https://onlinelibrary.wiley.com/doi/full/10.1002/ueg2.70157

Key Summary

• Summarise the established knowledge on this subject?
  • ◦ IBS often presents with comorbid conditions, but the effect of these conditions on the overall disease burden is not well elucidated.
• What are the significant and/or new findings of this study?
  • ◦ In this study, we characterize and compare IBS with and without anxiety disorder, depression disorder, fibromyalgia and/or chronic fatigue syndrome to disease and healthy controls.
  • ◦ The symptom burden of gastrointestinal and non-gastrointestinal symptoms is more severe in IBS with comorbidities compared with IBS without comorbidities.
  • ◦ Furthermore, the symptom burden increases gradually with increasing number of comorbidities as well as with the number of psychiatric diagnoses in IBS.

ABSTRACT

Background

Patients with Irritable bowel syndrome (IBS) frequently suffer from comorbid psychiatric or somatic conditions, but the association with overall GI symptom severity and disease burden in IBS has not yet been established.

Objective

This pan-European project, the DISCOvERIE project, aimed to characterize IBS patients with and without comorbid psychiatric (anxiety, depression) and/or somatic (fibromyalgia, chronic fatigue syndrome) conditions, and to compare them with disease (psychiatric and/or somatic condition without IBS) and healthy controls to further elucidate the effect of comorbid conditions on the disease burden in IBS.

Methods

Participants from nine different European centers were included: IBS patients (Rome IV criteria) with and without comorbid conditions, disease controls, and healthy controls. The presence of comorbidities was assessed through the Mini International Neuropsychiatric Interview (MINI) for anxiety or depression or through diagnostic criteria for fibromyalgia or chronic fatigue syndrome. Validated questionnaires on IBS (IBS-SSS), depressive (PHQ-9), anxiety (GAD-7) and somatic symptom severity (PHQ-12), fibromyalgia symptoms (FIQ) and fatigue (MFI) were completed.

Results

In total, 842 participants were recruited between March 2021 and January 2023, of which 607 had IBS, 161 were disease controls and 74 were healthy controls. IBS, anxiety, depression, somatic symptoms and fatigue were more severe in IBS patients with comorbidities compared with IBS patients without comorbidities. The severity of the abovementioned symptoms all increased gradually with increasing number of comorbidities (all p < 0.001).

Conclusion

This large pan-European study highlights the significant impact of psychiatric and somatic comorbidities in IBS, and their strong link with outcomes and disease burden.