Irritable bowel syndrome subtypes: clinical and psychological features, body mass index and comorbidities

• Main Authors: Cristiane Kibune-Nagasako, Ciro García-Montes, Sônia Letícia Silva-Lorena, Maria Aparecida-Mesquita
• Format: Article
• Language: English
• Published: Aran Ediciones 2016-02-01
• Series: Revista Espanola de Enfermedades Digestivas
• Subjects: Irritable bowel syndrome; Mixed-irritable bowel syndrome; Anxiety; Gastroesophageal reflux disease; Constipation; Diarrhea; Dunctional dyspepsia
• Online Access: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000200002&lng=en&tlng=en

Background: Irritable bowel syndrome (IBS) is classified into subtypes according to bowel habit. Objective: To investigate whether there are differences in clinical features, comorbidities, anxiety, depression and body mass index (BMI) among IBS subtypes. Methods: The study group included 113 consecutive patients (mean age: 48 ± 11 years; females: 94) with the diagnosis of IBS. All of them answered a structured questionnaire for demographic and clinical data and underwent upper endoscopy. Anxiety and depression were assessed by the Hospital Anxiety and Depression scale (HAD). Results: The distribution of subtypes was: IBS-diarrhea (IBS-D), 46%; IBS-constipation (IBS-C), 32%, and mixed IBS (IBS-M), 22%. IBS overlap with gastroesophageal reflux disease (GERD), functional dyspepsia, chronic headache and fibromyalgia occurred in 65.5%, 48.7%, 40.7% and 22.1% of patients, respectively. Anxiety and/or depression were found in 81.5%. Comparisons among subgroups showed that bloating was significantly associated with IBS-M compared to IBS-D (odds ratio-OR-5.6). Straining was more likely to be reported by IBS-M (OR 15.3) and IBS-C (OR 12.0) compared to IBS-D patients, while urgency was associated with both IBS-M (OR 19.7) and IBS-D (OR 14.2) compared to IBS-C. In addition, IBS-M patients were more likely to present GERD than IBS-D (OR 6.7) and higher scores for anxiety than IBS-C patients (OR 1.2). BMI values did not differ between IBS-D and IBS-C. Conclusion: IBS-M is characterized by symptoms frequently reported by both IBS-C (straining) and IBS-D (urgency), higher levels of anxiety, and high prevalence of comorbidities. These features should be considered in the clinical management of this subgroup.