Older age, more symptoms prompt people with IBS to seek care

CHICAGO — Individuals with irritable bowel syndrome in the general population are more likely to seek medical care if they are older, more frequently bloated, more concerned about their bowel function and more socially affected by their symptoms, according to research presented at Digestive Disease Week.

Conversely, individuals with IBS who do not seek care have comparable severity of abdominal pain and burden of extraintestinal symptoms compared with those who do.

“IBS is associated with high socioeconomic and health care costs and also ... IBS patients utilize more medical health care than healthy controls, but ... we’re less certain of [why] IBS patients use medical health care, and which symptoms cause them to go to the doctor,” Navkiran Jossan, MD, of the department of internal medicine and clinical nutrition at the Institute of Medicine, Sahlgrenska Academy, University of Gothenburg in Sweden, said during her presentation. “We actually need to know more about the factors associated with medical consultation and also more about health care-seeking patterns and the prevalence of abdominal surgery and medication use among IBS subjects in the general population.”

To characterize these factors in a large multinational population sample, Jossan and colleagues evaluated internet survey responses from 6,300 adults in the U.S., U.K. and Canada; the surveys included questions on demographics, the Rome IV diagnostic questionnaire, the Patient Health Questionnaire (PHQ12), the 8-item Short Form (SF8) quality of life (QOL) questionnaire, health care utilization and prior GI diagnoses.

“The participants were not aware of the GI focus of this survey. It was only introduced as a health survey in the invitations,” Jossan said.

The investigators excluded results from 369 individuals due to inconsistent responses, leaving 5,931 respondents who were fairly evenly distributed across participating countries in the analysis (49.2% women; mean age, 47.4 years).

The investigators further excluded 36 respondents who had a prior diagnosis of a lower GI organic disease, and among the remaining respondents, 35.1% had a functional GI disorder, and 305 met criteria for IBS (5.1%; 66% women; mean age, 44.7 years).

Of those with IBS, 195 (64%) had seen a doctor about their GI symptoms. Between individuals who did and did not see a doctor for their GI symptoms, there was a comparable proportion of women, similar somatization scores, similar abdominal pain severity (which was the most common symptom in both groups) and similar frequency of doctor visits for non-GI health issues.

However, those who had seen a doctor were older (mean age, 47.1 years vs. 40.5 years), showed more concern about their bowel function (P < .001), reported more frequent bloating (P = .01), and reported their GI symptoms had a greater impact on their social activities (P = .008). They were also more likely to have had abdominal surgery (P = .04), and consumed higher quantities of GI-related medications (P < .001), prescribed pain medications (P < .001), and antidepressants (P = .03), but consumed similar amounts of anxiety medications and over-the-counter pain medications as those who had not seen a doctor.

In summary, “IBS subjects in the general population who are older, experience more frequent bloating, have a greater impairment in social activities and also greater concern of their bowel function are more likely to seek medical care for their bowel issues,” Jossan concluded.

“In contrast we found there was no difference [between] consulters and non-consulters regarding the predominant symptom of abdominal pain, the frequency of abdominal pain or the extraintestinal symptom burden.” – by Adam Leitenberger

Reference:

Jossan N, et al. Abstract 165. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Disclosures: Jossan reports no relevant financial disclosures.