IBS symptoms tied to depression, anxiety in NAFLD patients

Patients with nonalcoholic fatty liver disease (NAFLD) tend to have higher rates of irritable bowel syndrome (IBS) symptoms, depression, and anxiety, suggests a study.

This cross-sectional study included 130 patients in the hepatology clinic at Houston Methodist Hospital, Texas, US, based on a respondent postal survey. Those with inflammatory bowel disease, colorectal carcinoma, or small bowel tumours were excluded.

IBS was defined by the Rome IV questionnaire, while anxiety and depression were assessed using the Hospital Anxiety Depression scale. The researchers grouped patients based on Rome IV diagnostic criteria for IBS and Hospital Anxiety Depression scale.

Of the patients, 38 met the Rome IV criteria for IBS (IBS group) while 92 did not (non-IBS group). Depression (18.4 percent vs 5.4 percent; p=0.01) and anxiety (31.6 percent vs 9.8 percent; p=0.002) were more prevalent in patients with IBS.

Four multiple logistic regression models showed that female sex, depression, and body mass index >30 kg/m² independently predicted IBS in patients with NAFLD.

Moreover, gamma-glutamyl transferase levels were lower in patients with newly diagnosed IBS (67.5 vs 28; p=0.04). Additionally, abdominal pain (100 percent vs 81.3 percent; p=0.045) and pain associated with the change in stool frequency (96.3 percent vs 50 percent; p<0.001) were higher in the IBS group.

“Clinicians should be alert when IBS symptoms are reported by a NAFLD patient and be aware of the impact of these comorbidities on quality of life and response to therapy,” the researchers said.

“IBS affects 10 percent to 15 percent of the adult population worldwide and is linked to anxiety and depression” they noted.