The Prevalence, Humanistic Burden, and Health Care Impact of Irritable Bowel Syndrome Among United States Veterans,Clinical Gastroenterology and Hepatology

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The Prevalence, Humanistic Burden, and Health Care Impact of Irritable Bowel Syndrome Among United States Veterans
Clinical Gastroenterology and Hepatology ( IF 11.6 ) Pub Date : 2022-08-11 , DOI: 10.1016/j.cgh.2022.08.005
Andrea Shin ₁ , Huiping Xu ₂ , Thomas F Imperiale ₁

Affiliation

Background & Aims

Irritable bowel syndrome (IBS) in veterans is understudied. This study sought to investigate (1) prevalence of IBS; (2) phenotypic, environmental, and psychosocial factors associated with IBS; and (3) associations of IBS with health-related quality of life and health care use.

Methods

From June 2018 to April 2020, we invited veterans to complete the Rome IV IBS questionnaire; Short Form-12; posttraumatic stress disorder (PTSD) checklist; Hospital Anxiety and Depression Scale; and questionnaires on general health, antibiotic use, infectious enteritis (IE), and health care use.

Results

Among 858 veteran respondents, 244 (28.4%) met Rome IV IBS criteria (47.5% IBS with diarrhea, 16.8% IBS with constipation, 33.6% mixed IBS). IBS was associated with greater anxiety and depression and lower quality of life (all P < .001). Provisional PTSD, IE, and bowel problems after antibiotics were more common in IBS (all P < .001) as were multiple doctor visits (P < .01) and hospitalizations (P = .04). Comparisons across non-IBS and IBS subgroups revealed overall associations of psychological comorbidities (P < .01), multiple doctor visits (P < .01), hospitalizations (P = .03), IE (P < .01), and bowel problems after IE (P = .03) or antibiotics (P < .01) with subgroup. Highest anxiety and depression scores, PTSD, multiple doctor visits, hospitalizations, and bowel problems after IE were observed in IBS with constipation. In adjusted analyses, IBS was associated (all P < .001) with anxiety (odds ratio [OR], 3.47), depression (OR, 2.88), lower quality of life, PTSD (OR, 3.09), IE (OR, 4.44), bowel problems after antibiotics (OR, 1.84), multiple doctor visits (OR, 2.08), and hospitalizations (OR, 1.78).

Conclusions

IBS is prevalent among veterans and has a measurable impact on individuals and health care resources. Veterans with IBS may experience significant psychological impairment.

中文翻译：

美国退伍军人肠易激综合症的患病率、人文负担和医疗保健影响

背景与目标

退伍军人的肠易激综合症（IBS）尚未得到充分研究。本研究旨在调查 (1) IBS 的患病率； (2) 与 IBS 相关的表型、环境和社会心理因素； (3) IBS 与健康相关的生活质量和医疗保健使用的关联。

方法

2018年6月至2020年4月，我们邀请退伍军人完成罗马IV IBS问卷；简表-12；创伤后应激障碍（PTSD）清单；医院焦虑和抑郁量表；关于一般健康、抗生素使用、传染性肠炎 (IE) 和医疗保健使用的调查问卷。

结果

在 858 名退伍军人受访者中，244 名（28.4%）符合罗马 IV IBS 标准（47.5% 患有腹泻 IBS，16.8% 患有便秘 IBS，33.6% 患有混合 IBS）。 IBS 与更大的焦虑和抑郁以及较低的生活质量相关（所有P < .001）。临时性 PTSD、IE 和抗生素后肠道问题在 IBS 中更为常见（所有P < .001），多次就诊 ( P < .01) 和住院治疗 ( P = .04) 也是如此。非 IBS 和 IBS 亚组的比较揭示了心理合并症 ( P < .01)、多次就诊 ( P < .01)、住院治疗 ( P = .03)、IE ( P < .01) 和肠道问题之间的总体关联IE ( P = .03) 或抗生素 ( P < .01) 亚组后。伴有便秘的 IBS 患者在 IE 后观察到最高的焦虑和抑郁评分、创伤后应激障碍 (PTSD)、多次就诊、住院治疗和肠道问题。在调整分析中，IBS 与焦虑（优势比 [OR]，3.47）、抑郁（OR，2.88）、生活质量较低、PTSD（OR，3.09）、IE（OR，4.44）相关（所有P < .001））、抗生素后肠道问题（OR，1.84）、多次就诊（OR，2.08）和住院治疗（OR，1.78）。