J Neurogastroenterol Motil.  2018 Apr;24(2):299-306. 10.5056/jnm17112.

Lower and Upper Gastrointestinal Symptoms Differ Between Individuals With Irritable Bowel Syndrome With Constipation or Chronic Idiopathic Constipation

• Shah ED
• Almario CV
• Spiegel BM
• Chey WD

• KMID: 2413106
• DOI: http://doi.org/10.5056/jnm17112

Abstract

BACKGROUND/AIMS
We evaluated the distribution of lower and upper gastrointestinal (GI) symptoms among individuals with irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) in a nationwide survey.
METHODS
Individuals (≥ 18 years of age) were identified from a nationwide sample of > 70 000 United States adults. Participants completed the National Institutes of Health GI Patient Reported Outcomes Measurement Information System (NIH GI-PROMIS) questionnaire. Symptom frequency and intensity in the prior 7 days were assessed using validated PROMIS scores. Odds ratios (OR) with 95% confidence intervals (CI) were calculated to compare symptom prevalence in IBS-C vs CIC, and one-way ANOVA was used to assess differences in PROMIS scores. Regression analysis was performed to adjust for demographic variables.
RESULTS
Nine hundred and seventy adults met eligibility criteria (275 with IBS-C, 734 with CIC). Demographics were similar among groups except for education, marital and employment status, and income. Adjusting for demographic differences, GI-PROMIS scores of global GI symptoms were higher in IBS-C (251.1; 95% CI, 230.0-273.1) compared to CIC (177.8; 95% CI 167.2-188.4) (P < 0.001). Abdominal pain was more prevalent (OR, 4.3; 95% CI, 2.9-6.6) and more severe (P = 0.007) in IBS-C. Constipation was more severe in IBS-C (P = 0.011). Incontinence was more common (OR, 2.9; 95% CI, 1.3-6.3) but just as severe (P = 0.389) in IBS-C versus CIC. Regarding upper GI symptoms, the prevalence of dysphagia, heartburn, and nausea were similar. However, IBS-C individuals had more severe heartburn (P = 0.001).
CONCLUSION
GI symptoms are generally more severe in IBS-C compared to CIC, however abdominal pain, bloating, and upper GI symptoms still commonly occur in CIC.

Keyword

Cross-sectional studies; Irritable bowel syndrome; Surveys and questionnaires; Symptom assessment

MeSH Terms

Abdominal Pain
Adult
Constipation*
Cross-Sectional Studies
Deglutition Disorders
Demography
Education
Employment
Heartburn
Humans
Information Systems
Irritable Bowel Syndrome*
National Institutes of Health (U.S.)
Nausea
Odds Ratio
Prevalence
Surveys and Questionnaires
Symptom Assessment
United States