Abdominal bloating frequency and clinical burden in irritable bowel syndrome classified using an operationalized Rome V algorithm.

INTRODUCTION

abdominal bloating is common in irritable bowel syndrome (IBS), but its frequency and clinical associations remain incompletely characterized. We aimed to evaluate abdominal bloating frequency and its association with clinical burden in IBS classified using an operationalized Rome V algorithm.

METHODS

in a prospectively recruited sample, we conducted cross-sectional analyses of baseline associations. Consecutive patients with IBS completed validated questionnaires assessing gastrointestinal symptoms, psychological comorbidities, and health-related quality of life. Patients were classified by bloating frequency (≥ 1 day/week vs. < 1 day/week). Between-group comparisons and multivariable logistic regression were performed.

RESULTS

among 443 patients classified using the operationalized Rome V algorithm, 211 (47.6 %) reported abdominal bloating ≥1 day/week. Compared with those with less frequent bloating, these patients had greater IBS symptom severity and more frequent functional dyspepsia overlap and food-related symptoms (all p < 0.05). They also showed higher psychological comorbidity across five domains (anxiety, depression, gastrointestinal-specific anxiety, somatic symptom, and perceived stress, all p < 0.001), poorer quality of life (p < 0.001), and more gastroenterology clinic and emergency department visits (p < 0.001 and p = 0.022, respectively). On multivariable logistic regression, functional dyspepsia overlap and higher gastrointestinal, anxiety, and somatic symptom burden were independently associated with weekly bloating. Sensitivity analyses restricted to patients meeting the Rome IV criteria yielded similar findings.

DISCUSSION: abdominal bloating ≥1 day per week affects nearly half of patients with operationalized Rome V IBS and is associated with greater symptom severity, higher psychological burden, poorer quality of life, and increased healthcare utilization. Assessing bloating frequency may help identify patients with greater clinical burden.