Prevalence of extra‐intestinal symptoms according to irritable bowel syndrome subtype

Abstract

BackgroundIrritable bowel syndrome (IBS) is a functional disorder commonly associated with extra‐intestinal symptoms. However, the prevalence of these symptoms according to IBS subtype is not well established.AimTo compare the prevalence of extra‐intestinal symptoms among patients with different subtypes of IBS.MethodsA descriptive cross‐sectional study including patients with IBS according to Rome IV criteria was performed between July 2022 and April 2023. Patients were classified according their subtype of IBS: IBS‐D (diarrhea‐predominant), IBS‐C (constipation‐predominant), and IBS‐M (mixed bowel habits). Patients completed the IBS severity scoring system questionnaire (IBS‐SSS) to determine severity of IBS symptoms and patient health questionnaire‐ 9 (PHQ‐9) to define presence and severity of depressive symptoms. The prevalence of reported extra‐intestinal symptoms was also assessed and compared between groups.Key ResultsA total of 4862 patients with IBS were included; 608 IBS‐D (12.5%), 1978 IBS‐C (40.7%), and 2276 IBS‐M (46.8%). Patients with IBS‐C had significantly lower IBS‐symptoms severity (mean IBS‐SSS 290 vs. 310 and 320 for IBS‐D and IBS‐M, respectively, p = 0.03). The prevalence of obesity was also significantly lower in these patients (17.1% vs. 30.9% IBS‐D and 27.9% IBS‐M, p = 0.0001). Patients with IBS‐D showed a significantly higher prevalence of food intolerance perception (9.5%, p = 0.03), history of cholecystectomy (17.8%, p = 0.03), and fecal incontinence (36.2%, p = 0.0001) as compared to the other groups. Patients with IBS‐M had significantly higher mean PHQ‐9 score (12.7 vs. 11.1 IBS‐D and 10.5 IBS‐C, p = 0.001) and prevalence of depressive symptoms (80.0%, p = 0.01). Patients with IBS‐M also had higher prevalence of extra‐intestinal symptoms such as arthralgia (62.4%, p = 0.0001), extremity numbness (64.5%, p = 0.0001), atopic dermatitis (28.2%, p = 0.02), and chronic cervicalgia (81.0%, p = 0.01).Conclusions & InferencesThe prevalence of most extra‐intestinal symptoms is higher among patients with IBS‐M. Further research is needed to better characterize IBS subtypes, which could potentially help refining tailored therapeutic strategies.