Gastrointestinal Disturbances in Marfan syndrome
A significant proportion of patients with Marfan syndrome (MFS) have gastrointestinal disturbances constituting irritable bowel syndrome (IBS). A recent St George's Hospital student project found that MFS patients suffer more with IBS than the general population. IBS often first develops in young adults and teenagers in the general population and it is twice as common in women as in men. It is also common in Ehlers-Danlos syndrome due to collagen deficiency, which has many similarities to MFS.
At St George’s Hospital a medical student project involved 118 Marfan syndrome patients (56 men and 62 women) aged 18-88 years who were asked to fill out a bowel questionnaire. The results were compared with two control groups. All those participating also filled out anxiety and depression questionnaires as these can influence the perception of pain.
MFS patients suffered more abdominal discomfort and IBS than control groups. 40% of the MFS group as compared to 15% of the control group reported symptoms, consisting of both types of IBS, namely diarrhea predominant or constipation predominant. Women with MFS had higher rates of bloating and constipation than men. There was no significant difference in bowel complaints between anxious and non-anxious patients. However, depressed patients reported more symptoms. Medication for Marfan syndrome, for example antihypertensives including beta blockers, did not make any difference to bowel symptoms.
There is no blood test for IBS, however blood tests can rule out more serious conditions such as coeliac disease. The cause of IBS is unknown, but over-activity of the gut, emotional stress, and intolerance to certain foods may play a part. Specific dietary advice and medical management should be sought through your GP (general practitioner), and may include referrals to a hospital dietician andgastroenterologist. Careful attention to diet, avoiding foods such as wheat, dairy products, coffee and alcohol may be helpful, as well as eliminating stress and taking regular exercise.
Written by Benedict Scoones MBBS BSc, J Y Kang MD PhD FRCP FRCPED FRACP, Anne H. Child MD, FRCP
To find out first-hand what life is like when you have pain in the behind, please visit Lucy Atkinson's blog post (not for the squeamish).
For more information on bowel problems in MFS, download our info leaflet here.