Pan-enteric dysmotility, impaired quality of life and alexithymia in a large group of patients meeting ROME II criteria for irritable bowel syndrome.
OBJECTIVE
Psychological factors, altered motility and sensation disorders of the intestine can be variably associated with irritable bowel syndrome (IBS). Such aspects have not been investigated simultaneously. The aim of this paper was to evaluate gastrointestinal motility and symptoms, psychological spectrum and quality of life in a large group of IBS patients in southern Italy.


METHODS
One hundred IBS patients (F:M=73:27, age 48+/-2 years, mean+/-SE) fulfilling ROME II criteria matched with 100 healthy subjects (F:M=70:30, 45+/-2 years). Dyspepsia, bowel habit, alexithymia, psycho-affective profile and quality of life were assessed using specific questionnaires. Basally and postprandially, changes in gallbladder volumes and antral areas after liquid meal and orocaecal transit time (OCTT) were measured respectively by ultrasonography and H(2)-breath test. Appetite, satiety, fullness, nausea, and epigastric pain/discomfort were monitored using visual-analogue scales.


RESULTS
Compared with controls, IBS patients had increased dyspepsia (score 12.6+/-0.7 vs 5.1+/-0.2, P<0.0001), weekly bowel movements (12.3+/-0.4 vs 5.5+/-0.2, P<0.00001, comparable stool shape), alexithymia (score 59.1+/-1.1 vs 40.5+/-1.0, P=0.001), poor quality of life and psycho-affective profile. IBS patients had normal gallbladder emptying, but delayed gastric emptying (T50: 35.5+/-1.0 vs 26.1+/-0.6 min, P=0.00001) and OCTT (163.0+/-5.4 vs 96.6+/-1.8 min, P=0.00001). Fullness, nausea, and epigastric pain/discomfort were greater in IBS than in controls.


CONCLUSIONS
ROME II IBS patients have a pan-enteric dysmotility with frequent dyspepsia, associated with psychological morbidity and greatly impaired quality of life. The presence of alexithymia, a stable trait, is a novel finding of potential interest to detect subgroups of IBS patients with different patterns recovered after therapy.
Portincasa
Piero
P
Section of Internal Medicine, Department of Internal and Public Medicine (DIMIMP), University of Bari Medical School, Bari, Italy. p.portincasa@semeiotica.uniba.it
Moschetta
Antonio
A
Baldassarre
Giuseppe
G
Altomare
Donato F
DF
Palasciano
Giuseppe
G
D015746:Abdominal Pain / Q000175:diagnosis; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis*; D004415:Dyspepsia / Q000175:diagnosis; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires