Similarities and differences between IBS-C and FC with regards to symptomatology, sleep quality and psychological attributes

Abstract

Irritable bowel syndrome (IBS) and functional constipation (FC) are highly prevalent in the general population and have significant symptom overlap, while the clinical associations and psychological links between IBS and FC remains poorly understood. We aimed to compare the clinical, metabolic and psychological factors between patients with FC patients and constipation predominated IBS. We consecutively enrolled 360 patients from the outpatient clinics of Hualien Tzu Chi medical center. Constipation-predominant IBS (IBS-C) and FC were diagnosed based on Rome III criteria. All participants completed the Pittsburg Sleep Quality Index (PSQI) score, the State Trait Anxiety Inventory (STAI) score and the Taiwanese Depression Questionnaire (TDQ) score. Fifty-four patients had FC and twenty-three patients had IBS-C. Compared to asymptomatic controls, FC/IBS-C groups had female predominance (p<0.001), FC as well as more GI discomforts and inferior psychosocial characteristics (p<0.05). Compared to FC, IBS-C had higher severity scores of abdominal distention (4.52±1.90 vs. 3.07±1.88) and heartburn (2.17±1.50 vs. 1.46±1.14). However, FC was independently associated with poor sleep quality [adjusted OR: 1.19 (1.08-1.31), p<0.001] and IBS-C with depression [adjusted OR: 1.07 (1.02-1.12), p=0.005]. Patients with FC and IBS-C shared many similar GI complaints and psychosocial characteristics, however IBS-C had more severe bloating, heartburn and depression and FC had worse sleeping quality.