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The impact of abuse and mood on bowel symptoms and health‐related quality of life in irritable bowel syndrome ( IBS )
Author(s) -
Kanuri N.,
Cassell B.,
Bruce S. E.,
White K. S.,
Gott B. M.,
Gyawali C. P.,
Sayuk G. S.
Publication year - 2016
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12848
Subject(s) - irritable bowel syndrome , medicine , anxiety , quality of life (healthcare) , mood , depression (economics) , sexual abuse , psychiatry , physical abuse , somatization , clinical psychology , poison control , injury prevention , nursing , environmental health , economics , macroeconomics
Background Irritable bowel syndrome ( IBS ) is a common abdominal pain disorder without an organic explanation. Abuse histories (physical, sexual, emotional) are prevalent in IBS . While abuse relates to mood disorders (depression and anxiety) also common in IBS , the influence of abuse on gastrointestinal ( GI ) symptoms and health‐related quality of life ( HRQOL ) and its independence from psychological symptom comorbidity has not been studied. Methods Consecutive GI outpatients completed the ROME III Research Diagnostic Questionnaire and questionnaires on trauma (Life‐Stress Questionnaire), mood (Beck Depression/Anxiety Inventories), somatic symptoms ( PHQ ‐12), and HRQOL ( SF ‐36). Current GI symptom severity and bother were assessed using 10‐cm Visual Analog Scales. Key Results 272 ROME ‐defined IBS (47.6 ± 0.9 years, 81% female) and 246 non‐ FGID (51.6 ± 1.0 years, 65% female) subjects participated. IBS patients reported greater rates of physical, sexual, and emotional abuse ( p < 0.006 each), and higher depression, anxiety, and somatic symptoms ( p < 0.001). Greater bowel symptom bother (7.4 ± 0.2 vs 6.7 ± 0.2, p = 0.040), severity (7.7 ± 0.2 vs 6.5 ± 0.2, p < 0.001), recent symptomatic days (9.8 ± 0.4 vs 8.5 ± 0.3, p = 0.02), and poorer HRQOL (40.9 ± 2.3 vs 55.5 ± 1.7, p < 0.001) were noted in IBS with abuse. Abuse effects were additive, with greater IBS symptom severity and poorer HRQOL noted in cases with multiple forms of abuse. Mediation analyses suggested that abuse effects on GI symptoms and HRQOL were partially mediated by mood. Conclusions & Inferences Abuse experiences common among IBS sufferers are associated with reports of greater GI symptoms and poorer HRQOL , particularly in those with multiple forms of abuse; this relationship may be partially mediated by concomitant mood disturbances.