title: Fear of GI symptoms has an important impact on quality of life in patients with moderate-to-severe IBS.
abstract: OBJECTIVE
  Because irritable bowel syndrome (IBS) is a functional medical condition for which there is no curative therapy, treatment goals emphasize relieving gastrointestinal (GI) symptoms and optimizing the quality of life (QOL). This study sought to characterize the magnitude of the associations between QOL impairment, fear of IBS symptoms, and confounding variables.
  
  
  METHODS
  Subjects included 234 Rome III-diagnosed IBS patients (mean age, 41 years, 79%, female) without comorbid organic GI disease who were referred to two specialty care clinics of an National Institutes of Health trial for IBS. Subjects completed a testing battery that included the IBS-specific QOL (IBS-QOL), SF-12 (generic QOL), the UCLA GI Symptom Severity Scale, the Visceral Sensitivity Index, Trait Anxiety Inventory, and Brief Symptom Inventory.
  
  
  RESULTS
  Multiple linear regression was used to develop a model for predicting QOL. Data supported an overall model that included sociodemographic, clinical (e.g., current severity of GI symptoms), and psychosocial (e.g., fear of GI symptoms, distress, neuroticism) variables, accounting for 48.7% of the variance in IBS-QOL (F=15.1, P <0.01). GI symptom fear was the most robust predictor of IBS-QOL (β=-0.45 P <0.01), accounting for 14.4% of the total variance.
  
  
  CONCLUSIONS
  Patients' fear that GI symptoms have aversive consequences, is a predictor of QOL impairment that cannot be fully explained by the severity of their GI symptoms, overall emotional well-being, neurotic personality style, or other clinical features of IBS. An understanding of the unique impact that GI symptom fears have on QOL can inform treatment planning and help gastroenterologists to better manage more severe IBS patients seen in tertiary care clinics.
authors.affiliation: Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, New York, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Lackner
authors.affiliation: Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, New York, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Gudleski
authors.affiliation: Department of Biostatistics, School of Public Health and Health Professions University at Buffalo, Buffalo, New York, USA.
authors.forename: Chang-Xing
authors.initials: CX
authors.lastname: Ma
authors.affiliation: Department of Medicine, University at Buffalo School of Medicine, SUNY, Buffalo, New York, USA.
authors.forename: Akriti
authors.initials: A
authors.lastname: Dewanwala
authors.affiliation: 1] Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA [2] Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Naliboff
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D001008:Anxiety Disorders; D005239:Fear; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D000075384:Neuroticism; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires