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IDDF2018-ABS-0164 The temporal relationship of daily life stress, emotions and bowel symptoms in irritable bowel syndrome: a smartphone-based experience sampling study
  1. Yawen Chan1,
  2. Suzanne Ho-wai So1,
  3. Arthur Dun Ping Mak2,
  4. Kewin Tien Ho Siah2,
  5. Wai Chan1,
  6. Justin Che-yuen Wu3
  1. 1Department of Psychology, The Chinese University of Hong Kong, Hong Kong
  2. 2Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
  3. 3Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong


Background The current study aimed to model the moment-to-moment relationship between daily life stress, negative emotions and bowel symptoms among patients with irritable bowel syndrome – diarrhoea subtype (IBS-D) in the flow of daily life using a smartphone-based experience-sampling method (ESM).

Methods Patients with IBS-D (n=27) and healthy controls (HC) (n=30) completed ESM ratings of their real-time daily life stress, which was defined as the subjective stress related to daily activities, negative emotion and bowel symptoms 8 times a day for 14 consecutive days, following a baseline interview measuring bowel and mood symptoms. Moment-to-moment association between ESM variables was tested within and between groups using multilevel regression modelling.

Results Patients with IBS-D reported more severe bowel symptoms (ps <0.01) than HCs, but levels of daily life stress and negative affect were comparable between groups (ps >0.05). Time-lagged analysis of ESM data revealed that, among patients with IBS-D, daily life stress predicted a decrease in abdominal pain and urgency to defecation at a subsequent time point (ps <0.05), whereas severity of bowel symptoms and occurrence of diarrhoea predicted a subsequent increase in negative affect and daily life stress (ps <0.05). The above associations were not found among HCs (figure 1).

Abstract IDDF2018-ABS-0164 Figure 1

Conclusions ESM unveiled the dynamic relationship between bowel symptoms, stress and emotionality. Patients with IBS-D responded to bowel symptoms with more stress and distress momentarily. Counter-intuitively, daily life activity stress served as a protective factor for bowel symptoms. Our data informed the psychological understanding of IBS.

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