- Email: [email protected]
M1339 Alcohol Consumption, Irritable Bowel Syndrome (IBS) and Health Related Quality of Life (HRQoL) in Young Volunteers
quantitate poor sleep quality in patients with IBS when compared to healthy controls . Poor sleep quality appears to be yet another manifestation of the multi-organ involvement of the disease and may add further to the reduced QOL seen in IBS. References: 1, Buysse DJ et al. The Pittsburgh Sleep Quality index: A new instrument for Psychiatric Practice and Research. Psychiatry Research, 1989;28:193-213. 2, Ranjbararan Z et al. Impact of sleep disturbances in Inflammatory bowel disease. J Gastroenterol. Hepatol. 2007;27:1748-1753 M1339 Alcohol Consumption, Irritable Bowel Syndrome (IBS) and Health Related Quality of Life (HRQoL) in Young Volunteers Blanca E. Farfán-Labonne, Gabriela Gutierrez-Reyes, Joselín Hernández-Ruiz, Feggy Ostrosky-Solis, Adriana Diaz-Anzaldua, Juan Carlos Lopez-Alvarenga, Guillermo RoblesDíaz, David Kershenobich, Max J. Schmulson Background: Alcohol dependence and IBS are related to serotoninergic neurotransmission (Lesch K. 2005, Gershon M. 2007) and depression and both have a negative impact on HRQOL (Donovan D. 2005, Chang L. 2004). Aims: To determine if alcohol consumption is a risk factor for IBS in a young population and if the presence of both has a synergistic impact on HRQOL. Methods: Students from a university in the south of Mexico City were invited to participate by advertisement. They all answered the Alcohol Used Disorders Identification Test (AUDIT), Rome II Modular Questionnaire (RIIMQ) and the SF-36. The AUDIT includes 10 questions with a score from 0 to 40 as follows; Non drinkers: <8; Medium level of alcohol problems: 8-15; High level: 16-19; Possible dependence: >20. Also, subjects were classified as IBS vs. controls according to the RIIMQ. The X2 and Student's t test were used when appropriate, a p≤0.05 was considered significant. Analysis of covariance was used for adjustment and to contrast the effect of alcohol, IBS and sex, on HRQOL. Results are expressed by the β coefficients and 95%CI. Results: A total of 108 subjects (Age: 22±0.3 years old, males: 59%) were recruited. 63(58%) were non drinkers and 45 (42%) had problems with alcohol: Medium: 35 (32%); High: 5 (5%); Possible dependence: 5 (5%). Those with alcohol problems were older than the non-drinkers (23±0.5 vs. 21±0.3 years old, p=0.003) and included a higher proportion of men (69% vs. 44%, p=0.039). There were no differences in the presence of IBS, drinkers: 40% vs. non-drinkers: 41%, NS. The table depicts the effect of alcohol, IBS and sex on HRQOL. Conclusions: In this sample of young subjects, drinking alcohol is not a risk factor for IBS. However, IBS and alcohol drinking have a synergistic negative effect on physical aspects of HRQOL. In contrast, IBS by itself affects general and mental health while alcohol by itself has an emotional impact probably related to social rejection. Supported by grant SDEI-PTID-06-14 of the Universidad Nacional Autónoma de México (UNAM).
M1337 Irritable Bowel Syndrome (IBS) Among Caregivers of Chronically Ill Patients: Prevalence, Quality of Life (QOL) and Association With Psychological Stress Jose M. Remes Troche, Maura Torres-Aguilera, Eli De la Cruz Patiño, Amyra A. Azamar Jacome, Federico B. Roesch Introduction: Recent studies have shown that caregiving over a long period can have a negative impact on caregivers both mentally and physically. Given the magnitude of services provided, caregiver burden represents a public health concern. Although, significant associations have been reported between IBS and psychological distress, including sexual abuse and posttraumatic stress disorder (i.e veterans of war), it is unknown if caregiving is associated with IBS. Aims: To evaluate the prevalence of IBS and their associations with anxiety, depression, and QoL among a group of caregivers of chronically ill patients. Methods: 53 caregivers (parents, spouses or non-related subjects) that had been caregiving for 6+ months, without neurological or incapacitating health problems were evaluated. In all subjects, the Zarit Caregiver Burden Interview (ZBI), an instrument for assessing the burden experienced by family caregivers was applied. ZBI comprises 22 questions graded on a Liker type (04), according to this instrument a score >47 (22-110) represents caregiver burden. IBS was diagnosed according to validated Rome-II questionnaire in Spanish-Mexico. HRQOL was assessed using the validated IBS-QOL in Spanish-Mexico. Anxiety and depression were assessed by using the HAD scale, also validated in Mexico. A statistical analysis was performed between caregivers with IBS (G1) and caregivers without IBS (G2) using Fisher and student t-tests. Also a correlation among ZBI, IBS-QOL and HAD performed. Results: There were 46 females (87%), and the mean age was 43 ± 12.5. Mean time of caregiving was 19.8 months. Among chronically ill patients who received caregiving 58% had chronic kidney diseases, 13% cancer, 11% neurological disease, 8% diabetes and 10% other chronic condition. Twenty-three subjects (46%) had IBS (G1) according to Rome II criteria (11 IBS-C, 8 IBS-D, and 4-IBS M). According to the ZBI, 38 subjects (72%) had caregiver burden. Compared to those without IBS (G2), the G1 reported higher scores in the ZBI (63.5 ± 16 vs. 52.4 ± 16, p=0.01), higher scores for anxiety (11.9±4 vs. 8.3±4, p=0.006 ) and depression (10.4 ±4 vs. 7.9±3.8, p=0.008). Subjects in G1, had lower IBS-QoL overall scores compared to G2 (67 ± 18 vs. 93 ±7, p=0.0001). Also,there was a significant negative correlation between the ZBI scores and the overall IBS-QoL (r=-0.60, p=0.001).Conclusions: Caregivers of chronically ill patients have high prevalence (46%) of IBS, which are highly associated with presence of depression, anxiety and a poor QoL. This novel association should be considered as another psychological distress condition associated to IBS.
Results are expressed in β(IC95%). M1340 Is Atopy of Relevance for Food-Related Gastrointestinal Symptoms in Irritable Bowel Syndrome (IBS)? Katarina Wilpart, Stine Störsrud, Anette Lindh, Pernilla Jerlstad, Gisela Ringstrom, Magnus Simren
M1338
Background: Postprandial worsening of symptoms and adverse reactions to one or more food items are common in IBS (Simren et al 2001). A recent study suggested an association between atopic disease and IBS (Tobin et al 2008). However, factors of importance for foodrelated gastrointestinal (GI) symptoms in IBS remain to be established. Aim: To evaluate the correlation between atopic disease, symptom pattern, quality of life and perceived food intolerance in IBS. Methods: We included 70 consecutive IBS patients (mean age 35 (1972) years; 58 females) referred to our outpatient clinic. The levels of total and specific IgE in serum, and of blood eosinophilic granulocytes were measured. The patients also completed a questionnaire assessing the presence of atopic disease and symptoms after intake of 60 different food items, as well as questionnaires evaluating quality of life (IBSQOL), IBS symptom severity (IBS-SSS), general anxiety and depression (HAD), GI-specific anxiety (VSI) and somatic symptoms (PHQ-15). Results: GI symptoms after intake of at least one of the food items surveyed were reported by 55 patients (79%). The most commonly reported food items were fried and fatty foods (51%); dairy products (44%); apples (36%); beans and lentils (34%); alcohol (34%); and pork (31%). Patients with food-related GI symptoms reported more severe GI specific anxiety (45±17 vs. 34±17; p=0.04), somatic symptoms (12.6±4.1 vs. 9.1±4.1; p=0.006) as well as reductions in the quality of life domains sleep (72±25 vs. 92±14; p=0.01), social role (56±23 vs. 75±18; p=0.009) and food (56±16 vs. 71±14; p=0.002), whereas no significant association could be seen with IgE levels, eosinophilic counts or IBS symptom severity. The number of food items considered to give rise to symptoms were correlated with somatic symptom severity (r=0.28; p=0.02), IBS symptom severity (r=0.31; p=0.01) and the majority of QOL domains, but not with IgE levels or eosinophilic counts. A history suggesting atopic disease (eczema, rhinoconjunctivitis or
Sleep Dysfunction in Irritable Bowel Syndrome: A Controlled Study of Patients With IBS and Healthy Adults Guy Sisson, Cornelia Junghans, Ingvar T. Bjarnason Introduction: Irritable Bowel Syndrome (IBS) is a common disorder resulting in a wide range of abdominal and bowel symptoms which often have an impact on quality of life (QOL) . Poor sleep quality also affects QOL and is a recognised feature of inflammatory bowel disease as well as other medical and psychiatric disorders (1,2). Although poor sleep quality is reported in IBS little is known about its prevalence. Here we compare sleep quality in IBS with health controls using the Pittsburgh Sleep Quality Index (PSQI) a standardised and validated quantitative measure of sleep quality(1). Method: Consecutive patients with a diagnosis of IBS attending the outpatient gastroenterology department of Kings College Hospital were recruited. Healthy controls were recruited from hospital staff and students on a voluntary basis. All patients and controls gave informed written consent. Exclusion criteria were night shift work, current or past sleep disorder, inflammatory bowel disease (IBD) or other significant health problem that may affect sleep (IBS was excluded from the control group). All patients completed the a health and life style questionnaire and a PSQI which gives a quantitative sleep quality score from 1-21 with a higher score representing a worse sleep quality. Cases and controls were compared using the Mann Whitney U test in Stata 8 statistical software. Results: A total of 90 subjects, 63 patients and 27 controls were recruited. The mean PSQI was 9.6 and 4.4 in IBS and control subjects respectively (CI 8.6 - 10.7 and 3.5 - 5.4). (p <0.0001) Conclusion: This study is the first to demonstrate and
S-383
AGA Abstracts
AGA Abstracts
two groups. Among children, subanalysis by age 5-11 years and 12-17 years and gender were conducted. Results: A total of 15.6M patients with AP were identified (10.1% children, 89.9% adults) with 516.6M total consultations (12.4% children, 87.6% adults). Children demonstrated a non-linear trend in APCs (R2 = 0.030) and a quadratic trend was found to be the best fit (polynomial; R2 = 1.000; Figure 1). This indicates a seasonal pattern in APC among children but not adults (linear; R2 = 0.621). The trend in seasonal variation of APCs among children stratified by age and gender was consistent with the overall child population. Conclusions: Abdominal pain consultations in children are less common during summer months while APC among adults do not vary during the year. Factors involved in the pathogenesis of AP in adults and children may differ.
M1337 Irritable Bowel Syndrome (IBS) Among Caregivers of Chronically Ill Patients: Prevalence, Quality of Life (QOL) and Association With Psychological Stress Jose M. Remes Troche, Maura Torres-Aguilera, Eli De la Cruz Patiño, Amyra A. Azamar Jacome, Federico B. Roesch Introduction: Recent studies have shown that caregiving over a long period can have a negative impact on caregivers both mentally and physically. Given the magnitude of services provided, caregiver burden represents a public health concern. Although, significant associations have been reported between IBS and psychological distress, including sexual abuse and posttraumatic stress disorder (i.e veterans of war), it is unknown if caregiving is associated with IBS. Aims: To evaluate the prevalence of IBS and their associations with anxiety, depression, and QoL among a group of caregivers of chronically ill patients. Methods: 53 caregivers (parents, spouses or non-related subjects) that had been caregiving for 6+ months, without neurological or incapacitating health problems were evaluated. In all subjects, the Zarit Caregiver Burden Interview (ZBI), an instrument for assessing the burden experienced by family caregivers was applied. ZBI comprises 22 questions graded on a Liker type (04), according to this instrument a score >47 (22-110) represents caregiver burden. IBS was diagnosed according to validated Rome-II questionnaire in Spanish-Mexico. HRQOL was assessed using the validated IBS-QOL in Spanish-Mexico. Anxiety and depression were assessed by using the HAD scale, also validated in Mexico. A statistical analysis was performed between caregivers with IBS (G1) and caregivers without IBS (G2) using Fisher and student t-tests. Also a correlation among ZBI, IBS-QOL and HAD performed. Results: There were 46 females (87%), and the mean age was 43 ± 12.5. Mean time of caregiving was 19.8 months. Among chronically ill patients who received caregiving 58% had chronic kidney diseases, 13% cancer, 11% neurological disease, 8% diabetes and 10% other chronic condition. Twenty-three subjects (46%) had IBS (G1) according to Rome II criteria (11 IBS-C, 8 IBS-D, and 4-IBS M). According to the ZBI, 38 subjects (72%) had caregiver burden. Compared to those without IBS (G2), the G1 reported higher scores in the ZBI (63.5 ± 16 vs. 52.4 ± 16, p=0.01), higher scores for anxiety (11.9±4 vs. 8.3±4, p=0.006 ) and depression (10.4 ±4 vs. 7.9±3.8, p=0.008). Subjects in G1, had lower IBS-QoL overall scores compared to G2 (67 ± 18 vs. 93 ±7, p=0.0001). Also,there was a significant negative correlation between the ZBI scores and the overall IBS-QoL (r=-0.60, p=0.001).Conclusions: Caregivers of chronically ill patients have high prevalence (46%) of IBS, which are highly associated with presence of depression, anxiety and a poor QoL. This novel association should be considered as another psychological distress condition associated to IBS.
Results are expressed in β(IC95%). M1340 Is Atopy of Relevance for Food-Related Gastrointestinal Symptoms in Irritable Bowel Syndrome (IBS)? Katarina Wilpart, Stine Störsrud, Anette Lindh, Pernilla Jerlstad, Gisela Ringstrom, Magnus Simren
M1338
Background: Postprandial worsening of symptoms and adverse reactions to one or more food items are common in IBS (Simren et al 2001). A recent study suggested an association between atopic disease and IBS (Tobin et al 2008). However, factors of importance for foodrelated gastrointestinal (GI) symptoms in IBS remain to be established. Aim: To evaluate the correlation between atopic disease, symptom pattern, quality of life and perceived food intolerance in IBS. Methods: We included 70 consecutive IBS patients (mean age 35 (1972) years; 58 females) referred to our outpatient clinic. The levels of total and specific IgE in serum, and of blood eosinophilic granulocytes were measured. The patients also completed a questionnaire assessing the presence of atopic disease and symptoms after intake of 60 different food items, as well as questionnaires evaluating quality of life (IBSQOL), IBS symptom severity (IBS-SSS), general anxiety and depression (HAD), GI-specific anxiety (VSI) and somatic symptoms (PHQ-15). Results: GI symptoms after intake of at least one of the food items surveyed were reported by 55 patients (79%). The most commonly reported food items were fried and fatty foods (51%); dairy products (44%); apples (36%); beans and lentils (34%); alcohol (34%); and pork (31%). Patients with food-related GI symptoms reported more severe GI specific anxiety (45±17 vs. 34±17; p=0.04), somatic symptoms (12.6±4.1 vs. 9.1±4.1; p=0.006) as well as reductions in the quality of life domains sleep (72±25 vs. 92±14; p=0.01), social role (56±23 vs. 75±18; p=0.009) and food (56±16 vs. 71±14; p=0.002), whereas no significant association could be seen with IgE levels, eosinophilic counts or IBS symptom severity. The number of food items considered to give rise to symptoms were correlated with somatic symptom severity (r=0.28; p=0.02), IBS symptom severity (r=0.31; p=0.01) and the majority of QOL domains, but not with IgE levels or eosinophilic counts. A history suggesting atopic disease (eczema, rhinoconjunctivitis or
Sleep Dysfunction in Irritable Bowel Syndrome: A Controlled Study of Patients With IBS and Healthy Adults Guy Sisson, Cornelia Junghans, Ingvar T. Bjarnason Introduction: Irritable Bowel Syndrome (IBS) is a common disorder resulting in a wide range of abdominal and bowel symptoms which often have an impact on quality of life (QOL) . Poor sleep quality also affects QOL and is a recognised feature of inflammatory bowel disease as well as other medical and psychiatric disorders (1,2). Although poor sleep quality is reported in IBS little is known about its prevalence. Here we compare sleep quality in IBS with health controls using the Pittsburgh Sleep Quality Index (PSQI) a standardised and validated quantitative measure of sleep quality(1). Method: Consecutive patients with a diagnosis of IBS attending the outpatient gastroenterology department of Kings College Hospital were recruited. Healthy controls were recruited from hospital staff and students on a voluntary basis. All patients and controls gave informed written consent. Exclusion criteria were night shift work, current or past sleep disorder, inflammatory bowel disease (IBD) or other significant health problem that may affect sleep (IBS was excluded from the control group). All patients completed the a health and life style questionnaire and a PSQI which gives a quantitative sleep quality score from 1-21 with a higher score representing a worse sleep quality. Cases and controls were compared using the Mann Whitney U test in Stata 8 statistical software. Results: A total of 90 subjects, 63 patients and 27 controls were recruited. The mean PSQI was 9.6 and 4.4 in IBS and control subjects respectively (CI 8.6 - 10.7 and 3.5 - 5.4). (p <0.0001) Conclusion: This study is the first to demonstrate and
S-383
AGA Abstracts
AGA Abstracts
two groups. Among children, subanalysis by age 5-11 years and 12-17 years and gender were conducted. Results: A total of 15.6M patients with AP were identified (10.1% children, 89.9% adults) with 516.6M total consultations (12.4% children, 87.6% adults). Children demonstrated a non-linear trend in APCs (R2 = 0.030) and a quadratic trend was found to be the best fit (polynomial; R2 = 1.000; Figure 1). This indicates a seasonal pattern in APC among children but not adults (linear; R2 = 0.621). The trend in seasonal variation of APCs among children stratified by age and gender was consistent with the overall child population. Conclusions: Abdominal pain consultations in children are less common during summer months while APC among adults do not vary during the year. Factors involved in the pathogenesis of AP in adults and children may differ.