Health-Related Quality of Life in Irritable Bowel Syndrome

Abstract

Irritable bowel syndrome (IBS) affects up to 20% of the global population and is associated with impaired health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to investigate differences in HRQoL of those with IBS compared with healthy controls and to examine whether HRQoL improves following psychological intervention. Online databases were searched for articles from 2002 to 2017. Studies were screened and data extracted according to predetermined criteria. A total of 4,154 citations were identified from which 36 were eligible for inclusion. Eight studies compared HRQoL of those with IBS (n = 822) with that of healthy individuals (n = 3,809). Those with IBS suffered significant impairment across all HRQoL domains compared with healthy individuals, with the majority of effects (Cohen's d) being moderate to large. Twenty-eight studies investigated HRQoL in IBS following psychological intervention (n = 1,308) relative to controls (n = 1,006). All HRQoL domains improved with large effects following treatment; however, maintenance of these effects was inconsistent. Those with IBS experience poorer HRQoL than the wider community; nevertheless, psychological interventions are associated with improved HRQoL across all domains. High-quality studies are needed to better inform gastroenterological nurses of which interventions are most efficacious in alleviating the burden of IBS, and which IBS subpopulations would benefit.

Interventions for the Treatment of Irritable Bowel Syndrome: A Review of Cochrane Systematic Reviews

“…A systematic review published in 2020 showed that psychological interventions seem to improve the quality of life of patients with IBS. However, the authors reported the need to standardize the evaluation of this outcome in future studies (4) .…”

“…Symptoms vary among individuals and, for this reason, both diagnosis and treatment represent a challenge (1)(2)(3) . Other common symptoms in patients with IBS include urinary frequency, chronic fatigue, sleep, and mood disorders, and may lead to the patient being mistakenly referred to other clinical specialties (4,5) .…”

“…Psychological factors, changes in the connection of the central nervous system with the intestine, endocrine imbalance, visceral hypersensitivity, gastrointestinal infections and allergies and previous food intolerances are some of the criteria frequently analyzed. IBS occurs mainly between 15 and 65 years of age, and is more prevalent among women (3,4,6) . Diagnosis is difficult, mainly because it is a syndrome with signs and symptoms common to various pathologies.…”

“…Diagnostic criteria are based on Rome IV criteria, used for functional gastrointestinal disorders. According to these criteria, IBS is diagnosed based on recurrent abdominal pain related to defecation or associated with a change in the frequency or shape of feces (1,4,6) .…”

“Association between dietary inflammatory index (DII) and risk of irritable bowel syndrome: a case-control study”

“…Interestingly, these findings reveal the fact that the subjects with lower DII scores may adhere to a nutritionally balanced diet including various foods. Some previous research found that patients with IBS had lower QOL than the general population [ 35 , 36 ]. Other studies also showed that poor QOL in IBS patients might be due to several factors [ 37 , 38 ].…”