Impact of Irritable Bowel Syndrome on Quality of Life and Resource Use in the United States and United Kingdom

Abstract

Background: Although irritable bowel syndrome (IBS) is not a life-threatening condition, it can have a serious impact on a patient’s daily activities and quality of life. This effect on quality of life has not been compared previously across different cultures. Methods: We compared measures of health-related quality of life and health care resource utilization using a cross-sectional point-in-time postal survey of a random sample of 500 members of the International Foundation for Functional Gastrointestinal Disorders in the US and 500 members of the IBS Network support group in the UK. The analysis was limited to persons who reported that a physician had told them they had IBS. A general health status questionnaire, the SF-36, and a disease-specific questionnaire, the Irritable Bowel Syndrome Quality of Life questionnaire (IBSQOL), were self-administered as part of the survey to measure health-related quality of life. Results on the SF-36 were compared with published normative data for adults in the US and UK with and without chronic diseases. Results: The UK group (n = 343) reported significantly poorer quality of life on the SF-36 and on four parameters of the IBSQOL than did the US group (n = 287). The general health status of persons with IBS in either country was much poorer compared with that of general populations in the respective countries. Health care resource utilization (i.e. emergency room, doctor and hospital outpatient visits) of persons with IBS was similar in the two countries, as was the direct effect of IBS on employment. Nearly one third of those surveyed missed at least 1 day of work due to IBS in the previous 4 weeks, and a greater percentage cut back in their work or activites due to IBS. Taken together, average time lost or cut back amounted to nearly 5 days or 1 work-week. Conclusion: IBS has a significant impact on quality of life and resource use in both the US and UK. The effect on quality of life, however, appears to be greater in the UK than in the US.

Review article: intestinal serotonin signalling in irritable bowel syndrome

“…› indicates increase; fl indicates significant decrease; « indicates no significant change. 1 Measured area rather than the number of EC cells. TNBS, trinitro benzenesulphonic acid; DSS, dextran sodium sulphate.…”

“…Impairment in quality of life is common for the significant proportion of the population who suffer from IBS. [1][2][3] Specific clinical criteria differentiate IBS from other functional GI disorders as well as from inflammatory bowel disease (IBD) and other non-functional GI disorders. There are no specific biological, radiographic, endoscopic or physiological markers that have been identified in this disorder, and therefore, the diagnosis of IBS is based solely on these clinical criteria.…”

Perceived stigma in functional somatic syndromes and comparable medical conditions

“…However, in both ofthese studies, lBS sufferers who sought medical help did show elevated levels of psychological distress, leading these authors to suggest that psychopathology may influence help-seeking behaviour rather than symptom development. Although the disability associated with lBS has not been weIl studied, there is evidence that patients with lBS have elevated help seeking (TaIley, 1995), and lower quality of life and work productivity (Hahn et al, 1999) compared to the general population.…”

Serotonin receptor modulators in the treatment of irritable bowel syndrome

“…IBS ranks as the most common medical diagnosis among gastroenterologists and the seventh-leading diagnosis among primary care physicians in the U.S. (Sandler et al 2002). IBS is costly in terms of medical treatments and diagnostic procedures (Levy et al 2001), time lost from work (Hahn et al 1999), and nonmonetary costs such as diminished quality of life (Lackner et al in press) and activity limitations (Whitehead et al 1996). Each year, the direct (diagnostic testing, physician charges, drugs, hospital costs) and indirect (absenteeism, reduced work effi ciency, income loss, transportation, early retirement) costs of IBS in the US are pegged at $1.7-$10 billion and $19.2 billion, respectively (Talley et al 1995;American Gastroenterological Association 2002).…”