ArticleFrontiers in gastroenterology (Lausanne, Switzerland)2026
Irritable bowel syndrome-like symptoms are associated with increased healthcare utilization in patients with inflammatory bowel disease.
Article in Frontiers in gastroenterology (Lausanne, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Patients with Inflammatory Bowel Disease (IBD) experience Irritable Bowel Syndrome (IBS)-like symptoms more frequently than the general population. The impact of IBS-like symptoms on the clinical course of IBD remains uncertain. Methods: In a prospective cohort of patients with quiescent IBD, as defined by endoscopic remission, IBS-like symptoms were measured using the IBS-Symptom Severity Scale (IBS-SSS) at the time of endoscopy to define IBD patients with no IBS-like symptoms (IBS-SSS <75), mild IBS-like symptoms (IBS-SSS 75-175), and moderate-severe IBS-like symptoms (IBS-SSS >175). The primary outcome was total IBD-related healthcare utilization (HCU), while secondary outcomes included time to unscheduled/acute HCU and treatment failure among patients on biologics. Results: Among 114 patients with quiescent IBD, 53 had no IBS-like symptoms, 43 had mild IBS-like symptoms, and 18 had moderate-severe IBS-like symptoms. The median follow-up time was 3.5 years and was comparable among groups (p=0.330). Patients with mild or moderate-severe IBS-like symptoms had a higher total number of HCU events than patients without IBS-like symptoms (median (IQR): 8 (6-13) vs. 12 (9-15) vs 7 (5-11), respectively, p=0.042). After adjusting for IBD type and biologic therapy at baseline multivariable Cox proportional hazards regression analysis identified mild (HR: 3.6; 95%CI): 1.1-11.7; p=0.029) and moderate/severe (HR: 6.2; 95%CI: 1.8-21.3, p=0.004) IBS-like symptoms associated with unscheduled/acute HCU. Treatment failure did not differ by presence of IBS-like symptoms. Discussion: IBS-like symptoms in IBD are associated with increased HCU but not treatment failure. These findings suggest that IBS-like symptom burden in IBD is clinically meaningful, may drive healthcare seeking, and warrants targeted treatment within IBD care models.
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