Quality of Life and Bidirectional Gut-Brain Interactions in Irritable Bowel Syndrome From Adolescence to Adulthood

Reports on cross-sectional and longitudinal associations between health-related quality of life (HRQoL), psychological distress, and irritable bowel syndrome (IBS) in the adolescent and young adult general population are few. We aimed to describe cross-sectional associations between HRQoL and IBS in adolescence and young adulthood, and examine bi-directional gut-brain interactions in the transition from childhood to adulthood. We included 3391 subjects from a prospective birth cohort study, with data on IBS at 16y and 24y. IBS was assessed using the pediatric Rome III (16y) and the adult Rome IV (24y) diagnostic questionnaires. HRQoL and psychological distress were assessed through EQ-5D. Sex-adjusted logistic regression models were used to examine associations between overall HRQoL/psychological distress at 16y and new-onset IBS at 24y (brain-gut), and between IBS at 16y and new-onset psychological distress at 24y (gut-brain). In subjects with vs. without IBS at 16y and 24y respectively, overall HRQoL (EQ VAS, EQ-5D index value) was lower, and it was more common reporting problems in four of five EQ-5D dimensions (all P<0.05). EQ-5D index value at 16y was inversely associated (OR 0.1, 95% CI 0.01-0.6), and psychological distress at 16y was positively associated (OR 1.6, 95% CI 1.2-2.3), with new-onset IBS at 24y. Having any abdominal pain-related disorder of gut-brain interaction (AP-DGBI) at 16y was associated with new-onset psychological distress at 24y (OR 1.7, 95% CI 1.2-2.5). Adolescents and young adults with IBS in the general population have impaired HRQoL. Bi-directional gut-brain interactions are relevant for symptom generation in AP-DGBI, and for HRQoL impairment and psychological distress in the transition from childhood to adulthood.