The economic impact of irritable bowel syndrome

Inadomi, John M.; Fennerty, M. Brian; Bjorkman, David J.

doi:10.1046/j.1365-2036.2003.t01-1-01736.x

Cited by 155 publications

(105 citation statements)

References 36 publications

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“…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.…”

Section: Studies Assessing Humanistic Burden Of Diseasementioning

confidence: 99%

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

Nellesen

Yee²,

Chawla³

et al. 2013

JMCP

197

154

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BACKGROUND: Irritable bowel syndrome (IBS) and chronic constipation (CC) are common functional gastrointestinal disorders affecting 14% and 20% of the U.S. population, respectively. Reviews of the evidence on the burden of illness associated with IBS and CC have not been comprehensive in scope and have not provided an assessment of the distribution of health care costs across categories of resource use.

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Section: Studies Assessing Humanistic Burden Of Diseasementioning

confidence: 99%

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

Nellesen

Yee²,

Chawla³

et al. 2013

JMCP

197

154

View full text Add to dashboard Cite

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“…In the US as well as other western countries, women seek health care services disproportionately more than men. The public health impact of IBS in the US is enormous with direct costs totaling approximately $1.35 billion/year and indirect costs about 205 million/year (Inadomi et al, 2003) . In South Korea, the direct medical costs were approximately $96 million (108 billion KRW) in 2007 by the National Health Insurance Statistical Yearbook (Jung et al, 2011) and it is increasing.…”

Section: Wwwkanorkrmentioning

confidence: 99%

Update on Irritable Bowel Syndrome Program of Research

2013

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Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

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“…25 Talley et al found that patients with IBS incurred median annual all-cause medical care charges that were 73% higher than healthy controls without IBS ($742 vs. $429 in 1992 dollars). 26 In a systematic review, Inadomi et al (2003) found the total economic costs of IBS to be $1.56 billion (1998 dollars) in the United States, of which 87% were direct costs and 13% were indirect costs associated with absenteeism from work attributable to IBS symptoms. 27 Hulisz estimated much higher costs of IBS in the United States, including indirect costs associated with lost productivity and adverse effects on quality of life.…”

Section: Economic Burden Of Ibs Is Potentially Largementioning

confidence: 99%

Irritable Bowel Syndrome and Antidepressants

Curtiss¹

2008

JMCP

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I n this issue of JMCP, Faresjö and colleagues found that 13.3% of patients with irritable bowel syndrome (IBS) reported using antidepressants versus 4.5% of control patients without IBS.1 The more than 3-fold higher use of antidepressants (odds ratio [OR] = 3.27, 95% confidence interval [CI] = 2.27-4.70) among patients with IBS is not a surprising finding, but the actual use of drugs by IBS patients is little studied despite the high prevalence of IBS, which is estimated to affect 12% of adults in the United States.2 However, a plethora of research reports exist regarding the comorbidity of psychiatric conditions and IBS; a MEDLINE search performed in October 2008 revealed 456 citations for the combination of the search terms "irritable bowel syndrome" and "depression." The medical literature shows a strong relationship of IBS with anxiety, chronic fatigue syndrome, and fibromyalgia, as well as depression.3,4 The research is sufficiently specific to differentiate a higher frequency of IBS symptoms with panic disorder, generalized anxiety disorder, and major depressive disorder versus social anxiety disorder, specific phobia, and obsessivecompulsive disorder. 5There is considerable discussion regarding the role of serotonin in IBS, 6 which suggests that some antidepressants may be more effective than others. Hayee and Forgacs in their clinical review (2007) presented evidence that (a) the diagnosis of IBS is stigmatized by the method of exclusion, leading to an aura of negativity for the patient; (b) IBS does not have a single cause and is associated with a complex of symptoms; (c) the association of IBS with psychiatric disorders begs the question of cause and effect; (d) despite the reported high prevalence of IBS, many more patients may have IBS who do not consult a physician; and (e) among the antidepressant drugs, the tricyclic antidepressants have been studied most often in IBS, with consistently favorable effects and a number needed to treat (NNT) of 3.2 (95% CI = 2.1-6.5) compared with an NNT of 2.0 for cognitive behavioral therapy and mixed but generally poor results with the selective serotonin-reuptake inhibitors (SSRIs).7 Unfortunately, in the present study, Faresjö et al. did not record the subtypes of antidepressants (e.g., SSRIs, serotonin-norepinephrine reuptake inhibitors, or tricyclic antidepressants) reported by the respondents in their population survey. Choice of AntidepressantAmitriptyline has been shown to be effective in adolescents 8 and adults with IBS, even at a low dose (10 mg per day). 9 In the meta-analysis performed by Jackson et al. (2000) 10 and summarized by Hayee and Forgacs, 7 of 9 clinical trials of tricyclic antidepressants showed a statistically significant effect with an overall mean difference of 0.9 (95% CI = 0.6-1.2) compared with placebo. 7 Mertz concluded that tricyclic antidepressants are recommended for moderate-to-severe IBS in which pain is prominent or when other therapies have failed.11 Mayer recommends a starting dose of amitriptyline 10 mg at bedtime an...

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The economic impact of irritable bowel syndrome

Cited by 155 publications

References 36 publications

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

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

Update on Irritable Bowel Syndrome Program of Research

Irritable Bowel Syndrome and Antidepressants

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