Extra-intestinal Symptoms and their Relationship to Psychological Symptoms in Patients withIrritable Bowel Syndrome

Abstract

Background: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. A signi_cant number of IBS patients have extra-intestinal symptoms (EIS), but the etiology of co-morbidity of IBS with these symptoms is unclear. The aim of this study was to evaluate the relationship of EIS with psychological symptoms in IBS patients.

 Materials and Methods: This multicenter, cross-sectional study was conducted on 18 to 65 year old IBS patients (Rome III criteria) referred to four gastroenterology outpatient clinics in the city of Isfahan from 2008-2009. Patients completed the IBS symptom severity scale, EIS severity scale, and anxiety and depression scale. Linear regression analysis was applied to evaluate the relationship of psychological symptoms with EIS, controlling for other variables.

Results: During the study period, 142 IBS patients (mean age=30.9±.1 years, 81.7% female) were included. ESI score was signi_cantly correlated to IBS severity score (r=0.534), anxiety (r=0.551) and depression scores (r=0.407); P<0.001. With linear regression analysis, female gender (P=0.028), IBS severity (P<0.001), and severity of anxiety (P=0.001) were related to ESI scores.

 Conclusion: According to these results, psychological  symptoms are associated with EIS in IBS patients, though prospective studies are needed to evaluate a causative association. Thus, gastroenterologists must pay attention to the association of psychological symptoms with EIS in the treatment of IBS patients and refer them for appropriate therapies.