Bowel Syndrome Quality Of Life Research Articles

Factors Associated with Defecation Satisfaction among Japanese Adults with Chronic Constipation.

Background: Constipation causes substantial morbidity worldwide. Methods: This survey assessed constipation-related factors in Japan using the Japanese version of the Irritable Bowel Syndrome Quality of Life (IBS-QOL-J) instrument. We also examined the relationship among laxative type, Bristol Stool Form Scale (BSFS) scores, and treatment cost. Finally, we examined differences in satisfaction scores according to laxative type, treatment type, treatment cost, and BSFS score. Results: IBS-QOL-J was higher among those taking salt and/or irritation laxatives. Those paying >JPY 5000 (USD 50.00) had the lowest IBS-QOL-J. IBS-QOL-J was significantly lower among those with a BSFS score of 1 or 2 (severe constipation). Conclusions: This study's findings suggest that a variety of factors, including treatment type and cost, are associated with defecation satisfaction. Those who had hard stools, used multiple laxatives, or spent more on treatment were less satisfied. Future strategies should target therapies that do not require multiple laxatives with lower treatment costs. Adequate defecation with a small number of appropriate laxatives at minimal cost appears to improve defecation satisfaction. It is desirable to identify appropriate laxatives and improve dietary habits and exercise routines. It is also necessary to stop blindly increasing laxative usage and properly diagnose constipation disorders such as anatomical abnormalities other than functional constipation.

The Inverted U-shaped Curvilinear Relationship Between Conscientiousness and the Quality of Life in Patients with Irritable Bowel Syndrome

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that greatly affects the quality of life. While prior research suggested a linear connection between conscientiousness and health outcomes like quality of life, recent studies propose a more intricate, curved relationship. Objectives: The present study aimed to determine the inverted U-shaped curvilinear relationship between conscientiousness and quality of life in patients with irritable bowel syndrome. Methods: This descriptive-correlational study in Tehran's private gastroenterology clinic in 2020 included 232 IBS patients. Data collected via the NEO Five-Factor Inventory (NEO-FFI) and Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire were analyzed using SPSS version 26 and Excel 2023 for statistical assessment at a 95% confidence interval. Results: Scatter plots and regression equations demonstrated a strong curvilinear relationship (R2 = 0.14) between conscientiousness and IBS patients' quality of life, surpassing the linear relationship (R2 = 0.08). Curvilinear regression analysis revealed significant correlations (95% CI) for both the first-degree coefficient (β1 = 2.304, P < 0.001) and the second-degree coefficient (β2 = -2.043, P < 0.001). Conclusions: The findings indicate an inverted U-shaped relationship between conscientiousness and quality of life in IBS individuals. This underscores the importance of addressing exceptionally high conscientiousness levels in healthcare.

Content, face, and construct validity of the Irritable Bowel Syndrome Quality of Life(IBS-QOL) as a measure of bowel-related quality of life in spinal cord injury.

Neurogenic bowel dysfunction is commonly encountered after a spinal cord injury (SCI),leading to a tremendous impact on quality of life (QOL).The neurogenic bowel dysfunction score (NBDS)is commonly used to measure the severity of bowel dysfunction and predict QOL. However, there is no comprehensive instrument to assess bowel-specific QOL for SCI patients. Instead, the Irritable Bowel Syndrome-Quality of Life (IBS-QOL)questionnaire evaluates the impact of bowel dysfunction on several aspects of QOL, although this questionnaire has not been validated for the SCI population. Motivated by the compelling need of instruments to accurately evaluate the QOL in patients who develope NBD after SCI, we aimed to assess the construct, content, and face validity of IBS-QOLin this population. Adult SCI patients with at least 3 months after their injury were recruited from the outpatient clinic of a national rehabilitation hospital. Patients completed the NBDS and IBS-QOLvia telephone interview or paper survey in the clinic. Content and face validity were assessed via interviews with professionals with expertise in providing chronic care for SCI, as well as a subgroup of patients. Construct validity was assessed using the hypotheses testing method. Internal consistency was assessed using Cronbach's ⍺. Factor analysis was performed to assess the dimensionality of the IBS-QOLin the SCI population. A total of 106 patients with a median age of 45.5 years (interquartile range: 21-79) participated in the study. The majority of the sample were men (n = 82, 77%) and had endured thoracolumbar injuries (n = 74, 71.2%). Twelve patients (sevenEnglish- and fiveSpanish speakers) and six professionals took part in content/face validation interviews. The median IBS-QOL total score was 15.91/100 (interquartile range: 4.55-33.14). IBS-QOLdifferentiated the subgroups of patients with severe bowel symptoms in terms of uneasiness, sweating, or headaches during bowel emptying (p = 0.0003), time spent on bowel emptying (p = 0.0065), flatus incontinence (p = 0.0076), and overall satisfaction with bowel function (p < 0.001), demonstrating its adequate construct validity. Interviews with the patients and professionals supported the comprehensiveness, comprehensibility, and relevance of IBS-QOLfor assessment of bowel-related QOL in the SCI population. Item-level analysis of professional responses showed that 97% of questions were relevant to the construct and population of interest. Internal consistency analysis yielded a Cronbach's ⍺ of 0.9684. Exploratory factor analysis yielded six underlying factors which cumulatively accounted for 72.21% of the total variance, reflecting the dimensionality of bowel-related QOL in SCI population. IBS-QOLquestionnaire is a comprehensive measure of bowel-related QOL which encompasses the concerns of SCI patients. Our findings support the content, face and construct validity of IBS-QOLas a measure of bowel-related QOL in SCI. Further studies are warranted to assess the reliability and responsiveness of IBS-QOL,and to evaluate its performance across different patient populations.

Factors associated with lower disease-specific and generic health-related quality of life in Rome IV irritable bowel syndrome.

Little is known about associations with reduced quality of life in irritable bowel syndrome (IBS) or impact of IBS on quality of life compared with other chronic conditions. We collected demographic, gastrointestinal and psychological symptoms, healthcare usage, direct healthcare costs, impact on work and activities of daily living data from 752 individuals with Rome IV-defined IBS. We used the irritable bowel syndrome quality of life (IBS-QOL) and the EQ-5D-5L questionnaires to examine characteristics associated with lower quality of life. The mean IBS-QOL among all 752 individuals with Rome IV IBS was 48.4 (SD 22.3) and the mean EQ-5D score was 0.570 (SD 0.283), the latter being comparable to people with stroke, leg ulcers or chronic obstructive pulmonary disease. Lower levels of both disease-specific and generic quality of life were associated with severe IBS symptom scores, abnormal anxiety or depression scores, and higher somatoform symptom-reporting and gastrointestinal symptom-specific anxiety scores (p < 0.001 for all analyses). Those with lower quality of life had significantly higher healthcare usage and direct healthcare costs and more impairment in work and activities of daily living (p < 0.01 for all analyses). Avoidance of alcohol, lower educational level, abnormal anxiety, depression or somatoform symptom-reporting scores, and impairment in social leisure activities, home management or maintaining close relationships were all independently associated with lower quality of life. IBS has a substantial impact on the quality of life of those affected, and worse than observed in some severe chronic organic conditions.

Quality of life, perceived stress and nutrition of patients with irritable bowel syndrome: A descriptive study

Background: Irritable Bowel Syndrome (IBS) is a chronic and common functional bowel disorder that currently has no definite treatment. Depending on the type and severity of the individual's symptoms, medication, diet, and/or lifestyle changes are recommended. Aims: This study aimed to determine the relationship between the quality of life, perceived stress levels, and nutrition of individuals diagnosed with IBS. Subjects and Methods: Between March 2020 and March 2021, 340 patients with IBS volunteered for this study. The demographic information questionnaire, Irritable Bowel Syndrome Quality of Life (IBS-QOL) scale, Perceived Stress Scale-14 (PSS-14), and Food Frequency Questionnaire were applied via an online form. Results: From the 340 patients, 230 were eligible. Out of them, 27% followed a special diet for IBS. When the IBS-QOL scores of men were compared according to their educational status, the scores of those with a high school or higher education level (109.7±32.8) were found to be higher than those with a lower education level than high school (95.4±17.5) (p=0.008), while the educational status of women did not affect the IBS-QOL scores (p&gt;0.05). The mean IBS-QOL score of men was 44.8 ± 20.1 and lower than women (50.9±21.7) (p=0.030). The mean IBS-QOL score of women following an IBS-specific diet was 57.6 ± 22.6 and higher than women who did not follow an IBS-specific diet (48.2±20.9) (p=0.023). The IBS-QOL scores of women with gluten or lactose intolerance were lower than women without any intolerances (p=0.004). The mean IBS-QOL score for women with lactose intolerance was higher than those with gluten intolerance (p=0.004). When the IBS-QOL scores were evaluated according to the frequency of food consumption, no significant differences were found in the food groups (p&gt;0.05). In this study, no significant correlation was found between IBS-QOL scores and PSS-14 scores (p&gt;0.05). Conclusions: The prediction equations developed for healthy populations are not accurate enough to determine the energy requirements in SCD. Keywords: Irritable bowel syndrome, nutrition, stress, quality of life, patients.

The specifics of emotional dysregulation in women with various types of irritable bowel syndrome

BACKGROUND. To this day, relatively little is known about the specifics and mechanisms by which psychological factors, such as a general tendency to anger and the style of expressing anger, can be associated with pro-inflammatory processes and visceral hypersensitivity, which contribute to the appearance of signs of irritable bowel syndrome and lead to its refractory course.&#x0D; AIM. The purpose of the work. to identify the specifics of differences in the presence and severity of depression, anxiety, anger expression and satisfaction with the quality of life in women (average age 39.210.6) with refractory IBS of constipated, diarrheal and mixed types (duration of the disease 33.848.1 months), based on the hypothesis that women with different types of IBS may have different styles of expressing negative emotions (for example, anger) and ways of controlling behavior.&#x0D; MATERIAL AND METHODS. PHQ-15 Patient Health Questionnaire-15; GAD-7 General Anxiety Disorder-7; PHQ-9 Patient Health Questionnaire-9; IBS-QOL Irritable Bowel Syndrome Quality of Life; STAXI StateTrait Anger Expression Inventory.&#x0D; RESULTS. Correlations between subtypes of IBS and negative aspects of the emotional sphere are observed and it is shown that subtypes of IBS-C and IBS-D demonstrate affective profiles characterized by a higher level of anxiety, depression and changes in the expression of anger with difficulties of expression both verbally and nonverbally. All types are characterized by autoaggression, suppression of anger, but these aspects are more pronounced in IBS-D and IBS-C. There is intense control of anger expression. With IBS-C and IBS-M, there is greater control over the expression of anger externally than with IBS-D. Women with IBS-C have more pronounced indicators of anger as a mental state. There are difficulties in verbal expression of anger, hetero- and autoaggression. Anger is a trait of character and is included in the structure of temperament. Women with IBS-D have pronounced indicators of anger as a reaction to a current life event, autoaggression, anger control inside. The level of affect somatization, the presence and severity of generalized anxiety disorder, depression, changes in life satisfaction are among the predictors that determine both the level of anger and the ways of its expression.&#x0D; CONCLUSION. Intestinal motility can be considered as an indicator of behavior control, as an indicator of the regulatory function of the patient, the intensity of affective involvement in a particular situation. Changes in the cognitive, emotional and executive components of the mental organization play only a significant role in the refractory course of IBS.

Measurement of Pain and Related Symptoms in Irritable Bowel Syndrome: The Use of Validated Pain Measurement Tools

This paper reviews the tools available to assess outcomes of treatment in irritable bowel syndrome, especially the effect on abdominal pain. Tools were identified through a wide-ranging scrutiny of PubMed and Google Scholar, together with a review of further references quoted in those publications. It critically considers their development, relevance and reliability. The Irritable Bowel Severity Scoring System (IBS-SSS) was the first simple method of monitoring the progress of the disease and its treatment. It led on to other instruments, such as The Irritable Bowel Syndrome Quality of Life (IBS-QOL). It is easier to read and faster to complete than the IBS-SSS., However, these and other tools were developed for English speaking populations. This review considers the impact of ethnicity and gender, together with the lack of information on the effect of age on the potential validity of these tools in other populations. Issues with the adequacy and appropriateness of translations of such tools are discussed. The overall conclusion is that there are few tools which meet the criteria necessary to place confidence in their validity as appropriate measures of patient outcomes.

The multiple effects of fecal microbiota transplantation on diarrhea-predominant irritable bowel syndrome (IBS-D) patients with anxiety and depression behaviors

BackgroundAnxiety and depression are complications in Irritable bowel syndrome (IBS) patients. In this study, we recruited 18 IBS patients with mild-modest anxiety and depression behaviors, and after the screening, we defined the FMT treatment group (n = 9) and the control group (n = 9). The IBS symptom severity scale (IBS-SSS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Irritable Bowel Syndrome Quality of Life (IBS-QOL) and Bristol stool scale (BSS) were evaluated one week before FMT (baseline), one-week-, one-month-, two-month-, and three-month-following FMT. Meanwhile, we determined the SCFAs in the patient’s feces and serum and continued the metagenomic analysis of the microorganisms in the patient’s feces.ResultsThe results showed that the patient’s anxiety and depression behavior gradually improved with FMT treatment. Moreover, the illness and quality of life had also been relieved significantly. The content of isovaleric acid and valeric acid was significantly reduced in the FMT group compared to the Col group. Metagenomic analysis showed that FMT treatment decreased the abundance of Faecalibacterium, Eubacterium and Escherichia. From KEGG functional analysis, we confirmed that the top five abundant pathways were “bacterial chemotaxis, “flagellar assembly”, “glycine, serine and threonine metabolism”, “apoptosis”, and “bacterial invasion of epithelial cells”.ConclusionsFMT treatment can effectively alleviate the anxiety and depression behaviors of IBS-D patients and reduce the IBS-SSS score, indicating that FMT can improve patients’ symptoms. The high throughput sequencing results show that Bifidobacterium and Escherichia play the most critical role in the formation and recovery of IBS-D patients. The GC/MS data indicated that faeces isovaleric acid and valeric acid might be more suitable as a metabolic indicator of IBS-D remission.Trial registration ChiCTR, ChiCTR1900024924, Registered 3 August 2019, https://www.chictr.org.cn/showproj.aspx?proj=41676.

The estimation of a preference-based single index for the IBS-QoL by mapping to the EQ-5D-5L in patients with irritable bowel syndrome

PurposeThe Irritable Bowel Syndrome Quality of Life (IBS-QoL) questionnaire is a commonly used and validated IBS-specific QoL instrument. However, this questionnaire is in contrast to the EQ-5D-5L, not preference-based and as such does not allow calculation of QALYs. The objective of this study was to describe the convergent- and known-group validity of both questionnaires and to develop a mapping algorithm from EQ-5D-5L which enable IBS-QoL scores to be transformed into utility scores for use in economic evaluations.MethodsWe used data from two multicenter randomized clinical trials, which represented the estimation and external validation dataset. The convergent validity was investigated by examining correlations between the EQ-5D-5L and IBS-QoL and the known-group validity by calculating effect sizes. Ordinary least squares (OLS), censored least absolute deviations (CLAD), and mixture models were used in this mapping approach.Results283 IBS patients were included (n = 189 vs. n = 84). Mean IBS-QoL score was 71.13 (SD 15.66) and mean EQ-5D-5L utility score was 0.73 (SD 0.19). The overall sensitivity of the IBS-QoL and EQ-5D-5L to discriminate between patient and disease characteristics was similar. CLAD model 4, containing the total IBS-QoL score and squared IBS-SSS (IBS severity scoring system), was chosen as the most appropriate model to transform IBS-QoL scores into EQ-5D-5L utility scores.ConclusionThis study reports the development of an algorithm where the condition-specific questionnaire IBS-QoL can be used to calculate utility values for use in economic evaluations. Including a clinical measure, IBS-SSS, in the model improved the performance of the algorithm.

Efficacy of Zemedy, a Mobile Digital Therapeutic for the Self-management of Irritable Bowel Syndrome: Crossover Randomized Controlled Trial.

BackgroundPatients with irritable bowel syndrome (IBS) experience abdominal pain, altered bowel habits, and defecation-related anxiety, which can result in reduced productivity and impaired health-related quality of life (HRQL). Cognitive behavioral therapy (CBT) has been shown to reduce symptoms of IBS and to improve HRQL, but access to qualified therapists is limited. Smartphone-based digital therapeutic interventions have potential to increase access to guided CBT at scale, but require careful study to assess their benefits and risks.ObjectiveThe aim of this study was to test the efficacy of a novel app, Zemedy, as a mobile digital therapeutic that delivers a comprehensive CBT program to individuals with IBS.MethodsThis was a crossover randomized controlled trial. Participants were recruited online and randomly allocated to either immediate treatment (n=62) or waitlist control (n=59) groups. The Zemedy app consists of 8 modules focusing on psychoeducation, relaxation training, exercise, the cognitive model of stress management, applying CBT to IBS symptoms, reducing avoidance through exposure therapy, behavioral experiments, and information about diet. Users interact with a chatbot that presents the information and encourages specific plans, homework, and exercises. The treatment was fully automated, with no therapist involvement or communication. At baseline and after 8 weeks, participants were asked to complete the battery of primary (Irritable Bowel Syndrome Quality of Life [IBS-QOL], Gastrointestinal Symptom Rating Scale [GSRS]) and secondary (Fear of Food Questionnaire [FFQ], Visceral Sensitivity Index [VSI], Gastrointestinal Cognition Questionnaire [GI-COG], Depression Anxiety Stress Scale [DASS], and Patient Health Questionnaire-9 [PHQ-9]) outcome measures. Waitlist controls were then offered the opportunity to crossover to treatment. All participants were assessed once more at 3 months posttreatment.ResultsBoth intention-to-treat and completer analyses at posttreatment revealed significant improvement for the immediate treatment group compared to the waitlist control group on both primary and secondary outcome measures. Gains were generally maintained at 3 months posttreatment. Scores on the GSRS, IBS-QoL, GI-COG, VSI, and FFQ all improved significantly more in the treatment group (F1,79=20.49, P<.001, Cohen d=1.01; F1,79=20.12, P<.001, d=1.25; F1,79=34.71, P<.001, d=1.47; F1,79=18.7, P<.001, d=1.07; and F1,79=12.13, P=.001, d=0.62, respectively). Depression improved significantly as measured by the PHQ-9 (F1,79=10.5, P=.002, d=1.07), and the DASS Depression (F1,79=6.03, P=.02, d=.83) and Stress (F1,79=4.47, P=.04, d=0.65) subscales in the completer analysis but not in the intention-to-treat analysis. The impact of treatment on HRQL was mediated by reductions in catastrophizing and visceral sensitivity.ConclusionsDespite its relatively benign physical profile, IBS can be an extraordinarily debilitating condition. Zemedy is an effective modality to deliver CBT for individuals with IBS, and could increase accessibility of this evidence-based treatment.Trial RegistrationClinicalTrials.gov NCT04170686; https://www.clinicaltrials.gov/ct2/show/NCT04170686

The Effects of Group Logotherapy on the Severity of Irritable Bowel Syndrome and the Quality of Life of the Affected Patients

ObjectiveIrritable Bowel Syndrome (IBS) is among the most unknown psychosomatic disorders in the field of gastroenterology. IBS is a chronic, disabling, and functional disorder of the gastrointestinal tract. Moreover, it is characterized by recurrent abdominal pain, bloating, and changes in bowel habits in the absence of identifiable structural diseases. The present study aimed to evaluate the effects of group logotherapy on the IBS symptoms and Quality of Life in patients with IBS.MethodsIn a randomized clinical trial study, 30 IBS patients were selected; of them, 15 took part in 10×1 group therapy, and 15 were the controls. The data gathering tools included the IBS Severity Scoring System (IBS-SSS) for assessing the severity of IBS and the Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire. These inventories were completed in 3 stages of pre-test, Post-test, and follow-up. The collected data were analyzed using descriptive statistics and Multivariate Analysis of Covariance (MANCOVA) in SPSS. ResultsThe mean scores of the experimental group, including pre-test (50.97), Post-test (30.50), and follow-up (25.83) phases, revealed significant changes in the studied patients’ Quality of Life and decreased IBS severity scores. Moreover, these results remained consistent in the follow-up study that indicated a significant decrease in the IBS severity and Quality of Life of the patients (P<0.05). ConclusionAccording to the present research data, developing a treatment plan based on group logo-therapy intervention is effective in improving the patients’ Quality of Life, and decreasing IBS severity

Increased gastrointestinal symptom frequency in diabetes mellitus even with good glycemic control

Background and Aim: Gastrointestinal problems are reportedly more frequent in patients with diabetes mellitus (DM) compared to the general population and are a cause of reduced quality of life (QOL). Even though studies have suggested that parameters such as glycemic control and disease duration are responsible for upper gastrointestinal (GI) symptoms in DM, there is little compelling evidence to show a direct relationship given the fact that various other studies report no relationship. These conflicts may be caused by the lack of standardization of patient populations, evaluation methods and other causes. Our aim was to determine and compare the frequency of GI symptoms and GI-related QOL in recently diagnosed DM patients and healthy controls in order to evaluate this relationship with minimization of confounding factors.Material and methods: A total of 59 patients newly diagnosed with DM and 92 age- and sex-matched controls were included in this study. Demographic characteristics, chronic diseases, GI symptoms (as measured by 8-MGSI score) and GI-related QOL (irritable bowel syndrome quality of life, IBS-QOL) scores were evaluated. Linear regression analysis was performed to determine factors that independently influenced IBS-QOL.Results: The patient and control groups were similar with regard to all characteristics except for chronic diseases. The scores for 8-MGSI and IBS-QOL were significantly worse in patients with DM. Regression analyses showed that IBS, DM and dyspepsia were independent factors that influences IBS-QOL scores.Conclusion:The results of our study show that the effect of DM on GI symptoms is not a function of disease duration or glycemic control; DM presence itself seems to have adverse effects on the GI system through mechanisms that are yet unknown. The explanation of these mechanisms rely on experimental research and prospective studies with rigid patient inclusion criteria.

Impact of Moderate Intensity Aerobic Exercise on Irritable Bowel Syndrome in Post Cholecystectomy Patients

AbstractBackground: Irritable bowel syndrome is a chronic func-tional disorder of the gastrointestinal system. Patients experi-ence abdominal pain and altered bowel habit, with either predominantly diarrhea, constipation, or both, the risk to develop Irritable Bowel Syndrome (IBS) after cholecystectomy is 2.2 times higher than in general population.Aim of Study: To evaluate the effect of moderate intensity aerobic exercise training (60% MHR) (Treadmill Training) on Irritable Bowel Syndrome (IBS) symptom and Quality of Life in post cholecystectomy patients.Patients and Methods: Thirty non-athletic post cholecys-tectomy patients complaining from Irritable Bowel Syndrome were recruited for this study; there age were ranged between 25 to 40 years, in the period between Oct. 2017 and Feb. 2019 from Kasr Al-Ainy Hospital. Patients who met the selection criteria were divided randomly into two equal groups, Group (A): They participated in 4 weeks of moderate intensity aerobic training program (60% MHR Treadmill Training) (3 sessions per week) plus receiving medical treatment protocol, Group (B) (Medical Treatment Group) received medical care only.Measurements: Irritable bowel syndrome was assessed by Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS) and Irritable Bowel Syndrome Quality of Life (IBS-QOL) Instrument Assessment was carried out before treatment and after 4 weeks of treatment in both groups.Results: The result showed that there was a significant decrease in post-treatment values of IBS-SSS and IBS-QOL in comparison to pre-treatment values at both groups with (p-value <0.001). Post-treatment comparison between both groups showed significant difference in IBS-SSS and IBS-QoL variables, in favor of Group A (study group).Conclusion: Moderate intensity aerobic exercise training (60% MHR) for 4 weeks is effective in treatment of IBS post cholecystectomy through reducing IBS symptoms and improving quality of Life.

The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome.

IntroductionSeveral studies have suggested that patients with irritable bowel syndrome (IBS) frequently have symptoms of sexual dysfunction.AimThe current study aims to map the current knowledge about the burden of sexual dysfunction in patients with IBS.MethodsA literature review was conducted on PubMed and EMBASE using the following search terms or combinations thereof: irritable bowel syndrome; functional colonic disease; sexual function; sexual health; sexual behavior; sexual dysfunction; dyspareunia; erectile dysfunction; quality of life; and questionnaire.Main Outcome MeasureSexual dysfunction.Results1,273 texts were found, 331 duplicates were removed, and 844 texts were excluded because they did not meet the inclusion criteria, leaving 98 full text articles. These were examined and it was found that 41 fulfilled the criteria. 4 questionnaires were found; Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire, the Irritable Bowel Syndrome – Quality of Life (IBSQOL) questionnaire, the Irritable Bowel Syndrome-36 question (IBS-36) questionnaire, and the Arizona Sexual Experience Scale. Subscores for sexual relations in IBS-QOL ranged from 37.7−100 (11.9) for patients with IBS and 82.2−100 (6.6) for controls. The IBSQOL and IBS-36 subscores for sexual relations ranged from 49.7−90.5 (9) to 3.9−5.4 (0.8) with no healthy controls for comparison. After interventions were implemented, there was an improvement in subscores (the IBS-QOL mean changed to 10.5%, IBSQOL mean changed to 3.8%, and the IBS-36 mean changed to 40%). The study using Arizona Sexual Experience Scale showed that 51% of patients with IBS had sexual dysfunction and also scored lower on the IBSQOL questionnaire.ConclusionThe information about sexual dysfunction in patients with IBS is sparse and emerges primarily from quality of life questionnaires. It seems as though patients with IBS have more sexual problems compared to controls, but further investigation regarding the extent and type of sexual dysfunction is needed.Sørensen J, Schantz Laursen B, Drewes AM, et al. The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome. Sex Med 2019;7:371–383.

Chronic functional constipation is strongly linked to vitamin D deficiency.

BACKGROUNDFew studies have examined intestinal motility disorders, which are disabling conditions associated with chronic functional constipation, whose pathogenesis is actually not well-defined.AIMTo investigate the relationship between serum 25-hydroxyvitamin D levels and functional chronic constipation associated to intestinal motility disorders.METHODSWe performed a prospective case-control study, from May-June to November 2017. Glucose/lactulose breath tests, radiopaque markers (multiple capsule techniques) and wireless motility capsule analysis were used to assess colonic and oro-cecal transit time, after excluding small-intestinal bacterial overgrowth condition. Then, we measured 25-hydroxyvitamin D levels in patients with intestinal motility disorders and we further evaluated the influence of intestinal motility disorders on psychological symptoms/quality of life using validated questionnaires, the Irritable Bowel Syndrome Quality of life (IBS-QOL), the Short Form Health Survey 12, and the Hospital Anxiety and Depression Scale 14 (HADS-14 A and HADS-14 D).RESULTSWe enrolled 86 patients with chronic functional constipation associated to intestinal motility disorders and 86 matched healthy subjects. Patients with intestinal motility disorders had lower 25-hydroxyvitamin D levels (P < 0.001), and they showed a significant impairment of all health-related quality of life and psychological tests (IBS-QOL, Short Form Health Survey 12-Physical Component Summary, Short Form Health Survey 12-Mental Component Summary, HADS-14 A and HADS-14 D), as compared to the control group (P < 0.001), which significantly correlated with low vitamin D levels (r = - 0.57, P < 0.001; r = 0.21, P = 0.01; r = - 0.48, P < 0.001; r = - 0.57, P < 0.001; r = - 0.29, P < 0.001, respectively). At multivariate analysis vitamin D low levels remained a significant independent risk factor for the occurrence of intestinal motility disorder (odds ratio = 1.19; 95% confidence interval: 1.14-1.26, P < 0.001).CONCLUSIONVitamin D deficiency, anxiety and depression symptoms are commonly associated with chronic functional constipation induced by intestinal motility disorders. Vitamin D serum levels should be routinely measured in these patients.

The impact of treatment with eluxadoline on health-related quality of life among adult patients with irritable bowel syndrome with diarrhea

PurposeIrritable bowel syndrome with diarrhea (IBS-D) significantly impacts health-related quality of life (HRQOL). This post hoc analysis of two phase III trials evaluated the effects of eluxadoline treatment on disease-specific HRQOL among patients with IBS-D.MethodsAdult patients meeting Rome III criteria for IBS-D were randomized to oral eluxadoline (75 mg or 100 mg) or placebo twice daily in two phase III clinical trials for 52 weeks (IBS-3001) and 26 weeks (IBS-3002). The Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire assessed disease-specific HRQOL throughout the study. Changes from baseline to Week 26 in IBS-QOL total and subscale scores were analyzed using an analysis of covariance model. Percentages of IBS-QOL responders with ≥ 14- and 20-point changes were evaluated for IBS-QOL total and subscale scores. A longitudinal mixed-effects model was fitted to evaluate mean IBS-QOL total scores. A cumulative distribution function for change from baseline to Week 26 in IBS-QOL total score was plotted.ResultsMean changes from baseline to Week 26 for the IBS-QOL total and all subscale scores were significantly higher for patients treated with eluxadoline (both doses) compared to placebo. A significantly greater proportion of eluxadoline-treated patients were responders compared to placebo. Mean and mixed-effects model estimated mean IBS-QOL total scores were consistently higher for eluxadoline versus placebo over 52 weeks.ConclusionsCompared to placebo, twice-daily eluxadoline treatment significantly improved HRQOL among patients with IBS-D in two phase III trials.

Gender and Weight Influence Quality of Life in Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain and bowel dysfunction in the absence of structural abnormality. Diagnosis can be challenging and often leads to extensive medical tests, non-effective therapeutic modalities, and reduced quality of life (QOL). Identifying factors associated with dysfunction have the potential to enhance outcomes. Participants with IBS (n = 41) and healthy volunteers (n = 74) were recruited into this cross-sectional, descriptive, natural history protocol at the National Institute of Health, Clinical Center. Demographic characteristics were self-reported. QOL was assessed with the Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire. Statistical analysis included descriptive statistics, factorial ANOVA, and multiple regression. Individuals with IBS reported lower QOL scores across all QOL-subscales compared to healthy controls. Normal-weight women and overweight men with IBS reported the greatest QOL impairment. Body fat percent had confounding effects on the relationship between IBS and QOL. The disparity between QOL scores in participants with IBS by both gender and weight groups may reflect different social pressures perceived by normal and overweight women and men. These findings enhance the recognition of the disparities in patients with chronic symptoms and thereby lead to personalized assessment and interventions to improve their QOL.

A systematic review of measurement properties of the instruments measuring health-related quality of life in patients with irritable bowel syndrome.

The systematic review of patient-reported outcome instruments can allow the selection of the most appropriate instrument for use in research and clinical practice. There has been no systematic review of the measurement properties of irritable bowel syndrome (IBS)-specific health-related quality-of-life (HRQOL) instruments. The purposes of this study were to identify all available instruments for measuring the IBS-specific HRQOL and to determine which is the most appropriate instrument to apply in clinical practice. A systematic review study was conducted. The MEDLINE, EMBASE, and CINAHL databases were searched. The methodological quality of the included studies was assessed using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) checklist. The measurement property results of each study were assessed using Terwee's quality criteria. Seven instruments were identified: The Irritable Bowel Syndrome-Quality of Life (IBS-QOL) instrument was the only one that had been analyzed in multiple studies, with each of the remaining six instruments only being analyzed in a single psychometric study. The IBS-QOL demonstrated moderate positive evidence for internal consistency and reliability and is the best instrument based on the currently available evidence. Even though the IBS-QOL is currently the best instrument, there is conflicting evidence for its underlying structural validity. The factor structure or dimensionality of the IBS-QOL needs to be elucidated further.

Gut-directed guided affective imagery as an adjunct to dietary modification in irritable bowel syndrome.

This work aimed to study the effect of guided affective imagery on the irritable bowel syndrome. A total of 15 irritable bowel syndrome patients received guided affective imagery and 19 patients served as controls. Symptom severity and irritable bowel syndrome quality of life were measured at baseline and 8 weeks. Symptom severity decreased following guided affective imagery compared to controls (-1.5 ± 1.9 vs 0.1 ± 1.6, p = 0.04). Irritable bowel syndrome quality of life increased following guided affective imagery compared to controls (12.1 ± 12.5 vs -0.7 ± 16.2, p < 0.01). Guided affective imagery predicted reduced symptom severity (odds ratio = 5.71, p = 0.02) and increased irritable bowel syndrome quality of life (odds ratio = 17.88, p = 0.01). Guided affective imagery combined with dietary modification may be beneficial in the management of irritable bowel syndrome, however larger studies are required.

Su1386 Clinical Benefit and Intestinal Mucosal Transcriptome Modulation After Long-Term Mast Cell Stabilization With Oral Disodium Cromoglycate in Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D) Patients

Introduction: Irritable bowel syndrome with diarrhea (IBS-D) is a chronic, functional gastrointestinal disorder with symptoms of abdominal pain and diarrhea that significantly impact health-related quality of life (HRQoL). Eluxadoline is an investigational, locally active, mixed mu opioid receptor agonist and delta opioid receptor antagonist that significantly improved both pain and diarrhea in two Phase 3 IBS-D trials (IBS3001 and IBS3002). Aim: To evaluate the impact of eluxadoline treatment on HRQoL in patients with IBS-D in two Phase 3 trials. Methods: Adults meeting Rome III criteria for IBS-D were randomized to twice-daily oral treatment with eluxadoline (75 or 100 mg) or placebo for 26 weeks in IBS3002 and 52 weeks in IBS3001. The Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire, which consists of 34 items, each with a 5-point response scale (1=not at all, 5=extremely or a great deal), was completed at baseline and Weeks 4, 8, 12, 18, and 26 in both trials, and at Week 30 in IBS3002 and Weeks 36, 44, and 52 in IBS3001. Mean IBS-QOL overall scores were evaluated for trends by treatment groups by employing a longitudinal mixedeffects polynomial model fitted to pooled data to estimate treatment effects of eluxadoline. Cumulative distribution functions for changes from baseline to Weeks 12, 26, and 52 in IBS-QOL overall scores were plotted. Results: The longitudinal mixed-effects model showed a significant treatment main effect (t=4.45, p<0.0001) for the eluxadoline 100 mg treatment group. Similar results were observed for the 75 mg treatment group. Patients treated with eluxadoline 100 mg showed consistently higher IBS-QOL scores over 52 weeks of treatment compared with patients who received placebo (Figure 1). Cumulative distribution function plots of change from baseline scores confirmed that patients treated with eluxadoline 100 mg showed consistently higher increases in IBS-QOL overall scores compared with patients who received placebo over a range of improvement levels for Weeks 12, 26, and 52 (Figure 2). Conclusions: Compared with placebo, twice-daily eluxadoline treatment significantly improved overall HRQOL among IBS-D patients over the course of the treatment periods in two Phase 3 trials as measured by the IBS-QOL, with patients treated with eluxadoline 100 mg showing particularly strong effects.