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Quality of Life and Psychological Burden in Irritable Bowel Syndrome: The Impact of Intestinal Parasitic Infections
Nourhan Badwei1, Abeer Abdelsalam2, Ghada O Wassif2
1Department of Tropical Medicine, Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Background:
Irritable bowel syndrome (IBS) is associated with impaired quality of life (QoL), anxiety and depression. Intestinal parasitic infections may exacerbate this burden, but their impact on psychological and functional outcomes remains underexplored.
Methods:
In this Phase II case-control study, 100 IBS patients and 100 age- and sex-matched healthy controls were assessed using a 36-item disease-specific QoL questionnaire and the Hospital Anxiety and Depression Scale (HADS). IBS patients were categorised as parasite-negative or parasite-positive (Giardia lamblia or Entamoeba histolytica). Subgroup analyses examined the effect of parasitic infection on QoL and psychological outcomes. Correlations between HADS scores and QoL were evaluated using Pearson's coefficient.
Results:
IBS patients exhibited significantly higher anxiety (13.8 ± 4.5 vs. 8.5 ± 4.3; p < 0.01) and depression (13.7 ± 4.4 vs. 6.9 ± 3.8; p < 0.01) scores compared to controls. QoL scores were lowest in E. histolytica-infected patients (41.0 ± 9.1), intermediate in Giardia-infected patients (54.5 ± 8.5) and highest in parasite-free IBS patients (72.0 ± 7.2). HADS anxiety (r = -0.61, p < 0.001) and depression (r = -0.58, p < 0.001) correlated negatively with QoL.
Conclusion:
IBS is associated with substantial psychological morbidity and QoL impairment, both of which are exacerbated by intestinal parasitic infection. These findings highlight the importance of addressing both infection and psychological health in comprehensive IBS management.
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