Fifty-nine patients were surveyed. Mood disturbance was high, with 48 (81%) scoring above the cut off for depression and 59 (100%) scoring above the cut off for anxiety. Additionally, 46 (78%) scored above threshold for functional impairment and IBS-QoL was low, 48.45 (SD = 27.96). Moderate/severe symptoms were reported for bloating 40 (68%), flatulence 39 (66%), incomplete evacuation 38 (64%), abdominal pain 32 (54%), faecal urgency 32 (54%), borborygmi 32 (54%), nausea 25 (42%), burping 24 (41%), acid regurgitation 22 (37%) and heartburn 19 (32%). Functional impairment was significantly correlated with anxiety (p<0.001), depression (p<0.001) and QoL (p<0.001). Depression, anxiety, QoL and functional impairment were correlated with nausea, borborygmi, bloating and abdominal pain. Anxiety, QoL and functional impairment were correlated with acid regurgitation. QoL was correlated with urgency to open bowels and depression was correlated with flatulence. Discussion The psychological needs and functional impairment in IBS patients in secondary care were high. Anxiety and depression were higher than findings from other tertiary services (Kawoos et al, 2017, Cohen et al, 2006. QoL was worse than has been found in other studies with IBS-d patients (Andrae et al, 2013) and functional impairment was worse than in patients with IBS in primary care (Everitt et al, 2018). This is probably a reflection on the severity of impairment in those accessing secondary care. Impairment and psychological need only overlapped partially with physical symptoms indicating that a biopsychosocial approach (Engel, 1977) is called for. Psychological interventions have been found to be helpful for those with IBS (Ballou & Keefer, 2017; Ford et al, 2014).This study promotes the need for psychological support for IBS patients accessing secondary care, which is currently under-resourced.
