Comparison of Symptoms, Healthcare Utilization, and Treatment in Diagnosed and Undiagnosed Individuals With Diarrhea-Predominant Irritable Bowel Syndrome

Sayuk, Gregory S.; Wolf, Ray A.; Chang, Lin

doi:10.1038/ajg.2016.574

Cited by 51 publications

(42 citation statements)

References 22 publications

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“…12 There have been relatively few studies dealing with the cost that IBS represents to society but from the data available it appears that patients with IBS are twice as likely to take time off work as those without (absenteeism) and also have high rates of presenteeism and impairment in performing daily activities regardless of IBS subtype. 17,22 In the UK and US, patients with IBS take an average of between 8.5 and 21.6 days off work in a year. 23 It has been estimated that absenteeism and presenteeism due to IBS amounts to an annual loss per patient of $748 in Canada (1996), 24 US$335 in UK 25 and $812 in Iran.…”

Section: The Burden Of Ibs On Healthcare Systemsmentioning

confidence: 99%

The global impact of IBS: time to think about IBS-specific models of care?

Corsetti

Whorwell

2017

Therap Adv Gastroenterol

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Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal (GI) disorder that can significantly erode the quality of life (QoL) of sufferers and places a major cost burden on healthcare services. This paper reviews the literature on the impact of IBS on healthcare services and society, including a recent report on the subject, in order to formulate a plan for the future. A completely different model of care for these patients is recommended based on this review and the experience of the two authors who have been treating patients with functional GI disorders for 20 and 35 years, respectively.

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Section: The Burden Of Ibs On Healthcare Systemsmentioning

confidence: 99%

The global impact of IBS: time to think about IBS-specific models of care?

Corsetti

Whorwell

2017

Therap Adv Gastroenterol

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“…Th e broader implications of the fi ndings by Sayuk et al ( 6 ) are that they highlight the importance of (i) educating non-patients and patients about IBS (and other FGIDs) symptoms regardless of whether they have sought medical attention, in order to increase common knowledge and clear misconceptions; (ii) and indeed when medical help is required, physicians need to feel confi dent in making the diagnosis and conveying it eff ectively to their patients. Th is should increase our ability to identify patients who are likely to gain from consultation and tailoring of an appropriate high.…”

confidence: 99%

“…Aft er all, an individual with IBS-symptoms seeking advice from a healthcare professional, for instance due to the severity of their symptoms, would rightfully expect to receive a diagnosis and appropriate advice in terms of treatment and management of their symptoms. Such a formal diagnosis helps initiate a dialogue between patient and healthcare provider with regards to insight into triggering factors and treatment options-so argue Sayuk et al ( 6 ). With regards to treatment options, a variety of nonmedicinal approaches (e.g., dietary and behavioral interventions) have shown to be eff ective treatments for IBS symptoms and many of the patients prefer and do well with these approaches.…”

confidence: 99%

“…Th e other 830 (43.1%) individuals fulfi lled the Rome III criteria for the disorder (IBS-D), but had never received a formal diagnosis. Furthermore, over half (53%) of these undiagnosed individuals have never spoken to a physician about their abdominal symptoms, and therefore, have never received a formal diagnosis ( 6 ). Given this considerable proportion, the question arises what factors drive individuals experiencing abdominal symptoms compatible with IBS to consult their health care providers about these symptoms?…”

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confidence: 99%

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Editorial: Clinical Implications of Diagnosing Irritable Bowel Syndrome: Do All Roads Need to Lead to Rome?

Keszthelyi

Ringel

2017

American Journal of Gastroenterology

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Irritable bowel syndrome (IBS) is one of the most common diagnoses made by healthcare providers. Yet the majority of patients with IBS are undiagnosed. The study by Sayuk et al. allows insight into the characteristics of different patient groups, e.g., with and without a formal diagnosis of diarrhea predominant IBS (IBS-D). We discuss the questions raised by this study regarding the importance of making a confi dent diagnosis, conveying it to patients and their implications for clinical practice. Am J Gastroenterol 2017; 112:900-902; doi: 10.1038/ajg.2017 Abdominal pain and diarrhea are the leading gastrointestinal (GI) symptoms prompting ambulatory visits in the United States with more than 27 million ambulatory, emergency department, and hospital outpatient clinic visits per year. Abdominal pain and diarrhea are also common leading GI diagnoses in the ambulatory setting, with "abdominal pain" being the most common (over 16.6 million per year) and "diarrhea" the ninth most common (over 2.6 million per year). Interestingly, the diag noses of abdominal pain and diarrhea are more common than the diagnosis of irritable bowel syndrome (IBS; tenth most common diagnosis with 2.4 million diagnoses per year) ( 1 ). Th e fact that these diagnoses are so oft en made does not come as a surprise when considering the high prevalence of GI symptoms in the general population. Although epidemiological data are scarce ( 2 ), the available numbers indicate that a signifi cant portion of the US population-42% of adults ( 3 ) and 23% of children and adolescents ( 4 ) -experience GI symptoms that correspond with at least one of 20 functional GI disorders (FGIDs), including IBS. However, more than half of the individuals with functional bowel symptoms do not seek medical care for their symptoms ( 5 ).Th ese individuals are oft en referred to as non-patient individuals with FGIDs.In this issue of the journal, Sayuk et al. report their fi ndings from an online survey conducted in 1,924 individuals from a general US population who had previously participated in various surveys and had indicated having GI symptoms. Individuals were excluded if they reported having habitual constipation or rectal blood loss in the month prior to participating in the survey. Th e authors found that 1,094 (56.9%) of the respondents met the Rome III criteria for IBS-D and received a formal diagnosis from their health care provider. Th e other 830 (43.1%) individuals fulfi lled the Rome III criteria for the disorder (IBS-D), but had never received a formal diagnosis. Furthermore, over half (53%) of these undiagnosed individuals have never spoken to a physician about their abdominal symptoms, and therefore, have never received a formal diagnosis ( 6 ). Given this considerable proportion, the question arises what factors drive individuals experiencing abdominal symptoms compatible with IBS to consult their health care providers about these symptoms? While most studies have repeatedly shown that abdominal symptom severity is an important determinant in...

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“…A recent long-term study (1980–2012) of emergency room visits in Finland showed non-specific abdominal pain was the most common diagnosis [14]. A recent survey study of 1924 patients with a history of gastrointestinal symptoms showed 43% were not formally diagnosed with IBS despite meeting the diagnostic criteria for this condition [15]. …”

Section: Epidemiology Of Chronic Pancreatitismentioning

confidence: 99%

Total pancreatectomy for recurrent acute and chronic pancreatitis: a critical review of patient selection criteria

Faghih

González

Makary³

et al. 2017

Current Opinion in Gastroenterology

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Purpose of review Critical review of the indications for total pancreatectomy and highlight limitations in current diagnostic criteria for chronic pancreatitis. Recent findings The diagnosis of noncalcific chronic pancreatitis remains controversial because of an overreliance on nonspecific imaging and laboratories findings. Endoscopic ultrasound, s-magnetic resonance cholangiopancreatography, and/or endoscopic pancreatic function testing are often used to diagnose noncalcific chronic pancreatitis despite the fact that there is no gold standard for this condition. Abdominal pain is not specific for chronic pancreatitis and is more likely to be encountered in patients with functional gastrointestinal disorders based on the high incidence of these conditions. The duration of pain and opioid analgesic use results in central sensitization that adversely affects pain outcomes after total pancreatectomy. An alcoholic cause is associated with poorer pain outcomes after total pancreatectomy. Summary The lack of a gold standard for noncalcific chronic pancreatitis limits the diagnostic accuracy of imaging and laboratory tests. The pain of chronic pancreatitis is nonspecific and is affected by duration, preoperative opioid use, and cause. These factors will need to be considered in the development of future selection criteria for this morbid surgery.

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Comparison of Symptoms, Healthcare Utilization, and Treatment in Diagnosed and Undiagnosed Individuals With Diarrhea-Predominant Irritable Bowel Syndrome

Cited by 51 publications

References 22 publications

The global impact of IBS: time to think about IBS-specific models of care?

The global impact of IBS: time to think about IBS-specific models of care?

Editorial: Clinical Implications of Diagnosing Irritable Bowel Syndrome: Do All Roads Need to Lead to Rome?

Total pancreatectomy for recurrent acute and chronic pancreatitis: a critical review of patient selection criteria

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