Coexisting Irritable Bowel–Like Symptoms in Inflammatory Bowel Disease in Remission Is Associated With Impaired Social Functioning and Increased Bodily Pain


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Abstract

Irritable bowel-like symptoms are frequently reported among patients with inflammatory bowel disease (IBD) deemed to be in remission. Previous studies have indicated that patients with coexisting irritable bowel syndrome (IBS) might have poorer health-related quality of life (HRQoL) than those without. However, it is not known what areas of HRQoL are most affected. In this study, we investigated the impact of coexisting IBS on HRQoL in IBD. Patients deemed to be in remission and not on current biological or steroid treatment were identified from a cohort of 140 IBD outpatients. HRQoL was measured using the generic Short Form–36 and the disease-specific Inflammatory Bowel Disease Questionnaire. Calprotectin in stools was measured as an objective marker of inflammation. Eighty-nine patients fulfilled the criteria for remission. Of these 89 patients, a total of 21 were irritable bowel-like symptom positive according to the Rome II criteria, whereas the comparable number in Rome III was 30. The level of calprotectin in stools was elevated in irritable bowel–like symptom positive patients, and HRQoL scores were clinically significantly reduced compared with those without IBS-like symptoms. These differences remained even when controlling for calprotectin through univariate analyses. Patients experiencing IBS-like symptoms in IBD are associated with poorer HRQoL even after controlling for objective disease markers. The HRQoL areas that are particularly affected are social functioning and bodily pain.

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