Clinical Epidemiology Characteristics And Quality Of Life Study On Patients With Irritable Bowel Syndrome

Objective1. To investigate clinical epidemiology characteristics on patients with irritable bowel syndrome(IBS);2. To investigate quality of life (QOL) and its influencing factors on IBS patients.Subjects and MethodsFrom September 2006 to October 2007, 373 consecutive Roma III criteria-positive IBS patients presented to digestive disease clinic and general medicine clinic of the first affiliated hospital of medical college of Shantou University were randomly sampled and evaluated by using demographic checklists, symptoms questionnaire and Chinese version IBS-QOL. Meanwhile, 400 regular healthy volunteers mainly from health examination center were involved as a normal control group on the study of quality of life.Results1. General information: 373 cases of IBS patients were investigated in the study. Of them, 168 cases were male, 205 cases were female, its proportion was 1vs1.2. their average age was 41.91±12.52 years. Compared with normal public in Shantou city, IBS was more common in female, adults in 20-59 years old, and among high educated and cadres samples (all P <0.01).2. Main colonic symptoms: 68.1% of IBS patients suffered abdominal pain, 63.3% of IBS patients suffered abdominal distention. 85.3% of IBS patients whose symptoms such as abdominal pain or discomfort were likely to be alleviated by defecation. Besides, IBS patients often suffered altered bowel trait or habits (81.5%), abnormal defecation process (85.0%) and mucous stool (45.6%).3. It was common that IBS accompanied with symptoms of other functional gastrointestinal tract diseases such as anepithymia(37.5%), rugitus or evacuation (31.6%), Upper abdominal pain or discomfort (16.1%),sour regurgitation(13.9%), belching or hiccup (12.6%); Besides colonic symptoms, IBS could cause generalized body discomfort and psychosocial problems like debilitation (38.6%), agrypnia (9.9%), dysuresia (6.6%), and anxiety (52.8%), depression (42.9%).4. The causative factors for IBS were improper diet(49.1%), emotional stress or suppression(23.9%), excess fatigue(13.9%), induced by drugs(2.7%);IBS had a high occurrence in spring (31.1%, P <0.01). There were 31.6% of IBS patients whose family members suffered from similar symptoms.5. IBS patients could manifest gastrointestinal disorders and accompanied with psychosocial problems including dissatisfied for work (30.5%), for economic status (29.1%), for emotion (23.0%), interpersonal relationship (23.9%) and family relationship (17.2%).6. The percentages of IBS subtypes simply judged by stool trait according Rome III criteria were as follow:IBS-D (43.7%), IBS-C (22.8%), IBS-M (15.0%), IBS-U (18.5%).The subtypes distribution had a significant statistics difference (P <0.01) among four subtypes, sex difference was significant, IBS-D was more prevalent in males while the other subtypes were more common in females (P <0.05).The age mean of IBS-D patients was larger than the patients of the other three subtypes. In addition, it showed that different subtype had different colonic and extra-colonic symptoms to a certain extent. In regards to the IBS predominant bowel symptom, there were significant differences among IBS subtypes. Abdominal pain (frequency over 3 days per week) were more frequent in IBS-M patients (P <0.01), IBS-D patients more frequently experienced of passage of mucus, rugitus or evacuation (all P <0.01), debilitation, anxiety and depression (all P <0.05) while abdominal distention (frequency over 3 days per week) were more frequent in IBS-C (P <0.01).7. IBS patients experienced momentous impairment in quality of life. Score of them were significantly lower on all scales (P <0.01) Compared with the control group (adjusted to gender and age), Decrements were most pronounced in dysphoria, interference with activity and health worry scales. QOL scores of female patients were lower than those of male in most scares. QOL in IBS-D scored even lower than any other subtype in all scales excepss for body image and health worry (P <0.05).8. Quality of life score had negative correlation with symptoms severity, symptoms severity, course of disease, age, sex, and drinking habit were the key influencing factors for QOL of IBS patients.Conclusion1. The prevalence of IBS had close correlation with sex, age, education and profession.2. The main symptoms for IBS were abdominal pain, abdominal distention or discomfort, accompanied with altered bowel trait or habits.3. Different IBS subtype that was simply judged by stool traits according to Rome III had considerable differences in clinical epidemiology characteristics. Consequently, the classification method might carry guiding significance on scientific research and clinic diagnose or treatment for IBS.4. IBS patients experience momentous impairment in quality of life. Moreover, quality of life score had negative correlation with symptoms severity. Symptoms severity, course of disease, age, sex, and drinking habit were the key influencing factors for QOL of IBS patients.