Conceptual models suggest that ‘irritable bowel syndrome (IBS) severity’ is a multidimensional outcome that is related to, yet distinct from, health-related quality of life.
Existing severity questionnaires are largely based on physician rather than patient-based ratings.
Since severity is a patient-centered outcome, it is essential that future instruments are based on patients' self-perceptions of severity.
Dr Brennan Spiegel and colleagues measured patient-derived predictors of severity in a large cohort of IBS patients.
The research team performed a cross-sectional analysis in 755 IBS patients recruited at a university-based center.
|Straining with defecation, was a factor that predicted severity|
|American Journal of Gastroenterology|
Subjects completed a bowel symptom questionnaire, including the Short-Form 36.
The main outcome was patient-assessed ‘overall severity of gastrointestinal symptoms‘, as measured on a 0 to 20 scale.
The research team first developed a conceptual model of IBS, and then performed bivariate analyses to identify biopsychosocial predictors of severity.
The team then entered significant predictors into a multivariable model to measure the independent association of each predictor with severity.
The researchers identified 6 factors that predicted severity that included abdominal pain rating belief that ‘something serious is wrong with body’.
Straining with defecation, myalgias, urgency with defecation, and bloating were also factors that predicted severity.
Severity correlated highly with health-related quality of life in bivariate, but not multivariate, analysis.
Dr Spiegel’s team comments, “Patient-derived severity in IBS is related to, yet distinct from, generic health-related quality of life.”
“IBS severity is predicted by abdominal pain, bloating, straining, urgency, myalgias, and disease-related concern.”
“These symptoms fall along both poles of the "brain-gut axis," indicating that a full assessment of patient severity must include a balanced biopsychosocial history.”