Boulton-Jones, J.R.; Spiller, R.C.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA86
Academic Journal
Introduction: Although it is well recognised that the probability of consultation with irritable bowel syndrome (lBS) is increased by anxiely, it is unclear what influence anxiety has on severity of symptoms. Aims: To prospectively evaluate the relationship between anxiety, symptoms, and final diagnosis in patients presenting with symptoms of lBS. Methods: Hospital anxiety and depression (HAD) scores were measured prospectively in 178 new out-patients referred with symptoms consistent with lBS. Investigations to exclude other diagnoses were instituted as clinically indicated. The final diagnosis was obtained from review of electronic records 0.3-3 years later. Patients were categorised by mode of onset (post-infectious (PI-IBS)) or predominant bowel habit/diarrhoea (d-lBS), constipation (c-lBS), alternating (alt-lBS)). The anxiety and depression scores were compared for each group. A healthy control group (n = 40) was included. Results: 28 patients had alternative diagnoses made including: bile salt malabsorption/5), lactose intolerance (4) microscopic colitis (2), diverticular disease (4), ulcerative colts (1} pancreatic disease (3), and coeliac disease (1} leaving 150 patients with lBS (38 c-lBS, 49 d-lBS, 20 alt-lBS, 37 PI-lBS 6 lBS unspecified). Abnormal anxiety levels were present in 68.6% (severe in 12%, moderate in 22.4% and mild in 34.4%). Raised depression scores were detected in 26.3% (severe in 2.5%, moderate in 10.7% and mild in 13.1%). The mean (-+ SEM) A and D scores were 9.3 (±0.35) and 4.5 (±0.32) respectively for all lBS patients, which was significantly greater than values in control patients (4.0 (±0.4) and 1.6 (±0.33) (P < 0.001)) but not from those in whom other diagnoses were made 19.9 (+0.78) and 6.36 (±0.68)). There were no significant differences in anxiety or depression scores between the subtypes of BS. Anxiety scores did not correlate with number of stools passed or days per week of bloating or pain...


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