ABDOMINAL bloating in patients with irritable bowel syndrome (IBS) was associated with greater symptom severity, higher psychological burden, poorer quality of life, and increased healthcare utilisation, according to a cross-sectional analysis of patients classified using an operationalised Rome V algorithm.
Abdominal bloating is a common feature of IBS, although its frequency and clinical implications have not been fully characterised. To investigate this, researchers analysed baseline data from a prospectively recruited cohort of consecutive patients with IBS. Participants completed validated questionnaires assessing gastrointestinal symptoms, psychological comorbidities, and health related quality of life. Patients were grouped according to abdominal bloating frequency, defined as at least 1 day per week or less than 1 day per week. Statistical analyses included between group comparisons and multivariable logistic regression to identify factors independently associated with weekly bloating.
Among 443 patients classified using the operationalised Rome V algorithm, 211 (47.6%) reported abdominal bloating on at least 1 day per week. Compared with those who experienced bloating less frequently, these patients had more severe IBS symptoms and more frequent overlap with functional dyspepsia, alongside a higher prevalence of food related symptoms. All these associations reached statistical significance (p<0.05).
Patients reporting weekly abdominal bloating also demonstrated a greater psychological burden across five assessed domains, including anxiety, depression, gastrointestinal specific anxiety, somatic symptoms, and perceived stress (all p<0.001). In addition, they reported poorer health related quality of life (p<0.001). Healthcare utilisation was also higher in this group, with more visits to gastroenterology clinics (p<0.001), and emergency departments (p=0.022).
Multivariable logistic regression showed that functional dyspepsia overlaps together with greater gastrointestinal anxiety and somatic symptom burden remained independently associated with abdominal bloating occurring at least weekly. Sensitivity analyses restricted to patients who met Rome IV criteria produced similar findings.
The findings suggested that abdominal bloating occurring at least once each week affected almost half of patients with IBS classified using the operationalised Rome V algorithm and identified individuals with a substantially greater clinical burden.
The researchers concluded that abdominal bloating occurring at least 1 day per week affected nearly half of patients with irritable bowel syndrome classified using the operationalised Rome V algorithm and was associated with greater symptom severity, higher psychological burden, poorer quality of life, and increased healthcare utilisation. They suggested that assessing bloating frequency may help identify patients with greater clinical burden.
Reference
Thongchuenjit S et al. Abdominal bloating frequency and clinical burden in irritable bowel syndrome classified using an operationalized Rome V algorithm. Rev Esp Enferm Dig. 2026;DOI:10.17235/reed.2026.12014/2026.
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