O63 Gastrointestinal symptom-specific anxiety and symptom severity in irritable bowel syndrome: new insights from factor analysis

Introduction Gastrointestinal symptom-specific anxiety and somatisation have both been associated with higher symptom severity in patients with irritable bowel syndrome (IBS). However, the relationship between these two factors and IBS symptom severity has not been explored fully. In addition, the performance of the instrument that measures gastrointestinal symptom-specific anxiety, the visceral sensitivity index (VSI), has not been examined in a UK population. We conducted a cross-sectional survey to examine these issues. Methods We measured levels of gastrointestinal symptom-specific anxiety, using the VSI, somatisation via the patient health questionnaire-12 (PHQ-12), as well as symptom severity in adult subjects from the UK community with Rome IV-defined IBS. We carried out exploratory factor analysis on the VSI, prior to subsequent analyses, to establish its factor structure. We carried out multiple regression analysis to determine the relationship between demographic features, different factors of the VSI, somatisation, and IBS symptom severity. Results 811 individuals with IBS provided complete data. The mean age was 47.4 years, and 85.9% were female. Factor analysis of the VSI revealed a three-factor structure, accounting for 47% of the variance. Three VSI items that loaded onto factor one were concerned with awareness of abdominal discomfort and two with worry about abdominal symptoms. Items that loaded onto factor two were concerned with fear that symptoms were caused by a serious underlying illness. Items loading onto factor three were concerned with the fear of symptoms in the context of new experiences, for example trying new foods or having access to toilets in places that someone hasn’t visited before. Both factor one of the VSI and the PHQ-12 were strongly and independently associated with IBS symptom severity, for the group as a whole (p Conclusions The factor structure of the VSI requires further investigation. Our findings cast doubt on the central role of gastrointestinal symptom-specific anxiety as a driver for symptom severity in IBS. Awareness of both gastrointestinal and extra-intestinal symptoms, however, is strongly associated with symptom severity.