Su2082 Colonic Barrier Function Is Impaired in Post-Campylobacter jejuni Irritable Bowel Syndrome

Abstract

Background: IBS is one of the most prevalent functional gastrointestinal disorders. Earlier studies have shown that IBS patients are more likely to be impaired at work and during daily activities compared to non-IBS patients. However, factors of importance for this impairment have not yet been fully examined. Aim: To investigate the relationship between work impairment and other factors related to IBS. Methods: We included 533 patients with IBS (median age 34 (17-80) years, 420 females). The patients completed the Work Productivity and Activity Impairment Questionnaire:IBS (WPAI:IBS), as well as questionnaires to assess IBS symptom severity (IBS-SSS), GI-specific anxiety (VSI), somatic symptoms (PHQ-15), depression and anxiety (HAD), and fatigue (MFI). Uniand bivariate analyses were performed, as well as linear regression analyses to determine factors independently associated with the work productivity and activity impairment measures. Results: The IBS patients reported 7±19% (mean±SD) absenteeism (actual work time missed), 33±25% presenteeism (impairment while at work), 36±27% overall work productivity loss and 46±27% activity impairment. Female IBS patients reported greater activity impairment than males (47±27 vs. 41±27 %; p<0.05), but no other gender differences were found. A weak, but statistically significant negative association was noted between age and activity impairment (rho=-0.11; p<0.05), but otherwise age was not associated with the work productivity and activity impairment. No differences between IBS-subtypes were found. With increasing severity of IBS symptoms, somatic symptoms and GI-specific anxiety, higher degrees of absenteeism, presenteeism, overall work productivity loss and activity impairment were seen (p<0.0001 for all). Among the fatigue measures, physical fatigue, general fatigue and reduced activity demonstrated the strongest associations with the work productivity and activity impairment (rho=0.280.47; p<0.01). Weaker, but still statistically significant associations were seen between general anxiety and depression and presenteesim, overall productivity loss and activity impairment (rho=0.19-0.30; p<0.05). Using linear regression analysis, IBS symptom severity, GI-specific anxiety and general fatigue were independently associated with presenteeism (R=0.36; p<0.05) and overall productivity loss (R2=0.42; p<0.05), while activity impairment was independently associated with IBS symptom severity and general fatigue (R2=0.40; p<0.05). Conclusions:Work productivity and activity impairment is a substantial problem in patients with IBS. A combination of IBS and somatic symptom severity, fatigue and psychological factors seem to impact the IBS patients' ability to be active and productive at work. Based on this, a multidimensional treatment approach for IBS patients seems logical.