IBS in Inflammatory Bowel Disease

Patients with inflammatory bowel diseases (IBD, which consists of Crohn's disease and ulcerative colitis) have symptoms that are similar to irritable bowel syndrome (IBS). After IBD is treated successfully, examination of the colon may show that there is no longer any sign of active inflammation. However, IBD patients may continue to suffer from gastrointestinal symptoms that fit the diagnosis of irritable bowel syndrome (IBS). Studying patients whose IBD is in remission allows us to understand the important role of IBS in their lives.
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Coping Strategies and Interpersonal Support in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disease

Jones MP, Wessinger S, Crowell MD (2006). Clinical Gastroenterology and Hepatology, 4, 474-481.

Introduction & Methods

  • The goal of this study was to examine the psycho-social issues of quality of life, interpersonal support, and coping strategies in patients with IBS and IBD.
  • Questionnaires evaluated quality of life (designed for IBS and IBD respectively), psychiatric symptoms, ways of coping, and quality of interpersonal support.

Results

  • Both IBS and IBD caused equally significant reduced quality of life, psychiatric distress, and interpersonal support.
  • Patients and healthy controls had similar overall coping scores. However, the most common method of coping in IBS was planful problem solving, while IBD patients were found to use avoidance as a primary coping strategy. Both IBS and IBD groups scored high in seeking social support.

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Quality of Life in Inflammatory Bowel Disease in Remission: The Impact of IBS-like Symptoms and Associated Psychological Factors

Simren M, Axelsson J, et al (2002). The American Journal of Gastroenterology, 97, 389-396.

Introduction & Methods

  • IBD patients in remission (no evidence of active inflammation) may suffer from IBS even though their colons are not inflamed. A group of patients with ulcerative colitis (UC) and a group of patients with Crohn's disease (CD), all in remission, were studied.
  • Patients completed measurements of psychological well-being, gastrointestinal symptoms, anxiety, and depression.

Results

  • 33% of UC patients had IBS, and 57% of CD patients had IBS.
  • Quality of life was worse in IBD remission patients with IBS— especially in Crohn's disease. Anxiety and depression were also more common if IBS was present, again more commonly in Crohn's patients than ulcerative colitis patients.

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Ulcerative Colitis and Irritable Bowel Syndrome: Relationships with Quality of Life

Ansari R, Attari F, et al (2008). Journal of Gastroenterology & Hepatology, 20, 46-50.

Introduction & Methods

  • This study records the percent of patients with ulcerative colitis (UC) in remission who have IBS. In addition, it compares quality of life in healthy patients, patients with active colitis, IBS patients with ulcerative colitis in remission, and non-IBS patients with ulcerative colitis in remission.

Results

  • 46% of the UC patients in remission had symptoms that fit the diagnosis of IBS. This confirms that IBS occurs very frequently in patients with IBD.
  • Patients with UC in remission with IBS and patients with active UC had worse quality of life than UC in remission or controls.

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