E0254 - Comparison of Quality of Life Between Patients With Diarrhea- and Constipation-Predominant Irritable Bowel Syndrome

Tuesday, October 25, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Joelle BouSaba, MD

Mayo Clinic
Rochester, MN

Joelle BouSaba, MD, Saam Dilmaghani, MD, MPH, Ann Taylor, , Irene Busciglio, BS, Michael Camilleri, MD
Mayo Clinic, Rochester, MN

Introduction: Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain and change in the form and consistency of stool. Two subtypes of IBS are diarrhea-predominant IBS (IBS-D) and constipation-predominant IBS (IBS-C). While IBS symptoms have been shown to decrease quality of life (QOL), the effects of IBS subtypes on QOL are still unclear. The aim of this study was to compare QOL parameters in patients with IBS-D and IBS-C.

Methods: Data were obtained as part of an institutional review board-approved study where participants with ROME III positive criteria for IBS-D and IBS-C completed the following validated questionnaires: Bowel Disease Questionnaire, IBS-QOL, Hospital Anxiety and Depression Scale (HADS), Symptom Checklist 90 (SCL-90). We used two sample t-test, Wilcoxon rank sum test, and Pearson chi squared to compare the results between the two groups.

Results: The study included 219 patients with IBS-D and 33 with IBS-C. The participants’ demographics are reported in the table. Most patients with IBS-C (70%) had 2-4 bowel movements (BM) per week, while 48% of patients with IBS-D had 13-26 BM per week and 13% had more than 26 BM per week. Patients with IBS-D had higher anxiety, depression, and total anxiety-depression scores on the HADS compared to patients with IBS-C (table). Patients with IBS-D had higher scores (reflecting worse symptoms) on the somatization, obsessive compulsive, depression, anxiety, and psychoticism dimensions as measured by the SCL-90. Moreover, patients with IBS-D had higher (reflecting worse) IBS-QOL total and subscale scores on 7 out of the 8 subscales (table). Notably, 42% of patients with IBS-D felt like they were slightly or moderately losing control of their lives because of their bowel problems, whereas 92% of patients with IBS-C reported not feeling loss of control at all. While 96% of patients with IBS-C did not feel that their life revolved around their bowel movements, 20% of patients with IBS-D reported life revolved around their bowel movements quite a bit or a great deal, specifically due to needing to be in proximity to a toilet and inability to take long trips.

Discussion: Our study shows that patients with IBS-D seem to have a worse general and IBS-specific quality of life compared to patients with IBS-C. These data reinforce the importance of considering QOL impact of IBS and opportunities for shared decision-making when discussing individual management plans for patients with IBS-D.

	IBS-D	IBS-C	P-value
	Demographics
Age (years), mean (SD)	41 (14)	51 (12)	0.001
% females	79	100	0.004
BMI (kg/m²), mean (SD)	30 (7)	28 (6)	0.1878
	Hospital Anxiety and Depression Scale (HADS) score, mean (SD)
HADS total score	8.5 (5.2)	3.4 (2.6)	< 0.0001
HADS anxiety score	6 (3.6)	2.5 (1.9)	< 0.0001
HADS depression score	2.5 (2.3)	0.97 (1.1)	0.0006
	IBS-Quality of Life total score, mean (95% CI)
Total score	30.1 (27.6, 32.5)	9.1 (6.7, 11.5)	< 0.0001
	IBS-Quality of Life subscales, mean (95% CI)
Dysphoria	28.1 (24.8, 31.5)	4.2 (1.9, 6.4)	< 0.0001
Interference with activity	37.2 (34.2, 40.2)	7.1 (4.3, 10.0)	< 0.0001
Proximity to toilet important: grades (1-5)	6/27/24/20/22%	59/37/4/0/0%	< 0.0001
Long trips difficult: grades (1-5)	14/32/20/19/16%	78/19/4/0/0%	< 0.0001
Body image	26.9 (24.2, 29.6)	18.3 (13.6, 23.0)	0.0249
Food avoidance	52.7 (48.5, 56.9)	13.0 (8.0, 17.9)	< 0.0001
Social reaction	27.5 (24.5, 30.5)	8.1 (4.0, 12.2)	< 0.0001
Sexual	17.2 (14.1, 20.2)	8.3 (2.8, 13.8)	0.0425
Relationship	20.1 (17.5, 22.8)	3.7 (1.4, 6.0)	< 0.0001

Table: Comparison of demographic factors, Hospital Anxiety and Depression Scale, and IBS-Quality of Life subscale results in 219 patients with IBS-D and 33 patients with IBS-C.
SD=standard deviation; CI=confidence interval. Italicized factors reflect participants’ answers on a 1-5 scale for the interference with activity subscale, with 1 being “not at all” and 5 being “extremely”; higher scores reflect worse QOL.

Disclosures:

Joelle BouSaba indicated no relevant financial relationships.

Saam Dilmaghani indicated no relevant financial relationships.

Ann Taylor indicated no relevant financial relationships.

Irene Busciglio indicated no relevant financial relationships.

Michael Camilleri: Aclipse Therapeutics – Consultant. Aditum Bio – Consultant. AEON Pharma – Consultant. Allergan – Grant/Research Support. Arena – Consultant. Bilayer Therapeutics – Stock Options. BioKier – Consultant. Coloplast – Consultant. Coloplast – Consultant. Colospan – Consultant. Cosmo Pharmaceuticals – Consultant. Dignify Therapeutics – Stock Options. Enterin – Stock Options. Fauna Bio – Consultant. GlaxoSmithKline – Consultant. Invea Therapeutics – Consultant. InveniAI – Consultant. Ironwood – Consultant. Kallyope – Consultant. NGM Biopharmaceuticals – Grant/Research Support. Novome – Consultant. Pfizer – Consultant. Protagonist Therapeutics – Consultant. Protagonist Therapeutics – Consultant. QED Therapeutics – Consultant. Sunovion Pharmaceuticals – Consultant. Takeda – Consultant. Thelium Therapeutics – Stock Options. Vanda – Grant/Research Support. VIPUN Medical – Consultant. Virios – Consultant. Zealand Biopharma – Consultant.

Joelle BouSaba, MD, Saam Dilmaghani, MD, MPH, Ann Taylor, , Irene Busciglio, BS, Michael Camilleri, MD. E0254 - Comparison of Quality of Life Between Patients With Diarrhea- and Constipation-Predominant Irritable Bowel Syndrome, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.