In IBS, Pathophysiologic Factors Can Worsen Symptoms, Quality of Life
Visceral hypersensitivity, abnormal colonic transit, and psychologic factors are all associated with irritable bowel syndrome (IBS), according to a recent study. The findings suggest that each factor has a cumulative effect on gastrointestinal and nongastrointestinal symptoms, as well as quality of life, among individuals with IBS.1
To determine the impact of pathophysiologic alterations associated with IBS on patient-reported outcomes, the researchers analyzed data on 407 individuals with IBS who were seen at a specialized unit for functional gastrointestinal disorders in Sweden from 2002 through 2014.
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Participants were evaluated for the following pathophysiologic factors: colonic transit time, rectal compliance, allodynia, hyperalgesia, anxiety, and depression. Patient-reported outcomes were assessed by IBS symptom severity, somatic symptom severity, and disease-specific quality of life.
At least 1 pathophysiologic factor was observed in 31% of participants. Additionally, 30% of participants had at least 2 factors, 20% had at least 3, and 18% had no factors. The more pathophysiologic abnormalities a participant had, the higher likelihood that they experienced a gradual increase in IBS symptom and somatic symptom severity, as well as a gradual reduction in quality of life.
Among all participants, 36% had allodynia, 22% had hyperalgesia, 18% had accelerated colonic transit, 7% had delayed transit, 52% had anxiety, and 24% had depression, with each factor associated with severity of at least 1 IBS symptom. Rectal compliance was not associated with more severe symptoms of IBS.
Since the factors have a cumulative effect on gastrointestinal and nongastrointestinal symptoms in individuals with IBS, the researchers said that the factors may be relevant treatment targets.
“The view of the gut and brain working together in IBS is beginning to be increasingly accepted, so many gastroenterology clinics are striving to work holistically, in multiprofessional teams, to manage their IBS patients," study lead author Magnus Simrén, a professor at the University of Gothenburg in Sweden, said in a press release.2
—Colleen Murphy
References:
1. Simrén M, Törnblom H, Palsson OS, Van Oudenhove L, Whitehead WE, Tack J. Cumulative effects of psychologic distress, visceral hypersensitivity, and abnormal transit on patient-reported outcomes in irritable bowel syndrome. Gastroenterology. 2019;pii:S0016-5085(19)36712-36715. doi:10.1053/j.gastro.2019.04.019.
2. Combination therapy advisable for bowel disorder IBS [press release]. Gothenburg, Sweden: University of Gothenburg; May 15, 2019. https://sahlgrenska.gu.se/english/research/news-events/news-article//combination-therapy-advisable-for-bowel-disorder-ibs-.cid1629036. Accessed May 16, 2019.