The Effect of Irritable Bowel Syndrome on Health-Related Quality of Life and Health Care Expenditures
Section snippets
Prevalence of IBS
It is estimated that the prevalence of IBS in North America and Europe ranges from 1% to over 20%.4, 5 This wide range indicates that IBS prevalence depends on many variables, including the case-finding definition employed (eg, Manning criteria vs Rome criteria), the characteristics of the source population (eg, primary care vs specialty clinic), and the study methods and sampling frame of the studies. To refine the prevalence estimate, it is worth evaluating the studies that specifically
Demographic predictors of IBS
Demographic predictors of IBS include gender, age, and socioeconomic status. The odds of having IBS are higher in women than men (pooled odds ratio [OR] 1.46; 95% CI 1.13 to 1.88).6, 7, 8, 9 However, IBS is now recognized to be a key component of the Gulf War syndrome, a multisymptom complex affecting soldiers (a predominantly male population was engaged in the Gulf War).11, 12, 13 Patients under the age of 50 years are more commonly diagnosed with IBS, although 2% to 6% of patients are 50
HRQOL of IBS
Several studies have compared HRQOL in IBS patients with HRQOL in healthy controls or patients with non-IBS medical disorders, and these have been summarized in a previous systematic review.2 Data consistently reveal that patients with IBS score lower on all 8 scales of the SF-36 HRQOL questionnaire compared with normal non-IBS cohorts. IBS patients have the same physical HRQOL as patients with diabetes, and a lower physical HRQOL compared with patients who have depression or gastroesophageal
Measuring HRQOL in IBS
Measuring HRQOL can provide useful information for various clinical and research purposes. For example, it can provide insight not only to a patient’s physical symptoms and burden of illness, but also provide information about emotional well being, social functioning, and other emotions and behaviors. Originally, the SF-36 questionnaire was used to measure HRQOL in IBS patients. However, given that the SF-36 is a generic instrument, the need for a syndrome-specific questionnaire arose. Multiple
Resource use in IBS
Patients with IBS consume a disproportionate amount of resources. Burden of illness studies estimate that there are 3.6 million physician visits in the United States annually for IBS, and that IBS care consumes over $20 billion in both direct and indirect expenditures.28 Moreover, patients with IBS consume over 50% more health care resources than matched controls without IBS.29, 30 These data suggest that the economic burden of IBS stems not only from the high prevalence of the disease, but
IBS burden of illness: summary
Overall, data indicate that IBS is a common condition with a large health economic burden of illness marked by HRQOL decrements, diminished work productivity, and high expenditures. Clinicians should routinely screen for diminished HRQOL by performing a balanced biopsychosocial history rather than focusing just on bowel symptoms. HRQOL decrements should be acknowledged and addressed when making treatment decisions. Patients with severe HRQOL decrements should be screened for suicidal ideation,
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