Abstract
BackgroundAbdominal bloating is a common symptom in patients with irritable bowel syndrome with constipation (IBS-C). However, it is not included among the required items in the Rome III diagnostic criteria for IBS. Little is known about an impact of abdominal bloating seen in patients with IBS-C. Using a large population-based sample, the aim of the present study was to investigate what is the most bothersome symptom in subjects with IBS-C.MethodsAn Internet survey of 30,000 adults drawn from the general public throughout Japan was conducted to identify subtypes of IBS using the Rome III diagnostic questionnaire. Consecutively, the screened subjects with IBS-C and the same number of age- and sex-matched non-IBS subjects who were randomly selected as controls were asked to answer a questionnaire on the degree of anxiety they experienced in their daily lives, thoughts about bowel habit, and their dominant gastrointestinal symptoms together with exacerbation factors (for IBS-C only).ResultsThe screening survey showed that the prevalence of overall IBS was 16.5 % (female 17.4 %, male 15.5 %) and that 2.8 % met the criteria for IBS-C, 4.5 % for IBS with diarrhea (IBS-D) and 8.2 % for mixed IBS (IBS-M). Seven hundred and fifty-nine of 835 (90.9 %) subjects with IBS-C and 746 of 830 (89.9 %) control subjects completed the consecutive questionnaire. IBS-C subjects felt a higher degree of anxiety in their daily lives (p < 0.01) and considered bowel habit to be an indicator of health (p < 0.01) to a greater extent than control subjects. In IBS-C, the degree of anxiety was significantly associated with abdominal discomfort (p < 0.01), pain (p < 0.01) and bloating (p = 0.02), but not with the frequency of bowel habit (p > 0.1). Abdominal bloating was the most bothersome symptom (27.5 %), which was more likely to occur after a meal (52.2 %), at work/school (29.2 %) and during times of stress (26.8 %). Only 4.5 % of IBS-C subjects reported abdominal pain as the ‘most bothersome’ symptom.ConclusionsA large population-based Internet survey suggests that abdominal bloating has a great impact on the daily lives of subjects diagnosed with IBS-C. Not only bowel movement/abdominal pain but also abdominal bloating should be evaluated in patients with IBS-C.Electronic supplementary materialThe online version of this article (doi:10.1186/s13030-016-0070-8) contains supplementary material, which is available to authorized users.
Highlights
Abdominal bloating is a common symptom in patients with irritable bowel syndrome with constipation (IBS-C)
The screening survey showed that the prevalence of overall Irritable bowel syndrome (IBS) was 16.5 % and that 2.8 % met the criteria for IBS-C, 4.5 % for IBS with diarrhea (IBS-D), 8.2 % for mixed IBS (IBS-M), and 1.0 % for unspecified IBS (IBS-U)
Subjects with IBS were more likely to report abdominal bloating for at least two to three days a month compared to nonIBS subjects (19.5 %, p < 0.01, respectively)
Summary
Abdominal bloating is a common symptom in patients with irritable bowel syndrome with constipation (IBS-C). It is not included among the required items in the Rome III diagnostic criteria for IBS. Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder that affects between 10 and 20 % of the population worldwide [1]. Based on the Rome III diagnostic criteria for functional GI disorders, IBS is defined as recurrent abdominal pain or discomfort (at least 3 days per month in the last 3 months) associated with at least two of the following: improvement with defecation, onset associated with a change in stool frequency, and/or onset associated with change in stool form [2]. Patients with IBS feel more stress compared to healthy subjects in their daily life [5, 6]. It has been reported that menstruation was associated with a worsening of abdominal pain and bloating and with more increase in rectal pain sensitivity compared with most other phases of the menstrual cycle in patients with IBS [8]
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