Patient‐perceived severity of irritable bowel syndrome in relation to symptoms, health resource utilization and quality of life

Abstract

Aim: In this study of patients with irritable bowel syndrome (IBS), we evaluated the relationship between patient‐rated severity of IBS and patients' physical and psychological symptoms, health care resource use and quality of life. Methods: One hundred and twenty‐six patients diagnosed with IBS were administered a series of questionnaires, including the Bowel Symptom Checklist, the Symptom Checklist‐90 R (a psychological symptom checklist), the IBSQOL (a disease‐specific quality of life instrument), the SF‐36 (a general health status instrument), and a health resource utilization assessment that measured health care use, time loss from work, impact on productivity, and days worked with symptoms. Results: No relationship was found between IBS severity and gastrointestinal symptoms, except for a feeling of unpassed stool. IBS severity was also not related to psychological symptom severity. Direct traditional indicators of resource use (e.g. physician visits, hospital admissions and emergency room visits) were not significantly associated by severity level; however, indirect measures of resource use (e.g. number of days with pain, productivity and number of bed days) were related to severity. Quality of life was clearly associated with perceived IBS severity. Patients who rated themselves as very severe reported the lowest scores and had the poorest health for all quality of life dimensions measured. Conclusions: These findings suggest that perceived IBS severity is defined by the limitations the disease imposes, rather than by the symptoms. Patients with reduced productivity and decreased functioning for most of the quality of life indicators were those who rated their IBS as very severe.

A randomized controlled trial of imipramine in patients with irritable bowel syndrome

“…Health-related QoL is affected significantly in patients with IBS compared to the general population. The health-related QoL is associated with perceived IBS severity defined by the overall disease limitations rather than symptoms and appears to improve in treatment responders and correlates with symptom improvement [30,31] . For that reason, the SF-36 model, a general health status instrument, was used in our study to assess QoL.…”

Review: Optimizing outcomes with alosetron hydrochloride in severe diarrhea-predominant irritable bowel syndrome

“…Using an IBS-specific QoL instrument (IBSQoL), Hahn and colleagues found that patients with severe IBS had significantly poorer scores in physical functioning, social functioning, energy/fatigue, mental health, and role limitations due to emotional and physical components than those with moderately severe disease [Hahn et al 1997]. A recent international Internet survey of 1966 IBS patients [Drossman et al 2009] confirmed these earlier findings, showing that patients with severe IBS scored lower than those with less severe disease in all domains of the IBSQoL and had more days of restricted usual/social activities.…”

“…Alosetron has been shown to significantly improve IBS-related abdominal pain and discomfort in randomized, double-blind clinical trials (Figure 3) [Krause et al 2007;Camilleri et al 2001Camilleri et al , 2000. [Hahn et al 1997]. Using the same instrument, Gralnek and colleagues compared HRQoL scores from patients with IBS with scores collected previously from patients with moderate to severe gastroesophageal reflux disease (GERD), diabetes mellitus (DM), dialysis-dependent end-stage renal disease (ESRD), and depression [Gralnek et al 2000].…”

Clinical economics review: irritable bowel syndrome

“…43 One study has used an IBS-speci®c quality of life questionnaire and a general quality of life questionnaire (the SF-36) to examine the association between selfperceived severity and quality of life in patients attending a tertiary care facility. 44 The disease-speci®c questionnaire showed that patients with mild and moderate IBS were not signi®cantly different but those with severe or very severe IBS rated their quality of life signi®cantly lower for physical functioning, role physical, role emotional, social functioning, energy and mental health, compared with those with moderate IBS. As might be expected, the SF-36 results revealed that the poorest health for all dimensions was reported by patients with very severe IBS but the other groups also showed signi®cant impairment of their quality of life.…”