NEW YORK (Reuters Health) – Individuals with inflammatory bowel syndrome (IBS) often have comorbid psychological problems, which may influence symptom severity, new research confirms.
IBS is a common functional gastrointestinal disorder affecting between 5% and 10% of the world’s population, note Dr. Alexander Ford with Leeds Gastroenterology Unit at St. James University Hospital, in the U.K., and colleagues in the American Journal of Gastroenterology.
The pathophysiology of the disorder remains incompletely understood but there is evidence that disordered communication between the gut and the brain is involved, such that IBS is now considered a disorder of gut-brain interaction, they point out.
The researchers examined psychological comorbidities in patients with IBS and their impact on prognosis over 12 months among 807 adults meeting Rome IV criteria for IBS at baseline.
Of these, 245 had no psychological comorbidity, 177 (22%) had one, 139 (17%) had two, 103 (13%) had three, 89 (11%) four, and 54 (7%) had five psychological comorbidities.
IBS symptom severity at baseline increased significantly with the number of psychological comorbidities; 72% of those with five psychological comorbidities reported severe symptoms compared with 29% of those with none (P<0.001).
A total of 452 (56%) participants were followed up at 12 months and those with more psychological comorbidities at baseline were significantly more likely to have seen a gastroenterologist, with 33% of those with five psychological comorbidities having done so versus 21% of those with no psychological comorbidities (P=0.001).
Adults with more psychological issues were also more likely to cycle through more treatments, report more severe IBS symptoms and continuous abdominal pain, and to report that symptoms impacted their daily activities at least half of the time.
Psychological assessment and access to therapy for patients with high psychological burden may improve IBS prognosis, the study team says.
“Unless psychological health is assessed formally in clinical practice, this subgroup of patients with IBS with a high psychological burden, and whose prognosis is worse, will not be identified, and their problems addressed. We believe, therefore, that this should be part of the routine evaluation of patients with IBS,” they suggest.
The study had no financial support and the authors have no relevant disclosures.
SOURCE: https://bit.ly/3dIzqZ0 American Journal of Gastroenterology, July 2021.
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