Wednesday, April 6, 2011

Quality of Life in Irritable Bowel Syndrome

It's not news that IBS is tough. The unpredictability of symptoms, misunderstanding by peers, fear,  misconceptions, desperation, all contribute to discrimination of sufferers and significant impairment of quality of life. In fact, IBS sufferers are affected by greater physiological and physical disturbances than patients of inflammatory bowel disease, proving that wellbeing is not directly associated with observable morbidity.

The most common psychological problems of IBS are anxiety, depression, panic, and post-traumatic stress. According to an Australian study (Mikocka-Walu et al, 2008), anxiety is a greater problem than depression, while a recent Korean study (Hyun Sun Cho et al., 2011) shows the same prevalence for anxiety and depression (observed in 38.6% and 38.6% of IBS patients, and in 24.2% and 16.5% of healthy subjects, respectively). Indeed, different cultural environments enhance or decrease problems associated with IBS - Greeks, for example, take it harder than the Swiss (Faresjö et al., 2006). Differences in IBS prevalence could also be the result of different environments, creating a reluctance to talk about digestive issues. In countries such as United States and UK more people may be suffering in silence.

The questionnaire below was developed by Kaiser Permanente (Longstreth et al., 2005) to capture the impact of irritable bowel syndrome and its treatment on patients’ lives.


Longstreth GF, Bolus R, Naliboff B, Chang L, Kulich KR, Carlsson J, Mayer EA, Naesdal J, Wiklund IK. Impact of irritable bowel syndrome on patients’ lives: development and psychometric documentation of a disease-specific measure for use in clinical trials European Journal of Gastroenterology & Hepatology 2005, 17:411–420

Groll D, Vanner SJ, Depew WT, DaCosta LR, Simon JB, Groll A, Roblin N, Paterson WG. The IBS-36: a new quality of life measure for irritable bowel syndrome. Am J Gastroenterol. 2002 Apr;97(4):962-71.

Faresjö A, Anastasiou F, Lionis C, Johansson S, Wallander MA, Faresjö T. Health-related quality of life of irritable bowel syndrome patients in different cultural settings. Health Qual Life Outcomes. 2006 Mar 27;4:21.

Mikocka-Walus AA, Turnbull DA, Andrews JM, Moulding NT, Wilson IG, Harley HA, Hetzel DJ, Holtmann GJ. Psychological problems in gastroenterology outpatients: A South Australian experience. Psychological co-morbidity in IBD, IBS and hepatitis C. Clin Pract Epidemiol Ment Health. 2008 May 23;4:15.

Cho HS, Park JM, Lim CH, Cho YK, Lee IS, Kim SW, Choi MG, Chung IS, Chung YK.
Anxiety, Depression and Quality of Life in patients with irritable bowel syndrome  Gut Liver. 2011 Mar;5(1):29-36.