Clinical Features And Psychological Characteristics Of Irritable Bowel Syndrome Based On Rome Ⅳ Diagnostic Criteria

Objective:To investigate the clinical features and psychological characteristics of irritable bowel syndrome(IBS)based on Rome IV diagnostic criteria.Methods:A total of 180 patients who met the Rome IV diagnostic criteria for irritable bowel syndrome(IBS)were collected from June 2017 to February 2018 in Affiliated Hospital of Chengde Medical College and Bethune International Peace Hospital.The questionnaire included general condition,symptoms and related factors,IBS gastrointestinal symptoms,extra intestinal manifestations,alarm symptoms,somatization,psychological states and sleep quality of subjects.Results:1.This study included 180 IBS patients,78 males and 102 females(male/female ratio 1:1.3),of mean age 45.5±13.6 years.2.Among the subjects,124(68.9%)were diagnosed as IBS with diarrhea(IBS-D),25(13.9%)as IBS with constipation(IBS-C),19(10.5%)as IBS with mixed IBS(IBS-M),12(6.7%)as IBS with unsubtyped IBS(IBS-U).There were no significant difference among the four subtypes in gender,age,employment and educational attainment(P>0.05).3.Of the IBS patients,20% of them complained of mild abdominal pain,54% with moderate abdominal pain and 26% with severe abdominal pain.The severity of abdominal pain did not differ among the four subtypes(P>0.05).4.Among the IBS patients,138 patients(77%)presented upper gastrointestinal symptoms.The most frequent upper gastrointestinal symptoms in IBS patients were abdominal distension,followed by heartburn,belching,nausea,right upper abdominal / upper abdominal pain,early satiety,vomiting and regurgitation.5.Ninty percent of IBS patients(162 cases)presented somatization symptom.The most frequent somatization symptom was fatigue(58%),more than half of the patients presented insomnia.Of the 180 IBS patients,99(55%)had anxiety symptoms,111(62%)had depressive symptoms and 84(47%)patients with anxiety and depression simultaneously.6.Anxiety and depression in patients with IBS were not related to gender(P>0.05).The anxiety and depression scores were not significantly different between men and women(P>0.05).Moreover,the scores were not different among the four subtypes(P>0.05).7.More than half of the patients with IBS had abnormal sleep.The incidence of abnormal sleep was not related to gender(P>0.05).There was a significant sleep disorder in the anxiety and depression groups compared with those without anxiety and depression groups(P<0.05).Conclusions:1.The distribution of IBS subtypes has changed significantly based on Rome IV criteria compared with that on Rome III criteria.The proportion of IBS-U was reduced markedly and IBS-U was the least among the four subtypes.2.Most IBS patients had moderate to severe abdominal pain,suggesting that IBS patients diagnosed by the Rome IV cirteria had severe intestinal symptoms and may have higher intestinal sensitivity.3.Approximately four fifths of IBS patients meeting Rome IV criteria had upper gastrointestinal symptoms.The proportion was significantly higher than that on Rome III criteria.It indicated that IBS patients diagnosed by Rome IV presented more frequent coexistence with other functional gastrointestinal diseases.4.Ninety percent of IBS were accompanied by somatization symptoms,indicating that IBS patients diagnosed by Rome IV criteria presented more frequent somatic hypersensitivity.We should pay attention to the treatment of somatic symptom disorders in patients with IBS.5.More than half of IBS patients reported anxiety or depression.Anxiety and depression often exist simultaneously.Anxiety and depression will aggravate sleep disorders in IBS patients.It should be identified and treated in time in clinical practice.