Background Health-related quality of life (HRQOL) is impaired in patients with systemic lupus erythematosus (SLE). Irritable bowel syndrome (IBS) is highly prevalent and also reduces HRQOL. However, the relationship between IBS in SLE and its impact on HRLQOL has not been explored.
Objectives To evaluate the prevalence and risk factors for IBS in patients with SLE and its impact on HRQOL.
Methods Patients with confirmed SLE according to American College of Rheumatology (ACR) criteria were included in this cross-sectional study. Sociodemographic and clinical variables were recorded. HRQOL was assessed using the Short Form 36 (SF-36) instrument; fibromyalgia (FM) and depression symptoms were also evaluated. The diagnosis of IBS was based on the Rome III criteria.
Results 105 women with SLE were included. The mean age and disease duration were 43.6±11.3 and 10.4±7.3 years, respectively. FM was present in 23.8% of patients. Fifty-one (48.6%) patients were diagnosed with IBS. The prevalence of IBS-C, IBS-D and IBS-M subtypes was 23.5%, 37.3% and 39.2%, respectively. IBS-C patients had higher depression scores than those of the other subtypes. Compared with non-IBS patients, those with IBS were more likely to have FM (33.0% vs. 14.8%; p= 0.02) and had higher SLE activity scores (2.5±8.6 vs. 1.7±2.0; p=0.03). Logistic multivariate analysis showed that IBS was significantly associated with depression and FM in SLE patients (OR= 1.07 95% CI: 1.02-1.13 and OR= 2.85 95% CI: 1.1-7.4, respectively). SF-36 scores were significantly lower in IBS patients compared with non-IBS patients (49.6 ± 18.5 vs. 62.6 ± 18.1; p = 0.025). There was a trend to a lower SF-36 lower global score in patients with IBS+FM compared to those without FM (p = 0.76).
Conclusions IBS is highly prevalent among women with SLE. Risk factors for this association were depression and fibromyalgia. SLE patients with IBS have worse HRQOL, independently of the presence of FM. We suggest that treating IBS may improve HRQOL in patients with SLE.
References Morgan DR, Squella FE, Pena E, Mearni F, Rey E, Enriquez-Blanco HE, et al. Multinational validation of the Spanish ROME III adult diagnostic questionnaire: comparable sensitivity and specificity to English instrument. Gastroenterology 2012;138:S386.
Lopez-Colombo A, Morgan D, Bravo-González D, Montiel-Jarquín A, Méndez-Martínez S, Schmulson M. The epidemiology of functional gastrointestinal disorders in Mexico: A population-based study. Gastroenterol Res Pract 2012;2012:606174
Acknowledgements We would like to thank to David Buss for the valuable guidance and advice in this project.
Disclosure of Interest None Declared