Determinants of Healthcare-Seeking Behaviour Among Subjects With Irritable Bowel Syndrome

R. E. Williams; C. L. Black; H.-Y. Kim; E. B. Andrews; A. W. Mangel; J. J. Buda; S. F. Cook

Disclosures

Aliment Pharmacol Ther. 2006;23(11):1667-1675. 

In This Article

Summary and Introduction

Summary

Background: Doctor visits for irritable bowel syndrome are associated with high medical costs. Predictors of medical consultation for irritable bowel syndrome remain poorly understood.
Aim: To determine factors associated with healthcare seeking for irritable bowel syndrome.
Methods: Subjects from previous US population-based survey were contacted 2 years later. Those who continued to have irritable bowel syndrome were included.
Results: 49% of subjects sought medical care for abdominal symptoms in the past year. Healthcare seeking did not differ significantly between males and females, but more females received an irritable bowel syndrome diagnosis. Predictors of irritable bowel syndrome healthcare seeking differed by gender. In multivariate analysis, age ≥55 years (OR = 2.8, 95% CI: 1.5-5.4), fear abdominal symptoms relates to serious illness (OR = 1.7, 95% CI: 0.95-3.1), decreased bowel movements (OR = 1.8, 95% CI: 0.98-3.2), dyspepsia (OR = 1.7, 95% CI: 0.94-3.2) and pelvic pain (OR = 2.3, 95% CI: 1.2-4.4) were associated with seeking care in females. Among males, being disabled (OR = 11.6, 95% CI: 2.4-56.1) and abdominal cramping (OR =4.3, 95% CI: 1.2-15.4) were associated with seeking care. Healthcare seekers had lower irritable bowel syndrome-related quality of life. Neither pain severity nor mental health status was associated with seeking care.
Conclusion: Healthcare-seeking behaviour among irritable bowel syndrome patients was determined by presence of comorbidities and extent that irritable bowel syndrome affected quality of life, not physical symptoms or mental health status.

Introduction

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, but previous studies have shown that only about 25% of individuals with IBS seek medical care for treatment of their abdominal symptoms.[1] However, IBS still remains the most common diagnosis made by gastroenterologists,[2] and medical costs associated with IBS in the United States are estimated to be $1.4 billion annually.[3] Severity of symptoms, psychological factors, non-gastrointestinal comorbid conditions and reduced quality of life have all been implicated as factors that discriminate between IBS subjects that seek medical care and those that do not.[1,4,5,6,7,8,9,10,11,12] However, the associations between each of these factors and healthcare-seeking behaviour among IBS subjects have not yielded consistent associations in previous studies. Therefore, predictors of medical consultation remain poorly understood. The objective of this study was to evaluate factors associated with healthcare-seeking behaviour among subjects with IBS.

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