Age-related symptom and life quality changes in women with irritable bowel syndrome

Abstract

Aim: To explore age-related changes in symptoms and quality of life (QoL) of women with irritable bowel syndrome (IBS).

Methods: Two-hundred and fifty-four female adult outpatients with IBS attending the Department of Gastroenterology at the First Affiliated Hospital of Nanjing Medical University between January, 2008 and October, 2008 were approached. Patients with a history of abdominal surgery, mental illness or those who had recently taken psychotropic drugs were excluded. A physician obtained demographic and abdominal symptom data. All patients were asked to complete the Zung Self-Rated Anxiety and Depression Scale (SDS/SAS) and the IBS-specific QoL questionnaire. The patients were divided into six groups according to age, in 10-year increments: 18-27 years, 28-37 years, 38-47 years, 48-57 years, 58-67 years and 68-75 years (maximum 75 years). Age-related differences of abdominal pain or discomfort were analyzed using rank-sum tests. Differences in SDS/SAS and IBS-QoL scores between age groups were analyzed using one-way analysis of variance. Pearson's correlations evaluated potential associations between IBS symptoms, psychological factors and QoL in each age group.

Results: There were no differences in the distribution of IBS subtypes between age groups (χ(2) = 20.516, P = 0.153). Differences in the severity of abdominal pain/discomfort with age were statistically significant (χ(2) = 25.638, P < 0.001); patients aged 48-57 years, 58-67 years or 68-75 years had milder abdominal pain/discomfort than those in the younger age groups. The severity of anxiety or depressive symptoms did not differ between age groups (SDS, χ(2) = 390.845, P = 0.110; SAS, χ(2) = 360.071, P = 0.220). Differences of IBS-QoL scores were statistically significant between age groups (χ(2) = 1098.458, P = 0.011). The scores of patients in the 48-57-year group were lower than those in the 18-27-year and 28-37-year groups (48-57-year group vs 18-27-year group, 74.88 ± 8.76 vs 79.76 ± 8.63, P = 0.021; 48-57-year group vs 28-37-year group, 74.88 ± 8.76 vs 79.04 ± 8.32, P = 0.014). The scores in the 68-75-year group were lower than those in the 18-27-year, 28-37-year and 38-47-year groups (68-75-year group vs 18-27-year group, 71.98 ± 9.83 vs 79.76 ± 8.63, P = 0.003; 68-75-year group vs 28-37-year group, 71.98 ± 9.83 vs 79.04 ± 8.32, P = 0.002; 68-75-year group vs 38-47-year group,71.98 ± 9.83 vs 76.44 ± 8.15, P = 0.039). Anxiety and depression were negatively correlated with QoL in all age groups (SDS and QoL: 18-27-year group, r = -0.562, P = 0.005; 28-37-year group, r = -0.540, P < 0.001; 38-47-year group, r = -0.775, P < 0.001; 48-57-year group, r = -0.445, P = 0.001; 58-67-year group, r = -0.692, P < 0.001; 68-75-year group, r = -0.732, P < 0.001. SAS and QoL: 18-27-year group, r = -0.600, P = 0.002; 28-37-year group, r = -0.511, P < 0.001; 38-47-year group, r = -0.675, P < 0.001; 48-57-year group, r = -0.558, 58-67-year group, P = 0.001; r = -0.588, P < 0.001; 68-75-year group, r = -0.811, P < 0.001). A negative correlation between abdominal pain severity and QoL was found in patients aged more than 58 years (58-67-year group, r = -0.366, P = 0.017; 68-75-year group, r = -0.448, P = 0.048 ), but not in younger patients (18-27-year group, r = 0.080, P = 0.716; 28-37-year group, r = -0.063, P = 0.679; 38-47-year group, r = -0.029, P = 0.812; 48-57-year group, r = -0.022, P = 0.876).

Conclusion: Factors affecting QoL should always be treated in IBS, especially emotional problems in young adults. Even mild abdominal pain should be controlled in elderly patients.

Keywords: Age; Female; Irritable bowel syndrome; Quality of life; Symptom.

Figure 1

Distribution of irritable bowel syndrome subtypes in each age group. IBS: Irritable bowel syndrome; IBS-C: IBS with constipation; IBS-D: IBS with diarrhea; IBS-M: Mixed IBS; IBS-U: Unsubtyped IBS.

Figure 2

Severity of abdominal pain/discomfort by age. 1 = Mild; 2 = Moderate; 3 = Severe.

Figure 3

Zung self-rated anxiety and depression scale scores according to age. SAS/SDS: Zung self-rated anxiety and depression scale.

Figure 4

Specific quality of life questionnaire scores for patients with irritable bowel syndrome. A: Specific quality of life questionnaire scores for patients with irritable bowel syndrome (IBS) according to age; B: Specific quality of life questionnaire scores for patients with IBS in each age group. ^aP < 0.05 vs 18-27-year and 28-37-year groups; ^cP < 0.05 vs 48-57-year group. QoL: Quality of life; SAS/SDS: Zung self-rated anxiety and depression scale.

Figure 5

Association of abdominal pain/discomfort severity, and Zung self-rated anxiety and depression scale scores for patients with irritable bowel syndrome in each age group. A: Age 18-27 years; B: Age 28-37 years; C: Age 38-47 years; D: Age 48-57 years; E: Age 58-67 years; F: Age 68-75 years. A1 to F1, association of abdominal pain/discomfort with quality of life in each age group. Severity of abdominal pain/discomfort was negatively correlated with irritable bowel syndrome-specific quality of life questionnaire (IBS-QoL) scores in the 58-67-year and 68-75-year groups (P < 0.05), but there was no correlation in the 18-27-year, 28-37-year, 38-47-year or 48-57-year groups (P > 0.05); A2 to F2, association of Zung Self-Rated Depression Scale (SDS) scores with quality of life in each age group. SDS scores were negatively correlated with IBS-QoL scores in all age groups (P < 0.01); A3 to F3, association of Zung Self-Rated Anxiety Scale (SAS) scores with quality of life in each age group. SAS scores were negatively correlated with IBS-QoL scores in all age groups (P < 0.01).