Clinical and extra-intestinal factors associated with irritable bowel syndrome: A case–control study

BACKGROUND: Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. Its pathophysiology remains incompletely understood, and no objective diagnostic markers are currently available. Diagnosis is based on the Rome IV criteria, which rely exclusively on gastrointestinal symptoms and may be limited in routine clinical practice. AIM: To develop a clinical score for IBS incorporating extra-intestinal factors, including mental health disorders, medication use, pain-related conditions, demographic characteristics, and medical history. METHODS: A case-control study including 109 participants was conducted. Clinical information, medication use, demographic data, and validated mental health questionnaires were collected through structured personal interviews. Variables associated with IBS in univariate analysis were included in a multivariate logistic regression model to develop the final probability score. RESULTS: A clinical score including six variables was developed: history of drug allergy, migraine, anxiety, Hospital Anxiety and Depression Scale score>7, low perceived work responsibility, and proton pump inhibitor use. The score estimates the probability of being classified as IBS in this model, with a sensitivity of 80.4% and a specificity of 73.6%. CONCLUSIONS: This clinical score integrates extra-intestinal factors and provides a more comprehensive approach to IBS assessment in clinical practice. Its use may facilitate earlier identification of patients with suspected IBS, although further studies are needed to validate its usefulness in primary care settings.