: 25–30.

  26. 26.

    , , , et al. Are twins and singletons comparable? A study of disease-related and lifestyle characteristics in adult women. Twin Research 2001;4: 464–477.

Download references

Acknowledgements

We are grateful to Bridget Gunson (Liver Laboratories, University Hospital, Birmingham) for initial data processing and analysis. We gratefully acknowledge financial support from Janssen Pharmaceuticals, Knoll, and Wyeth Laboratories. The Twin Research & Genetic Epidemiology Unit receives financial support from the Arthritis Research Campaign, British Heart Foundation, Chronic Disease Research Foundation, the European Commission 5th framework program (no. QLG2-CT-2002-01254) GenomEUtwin grant, and a DNA Resource grant from the Wellcome Trust.

Author information

Affiliations

  1. Department of Gastroenterology, Sandwell General Hospital, West Bromwich

    • Imtiyaz Mohammed
    •  & Nigel J Trudgill
  2. Department of Gastroenterology, Northern General Hospital, Sheffield

    • Stuart A Riley
  3. Twin Research & Genetic Epidemiology Unit, St Thomas' Hospital, London, United Kingdom

    • Lynn F Cherkas
    •  & Tim D Spector

Authors

  1. Search for Imtiyaz Mohammed in:

  2. Search for Lynn F Cherkas in:

  3. Search for Stuart A Riley in:

  4. Search for Tim D Spector in:

  5. Search for Nigel J Trudgill in:

Corresponding author

Correspondence to Nigel J Trudgill.

About this article

Publication history

Received

Accepted

Published

DOI

https://doi.org/10.1111/j.1572-0241.2005.41700.x

Further reading