Stress Triggers IBS Symptoms, Impacts Quality of Life More Than Diet, Study Finds

New research is calling attention to the potential value of a novel irritable bowel syndrome (IBS) classification system for tailoring management approaches based on the triggers most strongly affecting patients.

Study findings were presented at the American College of Gastroenterology (ACG) 2024 Annual Scientific Meeting in Philadelphia, Pennsylvania, and suggest psychological stress triggers IBS symptoms more frequently and impacts quality of life more severely than dietary factors. The research further calls attention to the ability to personalize treatment with stress-reducing strategies and dietary control measures based on the type of IBS a patient has.

IBS is typically subclassified into IBS with diarrhea, IBS with constipation, or IBS with mixed bowel habits. In an interview with HCPLive, lead investigator Mohammad Abuassi, MD, PGY2 at the University of Central Florida/HCA Healthcare GME, explained how his study is the first to classify IBS based on stress and diet triggers in an attempt to understand why treatment with dietary modifications or selective serotonin reuptake inhibitors only work for some patients and not others.

“It's the first study in the literature that looks into the IBS from that standpoint,” Abuassi said, going on to describe the value of his research for personalizing IBS treatment based on which category patients fall into.

The study enrolled 309 patients, 59.9% of whom were female with a mean age of 28.82 ± 10.8 years. Participants were asked questions about their IBS symptoms, diet, and stress as well as which they felt affected their quality of life the most.

On a Likert scale from 1-10, the average impact of diet was 6.81 (± 2.69) and the average impact of stress was 8.23 (± 2.35), indicating a significantly greater perceived impact of stress over diet (mean difference, 1.44; P <.001). Multivariate linear regression analysis revealed first-degree relatives (B, 0.813; 95% CI, 0.061-1.564) and strategies to avoid stress (B, 0.284; 95% CI, 0.871-1.890) were predictors of higher scores for effects of stress on IBS. For diet-induced IBS, consuming medications (B, 0.749; 95% CI, 0.131-1.367) and following alternative diets (B, 0.921; 95% CI, 0.316-1.527) were predictors of higher impact scores.

Acknowledging that his research is the first of its kind, Abuassi noted “it still needs more work on every aspect.”

Specifically, he pointed to the need to test this classification system in a broader patient population to provide more data for the validation of these IBS categories and eventual inclusion in future IBS guidelines.

Editors’ note: Abuassi has no relevant disclosures.

Reference

^{Abuassi M, Boustany A, Qudah HA, et al. P4051 - The Comparative Influence of Stress and Diet as Triggers for IBS: A Cross-Sectional Study. Paper presented at: ACG 2024 Annual Scientific Meeting. Philadelphia, Pennsylvania. October 25-30, 2024.}