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. 2021 Dec;9(10):1178-1188.
doi: 10.1002/ueg2.12153. Epub 2021 Oct 1.

Health care utilization of individuals with Rome IV irritable bowel syndrome in the general population

Navkiran T Tornkvist  1 , Imran Aziz  2 , William E Whitehead  3 , Ami D Sperber  4 , Olafur S Palsson  3 , Jóhann Pall Hreinsson  1 , Magnus Simrén  1 , Hans Törnblom  1
Affiliations

Health care utilization of individuals with Rome IV irritable bowel syndrome in the general population

Navkiran T Tornkvist et al. United European Gastroenterol J. 2021 Dec.

Abstract

Background: Irritable bowel syndrome (IBS) is highly prevalent worldwide but mechanisms for healthcare seeking behaviours in this patient group are poorly understood.

Objective: To describe healthcare utilization and identify factors associated with seeking healthcare amongst IBS subjects in the general population.

Methods: An internet survey was completed by 6,300 individuals equally distributed between United States, United Kingdom and Canada. The Rome IV diagnostic questionnaire was used to identify subjects with IBS. Data on demographics, medical history, gastrointestinal (GI) and non-GI symptoms, quality of life and health care consumption was collected.

Results: A total of 5,931 subjects were included; 274 (4.6%) IBS subjects and 5657 (95.3%) non-IBS controls. IBS subjects reported more doctor consultations for both GI and other health problems as well as increased use of medication and rate of abdominal surgery (appendectomy excluded). Having healthcare insurance or access to free public healthcare (adjusted odds ratio (AOR) 4.49, 95% confidence interval (CI) 1.31-15.44), followed by high frequency of bloating (AOR 2.65, 95% CI 1.42-4.93) and increasing age (AOR 1.02, 95% CI 1.01-1.05) were found to be independently associated with being an IBS consulter while doctor-diagnosed IBS subjects were more likely to be female and to report abdominal pain as their most bothersome GI symptom than other consulters with IBS.

Conclusion: IBS subjects have higher healthcare utilization than non-IBS controls, medication use and abdominal surgery included. Furthermore, consulters with and without an IBS diagnosis differ in sex distribution and symptom profiles. Hence, awareness of the possibility of unnecessary medical and surgical treatment in IBS subjects and a sex-related diagnostic bias by doctors is warranted.

Keywords: drug utilization; gastrointestinal symptoms; health care seeking behaviour; health care utilization; irritable bowel syndrome; surgery.

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Figures

FIGURE 1
FIGURE 1
Schematic overview of the study cohort and the IBS subgroups used for comparisons. A total of 4.6% of the cohort fulfilled Rome IV criteria for IBS (IBS subjects) and a majority of them reported having consulted a doctor for a gastrointestinal problem (IBS consulter). Of the IBS consulters, 55% had also been diagnosed with IBS by a doctor (Diagnosed IBS consulters)
FIGURE 2
FIGURE 2
Bar charts displaying the most bothersome gastrointestinal symptom in all groups
FIGURE 3
FIGURE 3
(a) Bar chart showing abdominal pain more than 3 times/week. (b) Percent of IBS subjects with abdominal bloating more than 3 times/month
See this image and copyright information in PMC

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