Patients with irritable bowel syndrome: health status and use of health care services.

The reason for consulting a physician is more related to illness behaviour than to the severity of complaints. Yet, little is known about the course of complaints, the health care seeking behaviour, and psychosocial factors influencing these items in patients with irritable bowel syndrome (IBS) attending the general practitioner (GP). Aim: to study health status, lifestyle, and use of health care services of patients with IBS in order to indicate problem areas accesible for intervention strategies. Method: structured interviews of 53 patients with IBS aged 15 years and older compared with a general population of 12975 in the same age range, all drawn from the Dutch National survey of Morbidity and Intervention in General Practice. Results: patients with IBS revealed a lower grade of
education (P<0.001), poorer health (P<0.001), a higher mean complaint score (8.3 versus 4.0, P<0.001), a higher score on the General Health Questionnaire (P<0.001), a higher score on the biographic problem list (BIOPRO, 2.3 versus 1.4, P<0.001), and more absence from work (32% versus
18% in two months, P<0.01. Patients with IBS consulted the family physician (1.6 versus 0.8 in three months, P<0.001), the physical therapist (30% versus 15% in one year, P<0.001), P<0.001) more often than those without. Conclusions: the study shows an excess of comorbidity, psychosocial problems, use of health care services, and absence owing to disease in patients with IBS. Special guidelines and training of GPs to apply a more integral approach may reduce the cost of health care and may
lead to a more favourable course in patients with IBS. (aut.ref.)