Yawn B P, Locke G R, Lydick E, Wollan P C, Bertram S L, Kurland M J
Department of Research, Olmsted Medical Center, 210 Ninth Street SE, Rochester, MN 55904, USA.
Am J Manag Care. 2001 Jun;7(6):585-92.
To identify the healthcare utilization and evaluation in a community-based population with an incident diagnosis of irritable bowel syndrome (IBS).
Retrospective cohort.
A randomly selected cohort of 149 Olmsted County, MN, adults with an incident diagnosis of IBS between June 1, 1992, and December 31, 1994.
Retrospective medical record review of each medical encounter for the 10 years before and the 3 years after the incident IBS diagnosis. Specific attention was given to healthcare visits, tests, and treatment associated with documented gastrointestinal (GI) tract symptoms and diagnosis of IBS.
Of 149 patients, 98 (66%) were women, and the mean patient age was 46.6 years. Patients averaged 4.7 healthcare visits annually, including 0.5 related to GI tract symptoms. Two thirds of patients had GI tract symptom-related visits at least 2 years before IBS diagnosis. Only 5% of IBS diagnoses were made by a gastroenterologist. Colon examinations (colonoscopy or barium enema) were performed on 47% of patients and were more common in those aged > or = 55 years (58% vs 36%; P = .02). One third of patients had no GI tract testing proximal to the IBS diagnosis. Following the IBS diagnosis, only about half the patients made any IBS or GI tract symptom-related visits per year.
The path to diagnosis of IBS is through the primary care physician and includes minimal testing and limited follow-up care.
确定社区中初诊为肠易激综合征（IBS）的人群的医疗利用情况和评估情况。
回顾性队列研究。
从明尼苏达州奥尔姆斯特德县随机选取的149名成年人，他们在1992年6月1日至1994年12月31日期间初诊为IBS。
对IBS确诊前10年和确诊后3年的每次医疗就诊进行回顾性病历审查。特别关注与记录的胃肠道（GI）症状和IBS诊断相关的医疗就诊、检查和治疗。
149名患者中，98名（66%）为女性，患者平均年龄为46.6岁。患者每年平均就诊4.7次，其中0.5次与胃肠道症状有关。三分之二的患者在IBS诊断前至少2年就有与胃肠道症状相关的就诊。只有5%的IBS诊断是由胃肠病学家做出的。47%的患者进行了结肠检查（结肠镜检查或钡灌肠），在年龄≥55岁的患者中更常见（58%对36%；P = 0.02）。三分之一的患者在IBS诊断前没有进行过胃肠道检查。IBS诊断后，每年只有约一半的患者因IBS或胃肠道症状就诊。
IBS的诊断途径是通过初级保健医生，包括最少的检查和有限的后续护理。
