Do gastrointestinal complaints increase the risk for subsequent medically certified long-term sickness absence? The HUSK study

Health data on 13 880 40-45 year olds from the Hordaland Health Study (1997-99) were linked to national registries on sickness absence. As part of a wider health screening, gastrointestinal complaints were ascertained. Participant's anxiety and depression, and the presence of other somatic symptoms were evaluated. In Cox regression models, we predicted sickness absences over an average 5.4 years follow-up, with adjustment for confounders, anxiety and depression and other somatic symptoms.After adjusting for gender, level of education and smoking, those reporting GI complaints had higher risk for later sickness absence (HR = 1.42, 95% CI 1.34-1.51). GI complaints were associated with both anxiety (OR = 3.66, 95% CI 3.31-4.04) and depression (OR = 3.28, 95% CI 2.89-3.72), and a high level of other somatic symptoms (OR = 8.50, 95% CI 7.69-9.40). The association of GI complaints was still independently associated with future sickness absence (HR = 1.17, 95% CI 1.10-1.16) adjusting for mental illness and other somatic symptoms.Sickness absence is a complex behavioural outcome, but our results suggest GI complaints contribute by increasing the risk of long term sickness absence independently of comorbid mental illness and presence of other somatic symptoms. Occupational consequences of illness are important, and should also be addressed clinically with patients presenting with GI complaints.Gastrointestinal (GI) complaints are very common in the general population, with, for example, more than half the sample of a large US-based study reporting such complaints in the previous three months [1]. In a Norwegian general population sample, 48% reported having had at least one GI complaint during the previous year [2]. Such complaints may be symptoms of distinct underlying organic pathology, but in many cases no clear explanation is found [3-7]. People with GI complaints, regardless of whether there is an underlying pathology, have a number of negative psychosocial sequelae, in