Reduction in IBS symptom severity is not paralleled by improvement in quality of life in patients with irritable bowel syndrome

Weerts ZZRM1, Vork L1, Mujagic Z1, Keszthelyi D1, Hesselink MAM1, Kruimel J1, Leue C2, Muris JWM3, Jonkers DMAE1, Masclee AAM1. Neurogastroenterol Motil. 2019 Aug;31(8):1-10. doi: 10.1111/nmo.13629. Epub 2019 May 22.


Author information

Division of Gastroenterology-Hepatology, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands.

Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands.

Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.


BACKGROUND: Irritable bowel syndrome (IBS) is a brain-gut disorder, of which the natural course varies between patients and is difficult to predict. This study aimed to evaluate symptom evolution over a 5-year follow-up period and to identify baseline predictors for symptom severity and quality of life (QoL) at follow-up.

METHODS: Maastricht IBS cohort participants completed questionnaires upon inclusion regarding demographics and lifestyle, gastrointestinal (GI) symptoms, anxiety and depression, and QoL. The same questionnaires, in addition to others, were completed after 5 years. Rome criteria were confirmed face-to-face at initial enrollment and through telephonic interviews at follow-up.

KEY RESULTS: At a mean follow-up of 4.7 years, 379 patients were approached of whom 203 (53.7%) responded. Of these, 161 were reached by telephone and analyzed; 49 (30.4%) did not fulfill the Rome III criteria at follow-up and had lower levels of GI symptoms and GI-specific anxiety compared to those remaining Rome III-positive (P < 0.001). However, Rome III-negative patients had comparable levels of QoL and life satisfaction, comorbid anxiety and depression, work absenteeism, and impaired productivity. No baseline predictors were found for being Rome III-positive or Rome III-negative. However, greater age and lower baseline physical QoL predicted lower physical QoL at follow-up (P < 0.005 and P < 0.01, respectively), while lower baseline mental QoL predicted lower mental QoL at follow-up (P = 0.005). Additionally, higher anxiety and depression scores at follow-up were associated with lower QoL and life satisfaction at follow-up (P < 0.001).

CONCLUSIONS AND INFERENCES: Long-term QoL and general well-being might depend on concurrent psychological symptoms, rather than GI symptom improvement.

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