{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T16:27:35Z","timestamp":1771000055976,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mounting evidence supports a mechanistic association between irritable bowel syndrome (IBS) symptoms and mast cell hyperactivity. Yet, association between IBS and mast cell disorders (MCDs) has not been studied. We examined this association using two large databases and verified with manual chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The IBM Watson Health Explorys database (Somers, NY), an aggregate of electronic health record (EHR) data from over two dozen US healthcare systems, and Epic's SlicerDicer tool, a self\u2010service tool containing de\u2010identified data from the Epic EHR, were used to identify patients with IBS and MCDs. Patients with organic gastrointestinal disease or diseases associated with secondary mast cell hyperproliferation were excluded. Results were verified with manual chart review from two academic centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Up to 4% of IBS patients had a comorbid MCD. IBS was strongly associated with all MCDs. The strongest association was between IBS and mast cell activation syndrome (OR 16.3; 95% CI 13.1\u201320.3). Odds ratios for IBS+urticaria, IBS+idiopathic urticaria, IBS+non\u2010malignant mastocytosis, and IBS+mast cell malignancy ranged from 4.5 to 9.9. Patients from each of these overlap cohorts were predominantly female, and the overlap occurred with all IBS subtypes. Thorough endoscopic evaluation and comorbid mood disorders and migraines are more common in the overlap cohorts than in IBS alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions\/Inferences<\/jats:title><jats:p>In a large US database encompassing &gt;53\u00a0million patients over &gt;20\u00a0years, patients with IBS are at least 4 times more likely to have a MCD than the general population. Further study of mast cell involvement in the pathogenesis of IBS is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14265","type":"journal-article","created":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T06:14:50Z","timestamp":1631945690000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Irritable bowel syndrome is strongly associated with the primary and idiopathic mast cell disorders"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2424-7310","authenticated-orcid":false,"given":"Michael","family":"Kurin","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbinaya","family":"Elangovan","sequence":"additional","affiliation":[{"name":"Internal Medicine\u2010Pediatrics Residency Program MetroHealth Medical Center  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammed Mustafa","family":"Alikhan","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program Department of General Internal Medicine University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basmah","family":"Al Dulaijan","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program Department of General Internal Medicine University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli","family":"Silver","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology University Hospitals Cleveland Medical Center Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C.","family":"Kaelber","sequence":"additional","affiliation":[{"name":"Center for Clinical Informatics Research and Education The MetroHealth System and Departments of Internal Medicine, Pediatrics and Population and Quantitative Health Sciences Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Cooper","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001036"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.031"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.12.021"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.014"},{"issue":"1","key":"e_1_2_8_6_1","first-page":"S1","article-title":"An evidence\u2010based position statement on the management of irritable bowel syndrome","volume":"104","author":"American College of Gastroenterology Task Force on Irritable Bowel Syndrome","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.suppl_1.i67"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.04.019"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.12.034"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.11.055"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-03118-2"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-309151"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.472"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.07.046"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306236"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2012.01928.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.100594"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2005.04143.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2003.021154"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2982.2000.00221.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.127068"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.213108"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2013.19.2.244"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13192"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640617691690"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.07.005"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365529509089786"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1409760"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2019.1596800"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21239030"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.11812"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-07-442400"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.05.026"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13209"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0207602"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2016.12.013"},{"issue":"3","key":"e_1_2_8_37_1","first-page":"2348","article-title":"Mast cell activation syndromes \u2010 evaluation of current diagnostic criteria and laboratory tools in clinical practice (Review)","volume":"20","author":"Leru PM","year":"2020","journal-title":"Exp Ther Med"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.01.006"},{"key":"e_1_2_8_39_1","unstructured":"IBM Explorys Solutions | Watson Health | IBM.https:\/\/www.explorys.com\/about\u2010us.html. Accessed February 3 2021."},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2011-000782"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60404-8"},{"key":"e_1_2_8_42_1","unstructured":"MedCalc's Odds ratio calculator.https:\/\/www.medcalc.org\/calc\/odds_ratio.php. Accessed February 3 2021."},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.06.007"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0809479105"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2017.00703"},{"issue":"2","key":"e_1_2_8_46_1","first-page":"199","article-title":"Evaluation of frequency of irritable bowel syndrome in patients with chronic urticaria","volume":"25","author":"Unal M","year":"2018","journal-title":"Ann Med Res"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15997"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1053\/rmed.2001.1409"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23443"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijd.IJD_490_18"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1159\/000503629"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14265","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.14265","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T19:36:31Z","timestamp":1692992191000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.14265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,17]]},"references-count":50,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1111\/nmo.14265"],"URL":"https:\/\/doi.org\/10.1111\/nmo.14265","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,17]]},"assertion":[{"value":"2021-03-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14265"}}