Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by chronic abdominal pain, diarrhea, constipation, and fluctuating bowel movement patterns between constipation and diarrhea. Some patients may also experience bloating, a feeling of incomplete bowel evacuation, and general discomfort [1]. Approximately 11% of the global population is affected by IBS, with female representing 55% of those impacted [2,3]. Its prevalence ranges from 10% to 25% in the United States, 17% to 21% in South America, 7% to 9% in South Asia, and 5.6% in the Middle East and Africa [2-4]. Notably, the prevalence of IBS is higher among college students in their 20s compared to other age groups [5]. Recent studies suggest that IBS poses social, economic, and psychological challenges, significantly affecting quality of life. Additionally, diagnosing and treating IBS can be difficult due to its influence on the visceral-brain axis, which is linked to mental health issues such as anxiety and depression [6].

Telomeres are specialized structures located at the ends of chromosomes that, along with their associated protein complexes, protect DNA and maintain genomic stability [7]. Each cell division results in the loss of telomeric repeats due to the incomplete replication of the chromosome’s 3’ end, leading to critically short telomeres that can trigger cellular senescence or crisis [8]. Telomere length (TL) progressively decreases with age; however, this decline is accelerated by oxidative stress and inflammation. TL is established at birth in individuals and reflects the cumulative effects of inflammation and oxidative stress throughout life [9,10]. Telomeres may be linked to various diseases, particularly those related to aging and neurodegeneration [11-13]. However, there was only one study about telomere change and its clinical characteristics in IBS patients [14]. This study showed that patients with IBS presented shorter TL when compared to healthy controls. For better understand this relationship, we aimed to determine clinical characteristics of patients with IBS and telomere in this study. As telomere may vary depending on age and genetic status, this study was performed in college students without hereditary disorder.

In the present study, TL was successfully measured in all 38 participants. The average TL was 4.40 ± 3.87, and participants were categorized into high and low TL groups based on the median value. The clinical characteristics of individuals with IBS and their TL were examined, with the findings summarized in Table 1. IBS was classified into three subtypes: diarrhea-predominant, constipation-predominant, and mixed types, none of which showed a significant association with TL. Female and smoking habits showed a tendency towards shorter TL, although these associations were not statistically significant (p = 0.192 and p = 0.157, respectively). Other clinical characteristics did not demonstrate any relationship with TL.

The average severity score of IBS symptoms in this study was 319.42 ± 64.84. Correlation analysis indicated a trend towards a negative association between IBS severity and TL (r = –0.285, p = 0.083; Fig. 1), although this relationship was not statistically significant. The correlation between VAS scores and TL was also examined, with the results shown in Table 2. TL was found to be negatively correlated with bloating (Q2) (r = –0.283, p = 0.086), though this correlation did not reach statistical significance. Most of VAS scores correlated to each other.

Telomeres, the protective caps at the ends of chromosomes, have been implicated in the pathogenesis of various diseases. In numerous chronic conditions, such as cardiovascular diseases, diabetes, and neurodegenerative disorders, telomere shortening has been associated with cellular aging and tissue dysfunction [9-11]. TL serves as a biomarker of cellular health, as its reduction reflects diminished replicative capacity of cells, leading to increased susceptibility to disease. In cancer, while short telomeres can contribute to genomic instability and tumorigenesis, some cancers exhibit abnormally long telomeres that enable uncontrolled cell division [16,17]. As such, understanding the role of telomeres in disease mechanisms could offer new insights into disease prevention, prognosis, and potential therapeutic strategies.

A previous study demonstrated that patients with IBS had significantly shorter telomeres compared to healthy controls [14]. Moreover, TL was shorter in IBS patients attributed to mental or psychological factors than in those affected by other factors. Interestingly, TL was longer in IBS patients who had taken antidepressants. In this study, we also confirmed the relationship between TL and the clinical features of IBS. To control for variables related to age and TL, the study was conducted exclusively with patient groups from specific age ranges. Unexpectedly, TL was found not to be associated with any clinical characteristics of IBS.

In this study, we observed a potential correlation between TL and the severity of IBS, although this correlation did not reach statistical significance. Our findings suggest that more severe IBS symptoms are associated with shorter TL, which is consistent with previous research indicating shorter TL in individuals with IBS compared to healthy controls [14]. Additionally, telomere shortening was linked to symptoms such as bloating and flatulence. Several studies have shown that mental and psychological factors in IBS are associated with shorter telomeres [18,19]. The stress induced by the severity of IBS may contribute to cellular senescence, leading to telomere shortening. Several hypotheses have been proposed to explain this mechanism. For example, changes in the intestinal microbiome in IBS may alter physiological and metabolic processes, potentially triggering cellular senescence [20,21]. Other research suggests that elevated glucocorticoid levels in IBS could accelerate stress-related aging of the epigenome, promoting telomere shortening [22,23]. However, the precise mechanisms underlying telomere regulation in IBS remain unclear, and further studies are needed to explore the detailed molecular pathways involved.

This is the first study to explore the relationship between IBS severity and TL; however, it has some limitations. The sample size was small, and there is a lack of data on the progression of IBS. Additionally, the VAS is subjective, as it assesses disease severity based on a questionnaire. Therefore, further long-term follow-up studies using objective experimental models are needed. IBS is not classified as a major disease, but, ongoing research is essential to improve the quality of life for patients.