Differences In IBS Symptoms In Patients Of Different Sexes And Age Groups

Objectives: To investigate the differences in the symptom manifestations of irritable bowel syndrome(IBS)in patients of different sexes and women with different stages of reproductive aging,as well as other factors affecting the severity of IBS symptoms.So as to provide new ideas for future researches as well as the individualized diagnoses and treatments of IBS.Methods: Subjects were selected from the gastroenterology outpatient clinic of the the Second Affiliated Hospital of Kunming Medical University from November2021 to December 2022.General demographic survey,Bristol stool type scale,IBS severity scoring system(IBA-SSS),7 items generalized anxiety disorder questionnaire(GAD-7),patient health questionaire-9(PHQ-9)were filled out for 327 participants who met the inclusion criteria after exclusion.First,patients were divided into mild,medium,and severe groups according to the IBS-SSS scoring criteria,and we compared the differences in baseline data of aforesaid 3 groups.Then women were divided into three groups according to the stages of reproductive aging:reproductive period,menopause and postmenopause,and male patients were divided into three groups according to age matching,and we compared the differences in IBS subtypes,IBS-SSS 5 scores and total scores of different groups of both men and women.We also analyzed the correlation between anxiety and depression with the severity of IBS symptoms,and the effects of covariate anxiety and depression were controlled separately using covariance,and the changes and differences in IBS-SSS scores in patients of different sexes and different stages of reproductive aging were reassessed.Finally,multiple linear regression was used to analysis the factors significantly affecting the severity of intestinal symptoms in IBS.Results:1.Comparison results of baseline data suggest that there are no significant differences in BMI,education level,income level,exercise duration,frequency of soy products,and IBS subtype in the three groups with mild,medium,and severe(all P>0.05).And more patients slept < 7 hours in the group with more severe symptoms,and more patients in the group with milder symptoms slept > 8 hours(P value < 0.05),meanwhile one-way ANOVA shows that IBS-SSS scores of patients with shorter sleep duration are higher(all P<0.05).2.IBS-C is the major group for women(42.0%)and IBS-D for men(47.7%),the differences between groups in both subtypes were statistically significant(all P<0.05).The degree of abdominal pain,abdominal distention,and total IBS-SSS scores in women are higher than those in men(all P<0.05).3.Abdominal pain is more severe in reproductive period,abdominal pain and abdominal distention are more severe in menopausal women,abdominal pain is more frequent in postmenopausal women,and the score of IBS-SSS in menopausal women is higher than that in reproductive women(all P<0.05).However,these differences between the three male groups are not statistically significant(all P>0.05).4.GAD-7(ρ=0.640,P<0.001)and PHQ-9(ρ=0.694,P<0.001)are strongly correlated with IBS-SSS score.After controlling anxiety and depression with covariance,the estimated IBS-SSS score in women are still higher than those in men,and the estimated IBS-SSS scores in both menopausal and postmenopausal women are higher than those in reproductive women(all P<0.05).The difference between the three male groups is still not statistically significant(all P> 0.05).5.Multiple linear regression analysis suggest that depression(B=8.172,95% CI6.424～9.920),anxiety(B=6.730,95% CI 4.857～8.604),sleep duration(B=-14.686,95% CI-21.373～-7.999),gender(male as reference,women B=12.744,95% CI3.729～21.759)are factors that affects IBS-SSS scores among overall patients.And depression(B=9.043,95%CI 6.661～11.425,P<0.001),anxiety(B=6.427,95%CI3.978～8.877,P<0.001),sleep duration(B=-12.109,95%CI 21.243～-2.975,P=0.010),stage of reproductive aging(reproductive period as reference,menopause B=19.856,95% CI 3.832～35.880,postmenopause B=20.909,95% CI 6.661～35.158)are factors that affects IBS-SSS scores among female patients.Conclusions:1.The predominant subtypes are IBS-C in women and IBS-D in men.2.The severity of IBS symptoms in women is higher than that in men,and the gender difference of the IBS-SSS score is still significant after controlling anxiety and depression score.3.The severity of IBS symptoms is higher in menopausal women.After controlling anxiety and depression score,the severity of IBS symptoms in both menopausal and postmenopausal women are significantly higher than that in reproductive women.4.Elevated depression scores,elevated anxiety scores,and reduced sleep duration may lead to worsening bowel symptoms in IBS.Female patients may face more severe IBS bowel symptoms than men.In women,menopausal and postmenopausal patients may face more severe IBS bowel symptoms than productive patients.