title: Gastrointestinal symptom severity in irritable bowel syndrome, inflammatory bowel disease and the general population.
abstract: Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) patients report similar gastrointestinal (GI) symptoms, yet comparisons of symptom severity between groups and with the general population (GP) are lacking.
  
  
  
  We compared Patient-Reported Outcomes Measurement Information System (PROMIS®) GI symptom scales measuring gastro-esophageal reflux (GER), disrupted swallowing, diarrhea, bowel incontinence, nausea/vomiting, constipation, belly pain, and gas/bloating in: (i) USA GP sample, (ii) IBS patients, and (iii) IBD patients from tertiary care and community populations. Symptom severity scores were based on T-score metric with mean 50±10 (standard deviation) relative to the GP.
  
  
  
  Of 1643 patients enrolled, there were 253 IBS patients (68% F, mean age 45±15 years), 213 IBD patients (46% F, mean age 41±14 years), and 1177 GP subjects (57% F, mean age 46±16 years). IBS patients reported greater severity of GER, disrupted swallowing, nausea/vomiting, belly pain, gas/bloating, and constipation symptoms than their IBD counterparts (all P<.05). Compared to the GP, IBD patients had worse belly pain, gas/bloating, diarrhea, and bowel incontinence, but less severe GER and disrupted swallowing (all P<.05), and IBS patients had more severe nausea/vomiting, belly pain, gas/bloating, and constipation (all P<.05). Women had more severe belly pain and gas/bloating than men, whereas men had more severe bowel incontinence (all P<.05).
  
  
  
  IBS and IBD are associated with more severe GI symptoms compared to the GP excluding esophageal symptoms. Unlike IBD, IBS is not characterized by observable GI inflammation but patients report more severe upper and lower GI symptoms.
authors.affiliation: Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|Department of Medicine, Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.|RAND Health Program, Santa Monica, CA, USA.|UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA, USA.|Division of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Lee
authors.affiliation: Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, USA.|Department of Medicine, Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.|UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA, USA.|Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.|Department of Medicine, UCLA Division of General Internal Medicine, Los Angeles, CA, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Spiegel
authors.affiliation: RAND Health Program, Santa Monica, CA, USA.|Department of Medicine, UCLA Division of General Internal Medicine, Los Angeles, CA, USA.|Department of Health Services, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Hays
authors.affiliation: Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: G Y
authors.initials: GY
authors.lastname: Melmed
authors.affiliation: UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA, USA.|Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Bolus
authors.affiliation: Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: D
authors.initials: D
authors.lastname: Khanna
authors.affiliation: Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: P P
authors.initials: PP
authors.lastname: Khanna
authors.affiliation: Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.|G. Oppenheimer Center of Neurobiology of Stress and Resilience, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Chang
mesh_terms: D000328:Adult; D003248:Constipation / Q000150:complications; D003680:Deglutition Disorders / Q000150:complications; D003967:Diarrhea / Q000150:complications; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000453:epidemiology*; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000150:complications; D012720:Severity of Illness Index; D014839:Vomiting / Q000150:complications
keywords: gender; inflammatory bowel disease; irritable bowel syndrome; symptom severity