Weerts ZZRM¹, Vork L¹, Mujagic Z¹, Keszthelyi D¹, Hesselink MAM¹, Kruimel J¹, Leue C², Muris JWM³, Jonkers DMAE¹, Masclee AAM¹. Neurogastroenterol Motil. 2019 Aug;31(8):1-10. doi: 10.1111/nmo.13629. Epub 2019 May 22.

Author information

1 Division of Gastroenterology-Hepatology, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands.

2 Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands.

3 Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

Abstract

BACKGROUND: Irritable bowel syndrome (IBS) is a brain-gut disorder, of which the natural course varies between patients and is difficult to predict. This study aimed to evaluate symptom evolution over a 5-year follow-up period and to identify baseline predictors for symptom severity and quality of life (QoL) at follow-up.

METHODS: Maastricht IBS cohort participants completed questionnaires upon inclusion regarding demographics and lifestyle, gastrointestinal (GI) symptoms, anxiety and depression, and QoL. The same questionnaires, in addition to others, were completed after 5 years. Rome criteria were confirmed face-to-face at initial enrollment and through telephonic interviews at follow-up.

KEY RESULTS: At a mean follow-up of 4.7 years, 379 patients were approached of whom 203 (53.7%) responded. Of these, 161 were reached by telephone and analyzed; 49 (30.4%) did not fulfill the Rome III criteria at follow-up and had lower levels of GI symptoms and GI-specific anxiety compared to those remaining Rome III-positive (P < 0.001). However, Rome III-negative patients had comparable levels of QoL and life satisfaction, comorbid anxiety and depression, work absenteeism, and impaired productivity. No baseline predictors were found for being Rome III-positive or Rome III-negative. However, greater age and lower baseline physical QoL predicted lower physical QoL at follow-up (P < 0.005 and P < 0.01, respectively), while lower baseline mental QoL predicted lower mental QoL at follow-up (P = 0.005). Additionally, higher anxiety and depression scores at follow-up were associated with lower QoL and life satisfaction at follow-up (P < 0.001).

CONCLUSIONS AND INFERENCES: Long-term QoL and general well-being might depend on concurrent psychological symptoms, rather than GI symptom improvement.