Sex differences in the symptoms and psychological factors that influence quality of life in patients with irritable bowel syndrome

Objective To investigate the relationship between gender and symptomatology, psychological factors, and quality of life (QOL) in irritable bowel syndrome (IBS). Methods The diagnosis of IBS was made on the basis of the Rome III Criteria. A physician obtained demographic and symptom data, Zung Self-Rated Anxiety and Depression Scale scores (SAS/SDS), and IBS-specific quality-of-life ratings (IBS-QOL). Results Of the 4015 patients approached, 452 patients were diagnosed with IBS. Age ranged from 14 to 79 years (44.05+/-14.89 years) and the male to female ratio was 1 : 1.3. The gender composition between the four IBS subtypes differed significantly (P < 0.01). Male and female patients differed in their rating of abdominal pain/discomfort in terms of severity and time (P < 0.01). Groups did not differ with regard to attack frequency. Female patients more frequently reported headache, dizziness, backache, muscular soreness, inappetence, insomnia, and fatigue (P < 0.01). In comparison with men, anxiety and depression scores were significantly higher in women (P < 0.01). Severity, duration, and frequency of abdominal pain/discomfort did not correlate with IBS-QOL scores. Insomnia/fatigue was negatively correlated with IBS-QOL scores (P < 0.01). SAS and SDS scores were negatively correlated with IBS-QOL (total score and each subscale; P < 0.01). Conclusion There are significant gender differences in the symptoms, psychological rating, and QOL scores in IBS. Somatic symptoms, anxiety, and depression all contribute to the negative impact of IBS. Our findings suggest that gender differences should be recognized in IBS treatment. Eur J Gastroenterol Hepatol 24: 702-707 (C) 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.