Epidemiology of Meal-Related Abdominal Discomfort or Pain in Irritable Bowel Syndrome.

Abstract

Background: Patients with IBS often report meal-related symptoms, which may negatively affect IBS-related quality of life, psychological health, and lead to food-avoidant behaviors. However, the understanding of the epidemiology of these symptoms is limited.

Methods: We compared characteristics of adult patients with Rome IV-defined IBS with and without meal-related abdominal discomfort or pain ≥ 50% of the time. Participants were recruited from the ContactME-IBS research register. We collected data concerning demographics, IBS symptoms, psychological health, quality of life, and impact on work and daily activities using validated questionnaires. We used logistic regression to explore independent predictors of meal-related discomfort or pain ≥ 50% of the time in IBS.

Key results: Of 752 respondents with Rome IV IBS, 561 (74.6%) reported meal-related abdominal discomfort or pain ≥ 50% of the time. 89.3% of individuals with meal-related discomfort or pain ≥ 50% of the time were female vs. 80.6% of those without (p = 0.002). Those with meal-related discomfort or pain ≥ 50% of the time were younger (43.7 years vs. 50.1 years, p < 0.001), had a higher prevalence of symptoms meeting criteria for functional dyspepsia (FD), especially postprandial distress syndrome (49.1% vs. 30.2%, p < 0.001), and reported higher gastrointestinal symptom-specific anxiety scores, lower IBS-related quality of life scores, and higher levels of activity impairment (p < 0.001 for all analyses). After logistic regression analysis, females, those meeting criteria for FD, younger individuals, and those reporting higher gastrointestinal symptom-specific anxiety scores were more likely to report meal-related discomfort or pain ≥ 50% of the time.

Conclusions: Meal-related abdominal discomfort or pain ≥ 50% of the time was associated with female sex, younger age, and comorbid FD. Better characterization and recognition of patients affected by meal-related discomfort or pain may allow more personalized dietary and psychological interventions.