August 26, 2014
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Symptoms, QOL did not differ between IBS subtypes

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The three subtypes of irritable bowel syndrome did not significantly differ in terms of symptom severity and quality of life, according to recent study data.

“Traditionally, it has always been thought that patients with the diarrhea form of IBS tend to be more anxious,” Peter J. Whorwell, MD, PhD, professor of medicine and gastroenterology, Wythenshawe Hospital, United Kingdom, told Healio.com/Gastroenterology. “In addition, it has also been considered that the symptom profiles in the three subtypes are different. However, our study does not support these ideas and, in this large group of patients, there was very little to choose between them.”

Peter J. Whorwell

Whorwell and colleagues grouped 1,000 patients (79.6% female) with at least a 2-year history of pharmacologically resistant IBS by diarrhea (IBS-D; n=256), constipation (IBS-C; n=296) or mixed (IBS-M; n=448) bowel habit subtype. All were administered validated questionnaires to score symptom severity, somatization, quality of life (QOL) and anxiety or depression levels.

Researchers found no differences between groups for all tested factors (all P>.05), including symptom severity (P=.24), abdominal pain intensity (P=.31), anxiety (P=.16), depression (P=.08), QOL (P=.64), and noncolonic symptoms and somatization (P=.53). They did observe that symptom severity was slightly correlated with anxiety (P<.001), depression (P<.001) and QOL (P<.001), and moderately correlated to somatization (P<.001).

“Consequently, a patient should not necessarily be denied treatment, say for anxiety, just because they are constipated and that group is generally not thought to be as anxious as the diarrhea group,” said Whorwell. “The strength of this study is that it was done on a very large group of patients, therefore, the results are likely to be reliable.

“A possible drawback is that our patients tend to be quite severe as we are a referral center. However, when the more severe patients were excluded, the results still stayed much the same.”

Disclosure: Whorwell reports receiving research grants or honoraria from Danone, Almirall, Salix, Shire, Abbott and Norgine. The researchers report no other relevant financial disclosures.