Irritable bowel syndrome-like symptoms and health related quality of life two years after Roux-en-Y gastric bypass - a prospective cohort study

Abstract Background Irritable bowel syndrome (IBS) is prevalent in patients with morbid obesity. After Roux-en-Y gastric bypass (RYGB) chronic abdominal pain is common, however the etiology is largely unknown. We aimed to study the change in the prevalence of IBS-like symptoms 2 years after RYGB and possible preoperative predictors of such symptoms. Secondly, to evaluate changes in symptoms of constipation and diarrhea, and Health related quality of life (HRQoL). Methods Patients with morbid obesity were included at two obesity centers in South-Eastern Norway. IBS was diagnosed according to the Rome III criteria. Predictors were evaluated in a multivariable logistic regression analysis. Results Of 307 participants operated with RYGB, 233 (76%) completed the study questionnaires. Preoperatively 27/233 participants (12%) had IBS, 2 years after RYGB 61/233 (26%) had IBS-like symptoms (p < 0.001). Eleven participants with IBS preoperatively (41%) did not report such symptoms after RYGB. New onset IBS-like symptoms was identified in 45/206 (22%) after RYGB. Fibromyalgia, low LDL levels, high vitamin B1 levels and IBS before RYGB were independent preoperative predictors of IBS-like symptoms at the follow-up visit. Symptom scores for constipation preoperatively and 2 year after RYGB were 1.5 (0.9) and 1.8 (1.2), and for diarrhea 1.4 (0.9) and 1.8 (1.1), respectively (p < 0.001). We observed a significant improvement in the physical component score for all participants. However, participants with new onset IBS-like symptoms had a significant worsening of the mental component score. Conclusions The prevalence of IBS-like symptoms doubled 2 years after RYGB, and these symptoms were associated with reduced HRQoL. Preoperative IBS and fibromyalgia were strong predictors of postoperative IBS-like symptoms.

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HEALTH-RELATED QUALITY OF LIFE AMONG PATIENTS WITH IRRITABLE BOWEL SYNDROME WITH DIARRHOEA

10.26226/morressier.57c5383cd462b80296c9b50b ◽

2016 ◽

Author(s):

Catherine Tucker

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Irritable Bowel

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Does Psychological Treatment Help Only Those Patients with Severe Irritable Bowel Syndrome Who Also Have a Concurrent Psychiatric Disorder?

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2005.01686.x ◽

2005 ◽

Vol 39 (9) ◽

pp. 807-815 ◽

Cited By ~ 36

Author(s):

Francis Creed ◽

Elspeth Guthrie ◽

Joy Ratcliffe ◽

Lakshmi Fernandes ◽

Christine Rigby ◽

...

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Treatment Group ◽

Psychiatric Disorder ◽

Psychological Treatment ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Irritable Bowel

Objective: We have previously reported improved health-related quality of life in patients with severe irritable bowel syndrome (IBS) following psychological treatments. In this paper, we examine whether this improvement was associated with improvement in psychological symptoms and was confined to those patients who had concurrent psychiatric disorder. Method: Two hundred and fifty-seven patients with severe IBS entering a psychological treatment trial were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. At entry to the trial and 15 months later, patients were also assessed using the Hamilton Depression Rating Scale, Symptom Cheecklist-90 (SCL-90) and Short Form-36 (SF36) physical component summary score as the main outcome measure. Partial correlation was used to compare changes in SF36 score and changes in psychological scores while controlling for possible confounders, treatment group and baseline scores. Multiple regression analysis was used to examine whether changes in psychological scores, changes in pain and a history of abuse could account for most of the variance of change in SF36 physical component score. Results: Of 257 patients with severe IBS, 107 (42%) had a depressive, panic or generalized anxiety disorder at trial entry. There were moderate but significant correlations (0.21–0.47) between change in the psychological scores and the change in SF36 physical component scores. The correlation coefficients were similar in the groups with and without psychiatric disorder. The superiority of psychotherapy and antidepressant groups over treatment as usual was similar in those with and without psychiatric disorder. Multiple regression found significant independent effects of change in depression, anxiety, somatization and abdominal pain but there was still variance explained by treatment group. Conclusions: In severe IBS improvement in health-related quality of life following psychotherapy or antidepressants is correlated with, but not explained fully by reduction of psychological scores. A more complete understanding of how these treatments help patients with medically unexplained symptoms will enable us to refine them further.

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