Health‐related quality of life among persons with irritable bowel syndrome: a systematic review

Abstract

Summary Aim : To perform a systematic review of the literature with three objectives: (1) to compare the health related quality of life (HRQoL) of patients with irritable bowel syndrome with that of healthy controls; (2) to compare the HRQoL of irritable bowel syndrome patients to those with other diseases; and (3) to examine therapy‐associated changes in HRQoL of irritable bowel syndrome patients. Methods : Searches of all English and non‐English articles from 1980 to 2001 were performed in Medline and Embase, and two investigators performed independent data abstraction. Results : Seventeen articles met our selection criteria. 13 studies addressed objective no. 1; 11 showed a significant reduction in HRQoL among irritable bowel syndrome patients. Of these, only one study was considered of high quality. Four studies addressed objective no. 2, none of which was considered to be high quality in addressing this objective. Four trials (three of high quality) addressed objective no. 3. One showed that symptomatic improvement with Leupron compared to placebo was accompanied an improvement only in the comparative health domain of the HRQoL. The second study reported significant positive changes in HRQoL after 12 weeks of cognitive behavioural therapy. The third report of two placebo‐controlled studies indicated significant improvement with alosetron on most domains of Irritable Bowel Syndrome Quality of Life Questionnaire. Conclusions : (i) There is reasonable evidence for a decrease in HRQoL in patients with moderate to severe irritable bowel syndrome; however, the data are conflicting regarding the impact of irritable bowel syndrome on HRQoL in population‐based studies of nonconsulters. (ii) HRQoL in irritable bowel syndrome patients is impaired to a degree comparable to other chronic disorders such as GERD and depression. (iii) A therapeutic response in irritable bowel syndrome‐related pain has a corresponding improvement in HRQoL. (iv) Limitations of the literature include focusing on moderate‐severe irritable bowel syndrome in referral centres, and lack of appropriate controls

Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis

“…3 The condition can be associated with significant emotional distress, impaired health-related quality of life, disability, and high health care costs. [4][5][6][7] No known structural or anatomical explanation accounts for the pathophysiology of IBS, although several mechanisms have been proposed, including low-grade mucosal inflammation, visceral hypersensitivity, alterations in fecal flora, and bacterial overgrowth. [8][9][10][11] Management guidelines for IBS recommend that a positive diagnosis is made using symptom-based diagnostic criteria, 12,13 in an attempt to minimize fruitless and repeated invasive investigation.…”

A Systematic Review of the Economic and Humanistic Burden of Illness in Irritable Bowel Syndrome and Chronic Constipation

“…Previous systematic reviews assessing burden of disease have focused on the effect of IBS on HRQOL 13,29 and direct resource utilization and productivity losses, 14 whereas no systematic reviews documenting the burden of disease for CC have been recently published. This systematic review aimed to identify burden-of-illness studies for IBS and CC and focus on their subtypes.…”

“…One systematic review published in 2002 assessed the healthrelated quality of life (HRQOL) burden of IBS, 13 and a review published in 2003 documented the costs of IBS symptom management, direct costs, and productivity costs.…”

Treatment of Dientamoeba fragilis in Patients with Irritable Bowel Syndrome

“…3 The IBS patients have reduced quality of life and increased sick leave, and a high use of resources in the health system. 2,[4][5][6][7] In Europe, the annual costs of an IBS patient have been estimated to 700-1600 Euros. 7 The cause(s) and pathogenesis of IBS are not well understood.…”