TY - JOUR
T1 - Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome
AU - Weerts, Zsa Zsa R. M.
AU - Vork, Lisa
AU - Mujagic, Zlatan
AU - Keszthelyi, Daniel
AU - Hesselink, Martine A. M.
AU - Kruimel, Joanna
AU - Leue, Carsten
AU - Muris, Jean W. M.
AU - Jonkers, Daisy M. A. E.
AU - Masclee, Ad A. M.
N1 - Publisher Copyright:
© 2019 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd
PY - 2019/8
Y1 - 2019/8
N2 - 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 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.
AB - 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 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.
KW - irritable bowel syndrome
KW - natural history
KW - quality of life
KW - Rome criteria
KW - symptom evolution
KW - PRODUCTIVITY COST QUESTIONNAIRE
KW - GASTROINTESTINAL SYMPTOMS
KW - HOSPITAL ANXIETY
KW - VALIDATION
KW - SCALE
KW - SATISFACTION
KW - COMMUNITY
KW - VALIDITY
KW - IMPACT
KW - HABIT
U2 - 10.1111/nmo.13629
DO - 10.1111/nmo.13629
M3 - Article
C2 - 31119844
SN - 1350-1925
VL - 31
SP - 1
EP - 10
JO - Neurogastroenterology and Motility
JF - Neurogastroenterology and Motility
IS - 8
M1 - 13629
ER -