Medication risks an acceptable trade-off for cure of IBS symptoms

Patients with irritable bowel syndrome (IBS) are willing to take on significant medication risks in exchange for a permanent cure of their symptoms, a study has found.

Researchers looked at 752 adult patients with Rome IV-defined IBS and collected demographic data. They also assessed the gastrointestinal symptoms, psychological health, and quality of life of the patients, as well as the disease’s impact on work and daily activities.

A standard gamble was used to examine the median willingness to take on the risk of death in return for cure with a hypothetical medication. Results showed that the patients would accept a median 2.0 percent (interquartile range [IQR], 0.0–9.0) risk of death in exchange for a 98.0 percent (IQR, 91.0–100.0) chance of permanent symptom cure.

The median accepted risk of death was notably higher in men vs women (5 percent vs 2 percent; p<0.001), patients with vs without continuous abdominal pain (4 percent vs 1 percent; p<0.001), in the presence of more vs less severe symptoms (p=0.005 for trend), abnormal vs normal depression scores (p<0.001 for trend), higher vs low gastrointestinal symptom-specific anxiety (p<0.001 for trend), and lower vs high IBS-related quality of life (p<0.001).

Further analysis reinforced that the patients who were willing to accept above median risk of death were more likely to be men (17.1 percent vs 9.1 percent; p<0.001), take higher levels of risks in their daily life (p=0.008 for trend), report continuous abdominal pain (53.1 percent vs 39.4 percent; p<0.001), and have higher depression (p=0.004 for trend) and lower quality of life (p<0.001 for trend) scores.

In light of the present data, the researchers acknowledged that the willingness to accept risk from medication fluctuates over time, and whether the changing clinical course of IBS influences this is unclear. Additional studies are needed to address these issues.