INCREASING UPPER DIGESTIVE SYMPTOM SEVERITY IN IBS IS ASSOCIATED WITH INCREASED PSYCHIATRIC DISTRESS

Abstract

Purpose: Many IBS pts also report symptoms (sxs) referable to the UGI tract or have abnormalities of UGI motility or sensation. Additionally, pts with one FGID often “morph” into another FGID at a later date. To better understand multi-organ sxs in IBS, we evaluated dyspeptic sxs in IBS pts, IBD pts and healthy ctrls. Methods: Consec. pts with IBD or RomeII IBS were enrolled and ctrls recruited by advertisement. Pts rated 15 dyspeptic sxs using the sx checklist of the Nepean Dyspepsia Index (NDI): upper abd. pain, discomfort and burning; chest pain, burning and regurgitation; upper abd. bloating; pressure; early satiety; inability to finish a meal; cramps; nausea; vomiting; belching/burping and bad breath. Pts also completed the SCL-90-R (SCL; a measure of psychiatric distress) and two measures of somatization: Toronto Alexithymia Scale (TAS) and Somatosensory Amplification Scale(SSAS). Comparisons across groups were made by ANOVA with Bonferroni's posttest. Results: 42 ctrls, 29 IBD pts and 79 IBS pts were studied. IBS pts had significantly higher NDI sx scores than IBD pts who were significantly more symptomatic than ctrls (fig). Sx scores in IBS pts showed a bimodal distribution. Subsequently, we compared three groups: IBS with sx scores > 70 (n = 23); IBS with sx scores < 50 (n = 48); and IBD with sx scores < 50 (n = 26). IBS and IBD pts with sx scores <50 did not differ with respect to sxs, SCL, TAS or SSAS scores. In contrast, IBS pts with sx scores >70 had significantly greater scores for total sxs, SCL and TAS but not SSAS (table).TableFigureConclusions: Reporting of UGI sxs is common in IBS and IBD pts. A subset of IBS pts (29%) reported significantly more upper digestive sx severity. This group demonstrated both greater psychiatric distress and somatization than did IBD and IBS pts reporting fewer upper digestive sxs.