The visceral sensitivity index: A novel tool for measuring GI-symptom-specific anxiety in inflammatory bowel disease.

Abstract

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are chronic gastrointestinal (GI) disorders. GI symptom-specific anxiety (GSA) is the cognitive, affective, and behavioral response stemming from fear of GI symptoms. The Visceral Sensitivity Index (VSI) measures GSA and is validated in IBS and may be useful in IBD. We compared VSI scores in IBD participants to IBS participants and healthy controls (HCs). Using validated questionnaires, we assessed the VSI's correlation with anxiety, health-related quality of life (HRQOL), and IBD activity. We recruited 222 age- and sex-matched participants (74 IBD [23 Crohn's disease; 51 ulcerative colitis], 74 IBS, and 74 HCs). IBD and IBS participants had higher VSI scores compared with HCs (IBD=26.62±16.64, IBS=38.83±15.06; HCs=3.42±5.06; all p's<0.001). VSI scores were lower in IBD vs IBS (p<0.001). In IBD, VSI modestly correlated with current anxiety (R=0.35, p=0.002) and the physical component of HRQOL (R=-0.45, p=0.0001) but less with the mental component of HRQOL (R=-0.23, p=0.05). Our findings suggest the VSI is a useful measure in IBD. The VSI in IBD is related to general anxiety but is measuring a different construct and is not affected by the presence of trait anxiety. IBD patients have GSA that is associated with decreased HRQOL, which can negatively affect treatment compliance and other long-term disease outcomes. Future studies are needed to further validate the VSI in IBD and to assess its correlation with disease activity.