Correlation of Anxiety and Structural Factors With Symptoms in Patients With Irritable Bowel Syndrome With Diarrhea / 胃肠病学

ABSTRACT

Background: Patients with irritable bowel syndrome (IBS) have comorbid anxiety, which influences the severity of IBS symptoms and therapeutic efficacy. Aims: To investigate the intestinal and extra-gastrointestinal symptoms and psychological status of patients with IBS with diarrhea (IBS-D), and to identify the correlation of comorbid anxiety and structural factors with symptoms. Methods: Consecutive patients met the Rome III criteria for IBS-D were enrolled in this study. The IBS symptom questionnaire and Hamilton anxiety scale (HAMA) were completed in a face-to-face manner. Correlations of HAMA and its structural factors with main bowel symptom, defecation symptom, overlapping with gastroesophageal reflux disease and extra-gastrointestinal symptoms were analyzed. Results: A total of 410 IBS-D patients were enrolled, 264 (64.4%) had comorbid anxiety. Compared with patients without anxiety, score of the main bowel symptom and abdominal pain/discomfort after defecation were significantly increased in patients with anxiety, proportions of abdominal bloating, difficulty in stool passage, mucous stool, overlapping with gastroesophageal reflux disease and extra-gastrointestinal symptoms were significantly increased (P<0.05). Psychic anxiety was significantly correlated with main bowel symptom score and degree of improvement of abdominal pain/discomfort after defecation (P<0.05). Somatic anxiety was significantly correlated with degree of pre-defecation abdominal pain/discomfort (P<0.05). No structural factor had significant correlation with bowel movements or stool form either in the symptom episode or in the non-symptom period. HAMA score, psychic anxiety score, somatic anxiety score in patients with abdominal bloating, mucous stool, overlapping with gastroesophageal reflux disease and extra-gastrointestinal symptoms were significantly higher than those in patients without the corresponding symptoms (P<0.05). Conclusions: The comorbid anxiety and structural factors are mainly correlated with degree of abdominal pain/discomfort in IBS-D patients, but not with bowel movements or stool form.