Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact

Abstract

Summary Background : The impact of irritable bowel syndrome, a gastrointestinal motility disorder, is underestimated and poorly quantified, as clinicians may see only a minority of sufferers. Aim : To determine the prevalence, symptom patterns and impact of irritable bowel syndrome in the US. Methods : This two‐phase community survey used quota sampling and random‐digit telephone dialling (screening interview) to identify individuals with medically diagnosed irritable bowel syndrome or individuals not formally diagnosed, but fulfilling irritable bowel syndrome diagnostic criteria (Manning, Rome I or II). Information on irritable bowel syndrome symptoms, general health status, lifestyle and impact of symptoms on individuals’ lives was collected using in‐depth follow‐up interviews. Data were also collected for healthy controls identified in the screening interviews. Results : The total prevalence of irritable bowel syndrome in 5009 screening interviews was 14.1% (medically diagnosed: 3.3%; undiagnosed, but meeting irritable bowel syndrome criteria: 10.8%). Abdominal pain/discomfort was the most common symptom prompting consultation. Most sufferers (74% medically diagnosed; 63% undiagnosed) reported alternating constipation and diarrhoea. Previously diagnosed gastrointestinal disorders occurred more often in sufferers than non‐sufferers. Irritable bowel syndrome sufferers had more days off work (6.4 vs. 3.0) and days in bed, and reduced activities to a greater extent than non‐sufferers. Conclusions : Most (76.6%) irritable bowel syndrome sufferers in the US are undiagnosed. Irritable bowel syndrome has a substantial impact on sufferers’ well‐being and health, with considerable socioeconomic consequences.

Significant psychological morbidity occurs in irritable bowel syndrome: a case‐control study using a pharmacy reimbursement database

“…16,60 Accurately estimating IBS incidence is further complicated by the fact that many people with functional gastrointestinal symptoms never seek medical attention. 38,39,58 Our study also provides longitudinal data on psychological comorbidity in IBS, using prescribing as a surrogate. Only one other study provides longitudinal data on psychological co-morbidity in IBS.…”

“…Estimates of IBS prevalence in community-based studies range from 3 to 20% depending on the diagnostic criteria used. 1,13,14,[38][39][40][55][56][57][58] The only published communitybased study to assess IBS incidence was performed using a postal validated questionnaire by Talley and colleagues in Olmstead County, Minnesota. A stable 18.1% prevalence and 9% incidence of IBS at 1 year follow-up was found, suggesting both a significant resolution and emergence of IBS symptoms over time.…”

Treatment of irritable bowel syndrome: beyond fiber and antispasmodic agents

“…Prevalence IBS is a common condition, affecting between 5% and 20% of the population in community surveys [Hungin et al 2005;Hillila and Farkkila, 2004;Agreus et al 2000]. The prevalence varies according to the diagnostic criteria used to define its presence with the Manning criteria, which do not require a minimum duration of symptoms, leading to a higher prevalence than the Rome criteria [Boyce et al 2000].…”

Irritable bowel syndrome and disease severity: are we undertreating our patients?

“…In fact, many healthcare providers are unsure of how to diagnose this disorder, as evidenced in a survey of 708 IBS patients in which 25% reported being evaluated multiple times before receiving a definitive IBS diagnosis [6,7].…”