IBS Prevalence High Among Veterans

Andrea Shin, MD

Veterans with irritable bowel syndrome (IBS) are more likely to also suffer from psychological comorbidities like depression and anxiety.

A team, led by Andrea Shin, MD, Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, investigated the prevalence of IBS, the phenotypic, environmental, and psychosocial factors linked to the disease, and the associations of IBS with health-related quality of life and healthcare utilization in Veterans.

There are not many studies focusing on the prevalence of IBS in the Veteran population.

Veteran Responders

In the study, Veterans completed the Rome IV IBS questionnaire, Short Form-12, Post-Traumatic Stress Disorder (PTSD) checklist, Hospital Anxiety and Depression Scale, and questionnaires on general health, antibiotic-use, infective enteritis (IE), and healthcare utilization between June 2018 and April 2020.

A total of 858 Veteran responded, with 28.4% (n = 244) met the Rome IV IBS (47.5% IBS with diarrhea [IBS-D], 16.8% IBS with constipation [IBS-C], 33.6% mixed-IBS [IBS-M]).

IBS Associations

An IBS was associated with greater anxiety and depression and a lower quality of life (all P <0.001).

Patients with IBS more commonly had provisional post-traumatic stress disorder, IE, and bowel problems following antibiotic use (all P <0.001), as were multiple doctor visits (P <0.01) and hospitalizations (P = 0.04).

After comparing results across patients with IBS subgroups and a control group, the investigators found overall associations of psychological comorbidities (P <0.01), multiple doctor visits (P <0.01), hospitalizations (P = 0.03), IE (P <0.01), and bowel problems after IE (P = 0.03) or antibiotics (P <0.01) with subgroup.

Patients with IBS-C also had the highest anxiety and depression scores, PTSD, multiple doctor visits, hospitalizations, and bowel problems after IE.

After conducting an adjusted analyses, the investigators found IBS was linked with anxiety (OR, 3.47), depression (OR, 2.88), lower quality of life, PTSD (OR, 3.09), IE (OR, 4.44), bowel problems after antibiotics (OR, 1.84), multiple doctor visits (OR, 2.08), and hospitalizations (OR, 1.78) (all P <0.001).

“IBS is prevalent among Veterans and has a measurable impact on individuals and healthcare resources,” the authors wrote. “Veterans with IBS may experience significant psychological impairment.”

IBS-C During COVID-19

There is considerable disease burden for patients with irritable bowel syndrome with constipation (IBS-C) that was only exacerbated by the COVID-19 pandemic.

In data presented during the 2021 Digestive Disease Week (DDW) Virtual Meeting, a team of researchers led by Brian E. Lacy, MD, PhD, Gastroenterology, Neurogastroenterology, the Mayo Clinic, examined how the pandemic shaped disease presentation and health care utilization.

The researchers used a sampling of 130 IBS-C patients with 130 control patients between August and October 2020 and found more than a third of surveyed IBS-C patients indicated worsening symptoms during the duration of the pandemic and a quarter of patients cancelling health care visits during the study period.

The investigators also found 46% of IBS-C patients did not seek healthcare in the previous year because of their symptoms.

However, more IBS-C patients reported a higher proportion of moderate-to-severe anxiety and depression and a lower health-related quality of life.

The study, “The Prevalence, Humanistic Burden, and Healthcare Impact of Irritable Bowel Syndrome (IBS) Among United States Veterans,” was published online in Clinical Gastroenterology and Hepatology.