S571 Knowledge and Utilization of Laxatives in the Inpatient Setting: A Resident Survey

Abstract

Introduction: Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain and change in the form and consistency of stool. Two subtypes of IBS are diarrhea-predominant IBS (IBS-D) and constipation-predominant IBS (IBS-C). While IBS symptoms have been shown to decrease quality of life (QOL), the effects of IBS subtypes on QOL are still unclear. The aim of this study was to compare QOL parameters in patients with IBS-D and IBS-C. Methods: Data were obtained as part of an institutional review board-approved study where participants with ROME III positive criteria for IBS-D and IBS-C completed the following validated questionnaires: Bowel Disease Questionnaire, IBS-QOL, Hospital Anxiety and Depression Scale (HADS), Symptom Checklist 90 (SCL-90). We used two sample t-test, Wilcoxon rank sum test, and Pearson chi squared to compare the results between the two groups.Results: The study included 219 patients with IBS-D and 33 with IBS-C. The participants' demographics are reported in the Table . Most patients with IBS-C (70%) had 2-4 bowel movements (BM) per week, while 48% of patients with IBS-D had 13-26 BM per week and 13% had more than 26 BM per week. Patients with IBS-D had higher anxiety, depression, and total anxiety-depression scores on the HADS compared to patients with IBS-C (Table ). Patients with IBS-D had higher scores (reflecting worse symptoms) on the somatization, obsessive compulsive, depression, anxiety, and psychoticism dimensions as measured by the SCL-90. Moreover, patients with IBS-D had higher (reflecting worse) IBS-QOL total and subscale scores on 7 out of the 8 subscales (Table ). Notably, 42% of patients with IBS-D felt like they were slightly or moderately losing control of their lives because of their bowel problems, whereas 92% of patients with IBS-C reported not feeling loss of control at all. While 96% of patients with IBS-C did not feel that their life revolved around their bowel movements, 20% of patients with IBS-D reported life revolved around their bowel movements quite a bit or a great deal, specifically due to needing to be in proximity to a toilet and inability to take long trips. Conclusion: Our study shows that patients with IBS-D seem to have a worse general and IBS-specific quality of life compared to patients with IBS-C. These data reinforce the importance of considering QOL impact of IBS and opportunities for shared decision-making when discussing individual management plans for patients with IBS-D.