Are bowel symptoms and psychosocial features different in irritable bowel syndrome patients with abdominal discomfort compared to abdominal pain?

Table 1 Demographic data for irritable bowel syndrome patients with abdominal pain alone, abdominal discomfort alone, and abdominal pain & discomfort

Variable	Pain group (n = 233)	Discomfort group (n = 83)	Pain & discomfort group (n = 51)	P value
Male, %	117 (50.2)	56 (67.5)	32 (62.7)	0.012
Age in yr	43.7 ± 11.7	42.3 ± 10.6	40.8 ± 11.0	0.23
BMI in kg/m2	23.0 ± 4.0	22.8 ± 4.0	22.3 ± 3.8	0.56
Education level, college and above, %	71 (30.5)	29 (34.9)	13 (25.5)	0.51
Physical labor, %	135 (57.9)	42 (50.6)	34 (66.7)	0.18
Family economic status, well-off & above, %	105 (45.1)	44 (53.0)	18 (35.3)	0.13
Marriage status, married, %	201 (86.3)	71 (85.5)	41 (80.4)	0.56
IBS disease course in yr1	6.0 (7.5)	5.3 (7.0)	6.0 (7.0)	0.38
IBS type				0.06
IBS-D, %	95.7	96.4	86.3
IBS-C, %	3.0	2.4	7.8
IBS-M, %	1.3	1.2	5.9

¹Data presented as median (interquartile range), Kruskal-Wallis test. Note: P value is the difference among pain group, discomfort group, and pain & discomfort group, superscript letter is significantly different at a P < 0.05.

²The difference is between the pain group and discomfort group.

Data presented as number (%) or mean ± SD. Analysis of variance and χ² tests. IBS-D: Irritable bowel syndrome with diarrhea; BMI: Body mass index; IBS-C: Irritable bowel syndrome with constipation; IBS-M: Mixed irritable bowel syndrome.

Table 2 Characteristics of bowel symptoms in irritable bowel syndrome patients with abdominal pain alone, abdominal discomfort alone, and abdominal pain & discomfort

Variable	Pain group (n = 233)	Discomfort group (n = 83)	Pain & discomfort group (n = 51)	P value
Location1, %				0.213
Left lower quadrant	67 (28.8)	14 (16.9)	12 (23.5)
Umbilical	79 (33.9)	27 (32.5)	20 (39.2)
Lower abdomen	65 (27.9)	23 (27.7)	15 (29.4)
Epigastric	11 (4.7)	2 (2.4)	2 (3.9)
Whole abdomen	12 (4.0)	8 (9.6)	5 (9.8)
Others	24 (10.3)	18 (21.7)	7 (13.7)
Severity, %				0.007
Mild	21 (9.0)	19 (22.9)	6 (11.7)
Moderate	160 (68.7)	55 (66.3)	37 (72.6)
Severe	52 (22.3)	9 (10.8)	8 (15.7)
Frequency, %				0.290
3 d/mo	37 (15.9)	11 (13.3)	4 (7.84)
1 d/wk	25 (10.7)	5 (6.0)	2 (3.9)
>1 d/wk	108 (46.4)	38 (45.8)	27 (52.94)
Every day	63 (27.0)	29 (34.9)	18 (35.3)
Ordinary pain/discomfort, %				< 0.001
Pain alone	84 (36.1)	6 (7.2)	6 (11.8)
Discomfort alone	21 (9.0)	43 (51.8)	3 (5.9)
Pain & discomfort	7 (3.0)	2 (2.4)	28 (54.9)
No pain or discomfort	121 (51.9)	32 (38.6)	14 (27.4)
Defecation-related symptoms, %
Abdominal bloating	93 (39.9)	43 (51.8)	35 (68.6)	0.0013
Abdominal distension	21 (9.0)	13(15.7)	12 (23.5)	0.013
Urgency	197 (84.6)	80 (96.4)	42 (82.4)	0.012,4
Defecation straining	70 (30.0)	25 (30.1)	23 (45.1)	0.10
Sensation of anorectal obstruction	62 (26.6)	30 (36.1)	19 (37.3)	0.13
Anorectal pain	28 (12.0)	15 (18.1)	17 (33.3)	0.0013
Sensation of incomplete evacuation	164 (70.4)	74 (89.2)	39 (76.5)	0.0032
Passing mucus	141 (60.5)	66 (79.5)	39 (76.5)	0.0022

¹Some patients reported more than one location. χ² test, data presented as number (%).

²The difference is between pain group and discomfort group.

³The difference is between pain group and pain & discomfort group.

⁴The difference is between discomfort group and pain & discomfort group.

P value is the difference among pain group, discomfort group, and pain & discomfort group, and superscript letters are significantly different at a P < 0.05.

Table 3 Coexisting extraintestinal symptoms of irritable bowel syndrome patients with abdominal pain alone, abdominal discomfort alone, and abdominal pain & discomfort

Variable	Pain group (n = 233)	Discomfort group (n = 83)	Pain & discomfort group (n = 51)	P value
GERD, %	60 (25.8)	14 (16.9)	10 (19.6)	0.20
Heartburn	35 (15.0)	6 (7.2)	6 (11.8)	0.18
Acid reflux	44 (18.9)	10 (12.1)	5 (9.8)	0.15
Food regurgitation	14 (6.0)	4 (4.8)	3 (5.9)	0.92
Retrosternal chest pain	10 (4.3)	3 (3.6)	2 (3.9)	0.96
Functional dyspepsia, %	86 (36.9)	23 (27.7)	18 (35.3)	0.32
Epigastric pain syndrome	49 (21.0)	6 (7.2)	7 (13.7)	0.012
Epigastric pain	43 (18.5)	5 (6.0)	7 (13.7)	0.022
Epigastric burning	12 (5.2)	2 (2.4)	3 (5.9)	0.54
Postprandial distress syndrome	64 (27.5)	22 (26.5)	15 (29.4)	0.94
Postprandial fullness	57 (24.5)	20 (24.1)	9 (17.7)	0.57
Early satiation	14 (6.0)	6 (7.2)	9 (17.7)	0.023
Somatic pain, %
Headache	17 (45.9)	37 (44.6)	26 (51.0)	0.76
Neck pain	21 (9.0)	7 (8.4)	3 (5.9)	0.77
Backache	41 (17.6)	8 (9.6)	7 (13.7)	0.21
Dyspareunia	12 (5.2)	6 (7.2)	11 (21.6)	< 0.0013,4
Menstrual pain1	30 (25.9)	10 (37.0)	11 (57.9)	0.0163

¹The number of female patients in the abdominal pain, abdominal discomfort, and pain & discomfort groups was 116, 27, and 19, respectively. χ² test. Data presented as number (%).

²P value is difference between the pain group and the discomfort group.

³The difference is between the pain group and the pain & discomfort group.

⁴The difference is between the discomfort group and the pain & discomfort group.

P value is the difference among the pain group, discomfort group, and pain & discomfort group, and superscript letters are significantly different at P < 0.05. GERD: Gastroesophageal reflux disease.

Table 4 Comorbid anxiety and depression among irritable bowel syndrome patients with abdominal pain alone, abdominal discomfort alone, and abdominal pain & discomfort

Variable	Pain group (n = 233)	Discomfort group (n = 83)		Pain & discomfort group (n = 51)	P value
HAMA score	16.1 ± 7.3		15.5 ± 7.3	17.3 ± 7.4	0.36
Comorbid anxiety, %	141 (60.5)		49 (59.0)	38 (74.5)	0.14
Mild	69 (29.6)		25 (30.1)	21 (41.2)	0.26
Moderate-severe	72 (30.9)		24 (28.9)	17 (33.3)	0.86
HAMD score	13.2 ± 6.2		12.3 ± 6.1	14.3 ± 5.5	0.18
Comorbid depression, %	66 (28.3)		22 (26.5)	18 (35.3)	0.53
Mild	54 (23.2)		20 (24.1)	17 (33.3)	0.31
Moderate-severe	12 (5.2)		2 (2.4)	1 (2.0)	0.40
Comorbid anxiety & depression, %	62 (26.6)		20 (24.1)	18 (35.3)	0.35

Data presented as mean ± SD or number (%). Student’s t test and χ²tests. P value is difference among the pain group, discomfort group, and pain & discomfort group. HAMA: Hamilton Anxiety Scale; HAMD: Hamilton Depression Scale.

Table 5 Consultations and medications of irritable bowel syndrome patients with abdominal pain alone, abdominal discomfort alone, and abdominal pain & discomfort

Variable	Pain group (n = 233)	Discomfort group (n = 83)	Pain & discomfort group (n = 51)	P value
In the whole disease course
Consultation times per year1	4.6 ± 6.7	5.7 ± 6.2	4.2 ± 4.1	0.54
Colonoscopies2	1.9 ± 1.4	1.5 ± 0.8	1.6 ± 0.9	0.22
In the last year
Consultation times1	4.0 ± 5.7	4.5 ± 4.5	4.9 ± 4.7	0.54
Medications, intermittent and long-term use, %	164 (70.4)	56 (67.5)	43 (84.3)	0.09
Antispasmodics use
Use rate	29 (12.4)	24 (28.9)	12 (23.5)	0.0023
Response rate	22 (75.9)	13 (54.2)	10 (83.3)	0.12
Overall satisfaction to medical care, %	125 (53.7)	39 (47.0)	21 (41.2)	0.21

¹Consultation times were average consultation times of consulters.

²Colonoscopies were average colonoscopies of patients who performed colonoscopies.

³The difference is between the pain group and the discomfort group.

Data presented as mean ± SD or number (%). Analysis of variance and χ² test. P value is difference among pain group, discomfort group, and pain & discomfort group, and superscript letter is significantly different at a P < 0.05.

Table 6 Risk factors for irritable bowel syndrome patients describing symptoms as abdominal pain alone, abdominal discomfort alone, and abdominal pain & discomfort

	Partial regression coefficient	Standard error	Wald χ2	95%CI	P value
Abdominal discomfort alone vs abdominal pain alone
Male sex	0.671	0.291	5.293	1.955 (1.104-3.462)	0.021a
Severity (mild defecatory pain or discomfort)	1.391	0.525	7.018	4.020 (1.436-11.253)	0.008a
Abdominal pain alone vs abdominal pain & discomfort
Abdominal bloating	0.805	0.372	4.692	2.238 (1.080-4.638)	0.030a
Anorectal pain	1.091	0.405	7.272	2.979 (1.347-6.585)	0.007a

^aP < 0.05. Multiple logistic regression analysis. Superscript letter is significantly different at a P < 0.05.

CI: Confidence interval.