Digestive and liver disease statistics in Iran

Gastrointestinal and liver diseases [GILD] are among the most common causes of morbidity in Iran and constitute a substantial proportion of mortality which imposes enormous economic consequences. Our purpose is to collect information and report current statistics on physician visits, hospitalizations, and deaths due to common GILD in Iran. Data on the leading causes of death were obtained from the Iranian Ministry of Health, Office of Health Statistics. A total of 213,322 deaths were reported from March 2003 to February 2004 [excluding mortality from the Bam earthquake] which equaled 4.4 deaths per 1000 population. Of these, 36,575 were due to accidents. Causes of death were reported on the basis of the 10th revision of the International Classification of Diseases [ICD-10; 1992]. The leading causes of hospitalization were obtained from the database of the GILD ward in Shariati Hospital, one of the largest and best known gastroenterology referral hospitals in Iran. Similarly, leading causes of out-patient referrals were identified from a large multi-physician outpatient clinic in Tehran. The five leading gastrointestinal causes of death in order of frequency were: gastric cancer, hepatobiliary cancer, liver cirrhosis, esophageal cancer, and colorectal cancer. The five leading causes of hospitalization in the GILD ward of Shariati Hospital were: liver cirrhosis, hepatitis, peptic ulcer disease, cholycystitis and cholangitis, and colorectal cancer. The most common outpatient diagnosis was gastroesophageal reflux disease followed by irritable bowel syndrome [IBS], duodenal ulcer [DU], non-ulcer dyspepsia, and chronic hepatitis B [HBV]. Gastrointestinal and liver malignancy along with chronic liver disease constitute the main GILD reasons for hospitalization and deaths in Iran. Gastroesophageal reflux disease, IBS, and chronic HBV are the most common GILD outpatient diagnoses

Irritable bowel syndrome and psychiatric disorders among university freshmen

Irritable Bowel Syndrome [IBS] is a very common disorder. Some researches have pointed to an interaction between psychiatric disorders and IBS. Present study aimed to determine psychiatric disorders in patients with IBS compared to normal controls among an Iranian population. All freshmen students [n=3012] of Tehran University invited to the study at 2001. A trained general practitioner interviewed the entire students for IBS based on Rome II criteria. A gastroenterologist visited the students who had Rome II criteria and ordered laboratory exams that are necessary for ruling out organic diseases. After confirming IBS patients, a matched control group by sex and age was selected. A psychologist who was blind to IBS diagnosis interviewed all cases and controls using a reliable 28- items General Heath Questionnaire. Chi-Square analysis used to compare psychiatric disorders in the cases and controls. P-value less than 0.05 determined as significant. A total of 3008 students [female; 1785, male; 1223] participated to the study and 143 had Rome II criteria for IBS [4.7%, 95% CI 4-5.6%]. Finally 46 [female; 31] with IBS and 97 [female; 62] controls underwent psychologic interview. Somatic symptoms, anxiety, depression, social dysfunction and mental disorder were reported by 41.3%, 34.8%, 15.2%, 43.5% and 41.3% respectively in IBS patients and 14.4%, 14.4%, 5.2%, 21.6% and 13.4% among control group respectively. All psychiatric disordoers were significantly more common among IBS patients than controls. Mental health in IBS patients is impaired. This fact could be primary or secondary. Control of psychiatric disorders may improve IBS symptoms