Abstract
BackgroundIrritable bowel syndrome with constipation (IBS-C) is a representative psychosomatic disorder. Several pathophysiological factors have been linked to IBS symptoms such as the modulation of gastrointestinal motility, visceral hypersensitivity, dysregulation of the gut-brain axis, genetic and environmental factors, sequelae of infection, and psychosocial disorders. It is likely that biopsychosocial aspects of IBS-C underlie its gender and age effects. However, the influence of each symptom of IBS-C by gender and age is not well understood. We hypothesized that the expression rate of each IBS-C symptom in females and in subjects aged 20–49 years was higher than that of subjects who were male and aged 50–79 years.MethodsWe conducted an internet survey of 30,000 adults from the general Japanese population. IBS-C subjects were asked to answer a questionnaire on the degree of anxiety, thoughts about bowel habits, and their dominant gastrointestinal symptoms together with exacerbation factors. The correlation between gender and age and IBS-C symptoms was analyzed.ResultsWhen analyzed by gender, the expression rate of abdominal discomfort, abdominal distention, and abdominal fullness was significantly higher in female than male IBS-C subjects (66.5% vs. 58.7%, p < 0.05; 54.7% vs. 43.6%, p < 0.01; 18.9% vs. 9.6%, p < 0.01, respectively). When analyzed by age, the expression rate of abdominal distention and abdominal pain was significantly higher among IBS-C subjects aged 20–49 years than those aged 50–79 years (55.7% vs. 46.8%, p < 0.05; 36.6% vs. 20.6%, p < 0.001, respectively). In contrast, there was no gender or age differences with regard to the most common and bothersome symptom (abdominal bloating) among IBS-C subjects.ConclusionsThe expression rate of some IBS-C symptoms was higher among females and those aged 20–49 years than males and those aged 50–79 years, respectively. It is important to understand the impact of symptoms by gender and age to evaluate the pathology of IBS-C from a biopsychosocial perspective.Trial registrationAlthough this survey was an anonymous internet survey, we obtained informed consent for the study as an online response. The disclosure of this study was approved by the Ethics Committee of Tohoku University Graduate School of Medicine (approval number: 2015–1-405).
Highlights
Irritable bowel syndrome with constipation (IBS-C) is a representative psychosomatic disorder
Gender Five hundred and forty-one female and 218 male IBS-C subjects completed the consecutive questionnaires in the main survey
There were no significant differences between female and male IBS-C subjects in whether participants considered bowel habit to be an indicator of health and in the degree of anxiety felt in daily life (Table 1)
Summary
Irritable bowel syndrome with constipation (IBS-C) is a representative psychosomatic disorder. Irritable bowel syndrome (IBS) is a functional disorder that is characterized by persistent or recurrent gastrointestinal (GI) symptoms. IBS mainly causes abdominal pain or discomfort and bowel movement disturbance, but is not associated with an organic disease that can explain these symptoms [1]. According to the Rome III diagnostic criteria [1], which are international criteria for functional GI disorders, IBS is defined as “symptom onset at least 6 months prior to diagnosis, and recurrent abdominal pain or discomfort for ≥ 3 days/month in the last 3 months. Based on the stool pattern at a particular point, IBS is classified into 4 subtypes: constipation (IBS-C), diarrhea (IBS-D), mixed (IBS-M), or unsubtyped IBS (IBS-U) [1] Among these subtypes, IBS-C is defined by hard or lumpy stools in ≥25% of bowel movements and loose (mushy) or watery stools in < 25% [1]
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