Phenotypic Characteristics of Patients With Irritable Bowel Syndrome: Association Between Gastrointestinal Symptoms and Psychological Factors – A Pilot Study

Irina Milovac; Zoran Mavija; Vanja Vidović; Stojko Vidović

doi:10.5937/scriptamed57-66161

Irina Milovac Medicinski fakultet, Katedra za humanu genetiku, Univerzitet u Banjoj Luci
Zoran Mavija Clinic of Gastroenterology and Hepatology, University Clinical Centre of the Republic of Srpska
Vanja Vidović Department of Human Genetics, Faculty of Medicine, University of Banja Luka,Centre for Biomedical Research, Faculty of Medicine, University of Banja Luka
Stojko Vidović Department of Human Genetics, Faculty of Medicine, University of Banja Luka,Centre for Biomedical Research, Faculty of Medicine, University of Banja Luka,Academy of Sciences and Arts of the Republic of Srpska

DOI: https://doi.org/10.5937/scriptamed57-66161

Keywords: Irritable bowel syndrome, Brain–gut axis, Visceral sensitivity, Hypersensitivity, Somatoform disorders, Psychological distress

Abstract

Background/Aim: Irritable bowel syndrome (IBS) is a heterogeneous functional gastrointestinal (GI) disorder frequently associated with psychological symptoms. Phenotypic characterisation of patients may improve understanding of the relationship between gastrointestinal and psychological dimensions. The aim of this pilot study was to describe gastrointestinal and psychological phenotypic features in IBS patients and to examine their interrelationships.

Methods: The study included 20 IBS patients (8 IBS-D, 7 IBS-M, 5 IBS-C) and 9 healthy controls. Gastrointestinal symptoms were assessed using the GSRS and VSI questionnaires, while psychological status was evaluated with the PHQ-15 and HADS. Groups were compared using independent samples t-tests and correlations within the IBS group were analysed using Spearman’s correlation. Statistical analysis was performed using SPSS.

Results: IBS patients demonstrated significantly more severe GI symptoms and higher somatic symptom perception compared to controls (p < 0.01). Within the IBS group, strong correlations were observed between VSI and PHQ-15 (p = 0.740, p < 0.001) and between GSRS and PHQ-15 (p = 0.605, p = 0.001). Associations between HADS and GI symptoms were weaker; the correlation with GSRS was not statistically significant (p = 0.333, p = 0.078), while the correlation with VSI reached statistical significance (p = 0.484, p = 0.008).

Conclusion: Gastrointestinal symptoms in IBS patients are strongly associated with somatic symptom perception, whereas associations with general anxiety and depression are weaker. These findings support the heterogeneity of the IBS phenotype and highlight the importance of individualised assessment of gastrointestinal and psychological dimensions in clinical practice.

References

Drossman DA, Hasler WL. Rome IV—functional GI disorders: disorders of gut brain interaction. Gastroenterology. 2016;150(6):1257 61. doi: 10.1053/j.gastro.2016.03.035.

Ford AC, Sperber AD, Corsetti M, Camilleri M. Irritable bowel syndrome. Lancet. 2020;396(10263):1675 88. doi: 10.1016/S0140-6736(20)31809-0.

Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32(9):920 4. doi: 10.3109/00365529709011203.

Ramic J, Milovac I, Mavija Z, Lojo Kadric N, Hadzic M, Vidovic S, et al. Fecal microbiome diversity in irritable bowel syndrome (IBS) clinical subtypes. Arch Clin Biomed Res. 2021;5(1):125 36. doi: 10.26502/acbr.50170155.

Shaikh SD, Sun N, Canakis A, Park WY, Weber HC. Irritable bowel syndrome and the gut microbiome: a comprehensive review. J Clin Med. 2023;12(7):2558. doi: 10.3390/jcm12072558.

Saeedinia E, Poursharifi H, Momeni F, Vahedi M, Sadeghi A, Abdi M, et al. Psychological determinants of irritable bowel syndrome and its impact on quality of life: a machine learning approach. Gastroenterol Hepatol Bed Bench. 2025;18(1):100 14. doi: 10.22037/ghfbb.v18i1.3082.

Mayer EA, Tillisch K. The brain gut axis in abdominal pain syndromes. Annu Rev Med. 2011;62:381 96. doi: 10.1146/annurev-med-012309-103958.

Camilleri M. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med. 2012;367(17):1626 35. doi: 10.1056/NEJMra1207068.

Soufan F, Ghosson A, Jaber R, Ghandour A, Uwishema O. The gut brain axis in irritable bowel syndrome: implementing the role of microbiota and neuroimmune interaction in personalized prevention—a narrative review. Health Sci Rep. 2025;8(4):e70660. doi: 10.1002/hsr2.70660.

Agarwal N, Spiegel B. The effect of irritable bowel syndrome on health related quality of life and health care expenditures. Gastroenterol Clin North Am. 2010;40(1):11 19. doi: 10.1016/j.gtc.2010.12.013.

Bhinder G, Meza Cardon JM, Low A, Aumais G, Attara GP, Gray JR, et al. Irritable bowel syndrome patient experience: a survey of patient reported symptoms by irritable bowel syndrome subtype and impact on quality of life. J Can Assoc Gastroenterol. 2023;6(6):219 28. doi: 10.1093/jcag/gwad028.

Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig Dis Sci. 1998;43(2):400 11. doi: 10.1023/A:1018831127942.

Gómez Castaños PC. Irritable bowel syndrome classification and subtypes. Clin Gastroenterol Mex (Engl Ed). 2025;1(1):21 30. doi: 10.24875/cgme.m25000004.

Grinsvall C, Törnblom H, Tack J, Van Oudenhove L, Simrén M. Relationships between psychological state, abuse, somatization and visceral pain sensitivity in irritable bowel syndrome. United Eur Gastroenterol J. 2018;6(2):300 9. doi: 10.1177/2050640617715851.

Svedlund J, Sjödin I, Dotevall G. GSRS—a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci. 1988;33(2):129 34. doi: 10.1007/BF01535722.

Labus JS, Bolus R, Chang L, Wiklund I, Naesdal J, Mayer EA, et al. The Visceral Sensitivity Index: development and validation of a gastrointestinal symptom specific anxiety scale. Aliment Pharmacol Ther. 2004;20(1):89 97. doi: 10.1111/j.1365-2036.2004.02007.x.

Kroenke K, Spitzer RL, Williams JB. The PHQ 15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med. 2002;64(2):258 66. doi: 10.1097/00006842-200203000-00008.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361 70. doi: 10.1111/j.1600-0447.1983.tb09716.x.

COST Association. COST Action BM1106 GENIEUR: Harmonized assessment tools for IBS research [Internet]. [Cited: 1-Mar-2026]. Available from: https://www.cost.eu/actions/BM1106/.

Deiteren A, de Wit A, van der Linden L, de Man JG, Pelckmans PA, de Winter BY. Irritable bowel syndrome and visceral hypersensitivity: risk factors and pathophysiological mechanisms. Acta Gastroenterol Belg. 2016;79:29 38.

Dudzinska E, Grabrucker AM, Kwiatkowski P, Sitarz R, Skienkiewicz M. The importance of visceral hypersensitivity in irritable bowel syndrome—plant metabolites in IBS treatment. Pharmaceuticals (Basel). 2023;16:1405. doi: 10.3390/ph16101405.

Qin H, Cheng C, Tang X, Bian Z. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20(39):14126 31. doi: 10.3748/wjg.v20.i39.14126.

Li X, Li X, Xiao H, Xu J, He J, Xiao C, Zhang B, et al. Meta analysis of gut microbiota alterations in patients with irritable bowel syndrome. Front Microbiol. 2024;15:1492349. doi: 10.3389/fmicb.2024.1492349.

Black CJ, Ford AC. Personalisation of therapy in irritable bowel syndrome: a hypothesis. Lancet Gastroenterol Hepatol. 2024;9(12):1162 76. doi: 10.1016/S2468-1253(24)00245-0.

World Gastroenterology Organisation. Irritable bowel syndrome global guidelines [Internet]. [Cited: 1-Mar-2026]. Available from: https://www.worldgastroenterology.org/guidelines/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs-english.