Negative Effects on Psychological Health and Quality of Life of Genuine Irritable Bowel Syndrome-type Symptoms in Patients With Inflammatory Bowel Disease

Background & Aims: Symptoms compatible with irritable bowel syndrome (IBS) are common in patients with inflammatory bowel disease (IBD), but it is unclear whether this relates to occult IBD activity. We attempted to resolve this issue in a secondary care population using a cross-sectional study design. Methods: We analyzed Rome III IBS symptoms; disease activity indices; and psychological, somatization, and quality of life data from 378 consecutive, unselected adult patients with IBD seen in clinics at St. James's University Hospital in Leeds, United Kingdom, from November 2012 through June 2015. Participants provided a stool sample for fecal calprotectin (FC) analysis; levels of ≥250 μg/g were used to define mucosal inflammation. Using symptom data and FC levels we identified 4 distinct groups of patients: those with true IBS-type symptoms (IBS-type symptoms with FC levels