Predictors of Health-related Quality of Life in Irritable Bowel Syndrome Patients Compared With Healthy Individuals

Addante, Raymond A.; Naliboff, Bruce D.; Shih, Wendy; Presson, Angela P.; Tillisch, Kirsten; Mayer, Emeran A.; Chang, Lin

doi:10.1097/mcg.0000000000000978

Cited by 36 publications

(39 citation statements)

References 62 publications

(71 reference statements)

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“…The data reported here suggest that concurrent, but not baseline, psychological comorbidities are more predictive of this impaired long‐term quality of life than GI symptom severity. Several studies in IBS have found similar results, in particular for the mental health‐related quality of life; that is, Naliboff et al reported that psychological distress had a stronger effect on health‐related quality of life than GI symptoms, Koloski et al reported that depression was independently associated with mental quality of life, and Addante et al reported that perceived stress, and anxiety and depression were significant predictors for mental health‐related quality of life . This raises the question whether current treatment goals for IBS in daily clinical practice should be revised.…”

Section: Discussionmentioning

confidence: 87%

Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Weerts

Vork

Mujagic

et al. 2019

Neurogastroenterology Motil

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Background Irritable bowel syndrome (IBS) is a brain‐gut disorder, of which the natural course varies between patients and is difficult to predict. This study aimed to evaluate symptom evolution over a 5‐year follow‐up period and to identify baseline predictors for symptom severity and quality of life (QoL) at follow‐up. Methods Maastricht IBS cohort participants completed questionnaires upon inclusion regarding demographics and lifestyle, gastrointestinal (GI) symptoms, anxiety and depression, and QoL. The same questionnaires, in addition to others, were completed after 5 years. Rome criteria were confirmed face‐to‐face at initial enrollment and through telephonic interviews at follow‐up. Key Results At a mean follow‐up of 4.7 years, 379 patients were approached of whom 203 (53.7%) responded. Of these, 161 were reached by telephone and analyzed; 49 (30.4%) did not fulfill the Rome III criteria at follow‐up and had lower levels of GI symptoms and GI‐specific anxiety compared to those remaining Rome III‐positive (P < 0.001). However, Rome III‐negative patients had comparable levels of QoL and life satisfaction, comorbid anxiety and depression, work absenteeism, and impaired productivity. No baseline predictors were found for being Rome III‐positive or Rome III‐negative. However, greater age and lower baseline physical QoL predicted lower physical QoL at follow‐up (P < 0.005 and P < 0.01, respectively), while lower baseline mental QoL predicted lower mental QoL at follow‐up (P = 0.005). Additionally, higher anxiety and depression scores at follow‐up were associated with lower QoL and life satisfaction at follow‐up (P < 0.001). Conclusions and Inferences Long‐term QoL and general well‐being might depend on concurrent psychological symptoms, rather than GI symptom improvement.

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Section: Discussionmentioning

confidence: 87%

Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Weerts

Vork

Mujagic

et al. 2019

Neurogastroenterology Motil

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“…However, we believe that the management of digestive symptoms should be considered in our efforts to improve the quality of life of CAI patients. Indeed, studies on IBS patients have demonstrated that the severity of GI symptoms is negatively associated with the “physical” dimension of health-related quality of life 28 and that the patient quality of life depends on IBS subtype, diarrhea have lower disease specific quality of life than constipation 29 .…”

Section: Discussionmentioning

confidence: 99%

Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms

Quénéhervé

Drui

Blin

et al. 2021

Sci Rep

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Gastrointestinal symptoms are frequent in acute adrenal insufficiency. Although digestive symptoms can significantly reduce quality of life, they are rarely described in patients with treated chronic adrenal insufficiency (CAI). We aimed to characterize digestive symptoms in CAI patients. We used the section pertaining functional bowel disorders of the Rome IV questionnaire. A questionnaire was published on the website of the non-profit patient association “Adrenals” (NPPA of CAI patients) for five months. Information on demographics, characteristics of adrenal insufficiency, digestive symptoms and quality of life was collected. The relatives of CAI patients served as a control group. We analyzed responses of 33 control subjects and 119 patients (68 primary adrenal insufficiency (PAI), 30 secondary adrenal insufficiency (SAI) and 21 congenital adrenal hyperplasia (CAH)). Abdominal pain at least once a week over the past 3 months was reported by 40%, 47% and 33% of patients with PAI, SAI and CAH respectively versus 15% for the controls (p = 0.01). Symptoms were consistent with the Rome IV criteria for irritable bowel syndrome in 27%, 33% and 33% of patients respectively versus 6% for the controls (p < 0.0001). Quality of life was described as poor or very poor in 35%, 57% and 24% of patients respectively versus 5% for the controls (p < 0.0001). In conclusion, digestive symptoms are frequent and incapacitating in CAI patients and similar to symptoms of irritable bowel syndrome in 30% of CAI patients. Assessment and management of digestive symptoms should be considered a priority for physicians treating patients with CAI.

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“…IBS is further classified by the predominant stool form observed during >25% of bowel movements: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), and IBS with mixed bowel habits [1]. Patients with IBS often have impairments in quality of life [3,4]. Indeed, the severity of IBS symptoms was shown to be associated with daily activity impairment [4].…”

Section: Introductionmentioning

confidence: 99%

Shortcomings of Trials Assessing Antidepressants in the Management of Irritable Bowel Syndrome: A Critical Review

Takakura

Rezaie

2020

JCM

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Irritable bowel syndrome (IBS) is a common disorder requiring complex, multidisciplinary management. Antidepressants are commonly used and recommended in guidelines for the treatment of patients with IBS. We assessed randomized controlled trials (RCTs) on antidepressants in patients with IBS, with specific attention to study design and data quality/reporting characteristics. Following a comprehensive search, data and RCT characteristics were systematically summarized. Fragility index, representing the number of positive “events” that the study relies on for its significance, was calculated. Eighteen RCTs were included. Overall, tricyclic antidepressants (TCAs), but not selective serotonin reuptake inhibitors (SSRIs), appeared to be efficacious in IBS. Eight studies reported on adverse events (AEs), which were significantly greater in patients receiving antidepressants versus placebo. The median (mean) fragility index of TCA trials was 0 (1.5). RCTs with positive results had significantly lower placebo rates (20.8%) versus negative studies (45.7%; p < 0.0001). RCTs exhibited limitations related to study design (sample size and blinding), data analysis (outcomes and placebo response), and data reporting (selective reporting of AEs and publication bias). Careful consideration of limitations of RCTs on antidepressants in IBS is warranted to formulate a safe and beneficial treatment regimen for patients with IBS.

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Predictors of Health-related Quality of Life in Irritable Bowel Syndrome Patients Compared With Healthy Individuals

Cited by 36 publications

References 62 publications

Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms

Shortcomings of Trials Assessing Antidepressants in the Management of Irritable Bowel Syndrome: A Critical Review

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