Association of Psychological Disorders with Extra-intestinal Symptoms in Patients with Irritable Bowel Syndrome

Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Poursina Hakim Research Institution, Isfahan, Iran


Background: Extraintestinal symptoms are common in patients with irritable bowel syndrome (IBS). In the present study, we determined the relationship between psychological disorders and extraintestinal symptoms in patients with IBS.

Methods: Adult patients with IBS referred to 4 gastroenterology clinics in Isfahan, Iran, completed the irritable bowel severity scoring system, extraintestinal symptoms scale, Hospital Anxiety and Depression Scale, and Irritable Bowel Syndrome Quality of Life (IBS-QOL) Questionnaire. Univariate and multivariate analyses were conducted.

Results: The patients included 113 females and 45 males with mean age of 34.8 11.1 years. Cumulative frequency of extraintestinal symptoms was 3.3 2.4 (0 to 10). Anxiety and depression were present in 79.7% and 54.4% of the patients, respectively. Frequency of extraintestinal symptoms was correlated with anxiety and depression (r = 0.289 to 0.531), IBS severity (r = 0.373 to 0.505), and quality of life (r = -0.317 to -0.398). Severity of IBS was independently associated with extraintestinal digestive symptoms frequency (? = 0.248). Female gender, education level, and anxiety were independently associated with extraintestinal non-digestive symptoms frequency (? = -0.225 to 0.260). Severity of IBS and frequency of non-digestive symptoms were independent predictors of quality of life (? = -0.494 and -0.218). After controlling for psychological factors, IBS severity and depression were independent predictors of quality of life (? = -0.435 and -0.318).

Conclusion: Extraintestinal symptoms and psychological disorders are common in patients with IBS and impact their quality of life. Psychological disorders are associated with extraintestinal symptoms, especially non-digestive symptoms. These results highlight the need for an integrated biopsychosocial approach to the management of IBS patients with physical and mental comorbidities.


  • Irritable bowel syndrome
  • Anxiety
  • Depression
  • Psychological
  • Comorbidity
  • Quality of life

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