Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Academic Unit of Gastroenterology & Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
United European Gastroenterol J. 2021 Dec;9(10):1178-1188. doi: 10.1002/ueg2.12153. Epub 2021 Oct 1.
Irritable bowel syndrome (IBS) is highly prevalent worldwide but mechanisms for healthcare seeking behaviours in this patient group are poorly understood.
To describe healthcare utilization and identify factors associated with seeking healthcare amongst IBS subjects in the general population.
An internet survey was completed by 6,300 individuals equally distributed between United States, United Kingdom and Canada. The Rome IV diagnostic questionnaire was used to identify subjects with IBS. Data on demographics, medical history, gastrointestinal (GI) and non-GI symptoms, quality of life and health care consumption was collected.
A total of 5,931 subjects were included; 274 (4.6%) IBS subjects and 5657 (95.3%) non-IBS controls. IBS subjects reported more doctor consultations for both GI and other health problems as well as increased use of medication and rate of abdominal surgery (appendectomy excluded). Having healthcare insurance or access to free public healthcare (adjusted odds ratio (AOR) 4.49, 95% confidence interval (CI) 1.31-15.44), followed by high frequency of bloating (AOR 2.65, 95% CI 1.42-4.93) and increasing age (AOR 1.02, 95% CI 1.01-1.05) were found to be independently associated with being an IBS consulter while doctor-diagnosed IBS subjects were more likely to be female and to report abdominal pain as their most bothersome GI symptom than other consulters with IBS.
IBS subjects have higher healthcare utilization than non-IBS controls, medication use and abdominal surgery included. Furthermore, consulters with and without an IBS diagnosis differ in sex distribution and symptom profiles. Hence, awareness of the possibility of unnecessary medical and surgical treatment in IBS subjects and a sex-related diagnostic bias by doctors is warranted.
肠易激综合征（IBS）在全球范围内高发，但该患者群体寻求医疗保健的机制尚不清楚。
描述普通人群中 IBS 患者的医疗保健利用情况，并确定与寻求医疗保健相关的因素。
通过互联网对 6300 名来自美国、英国和加拿大的个体进行了一项调查。采用罗马 IV 诊断问卷来识别 IBS 患者。收集了人口统计学、病史、胃肠道（GI）和非 GI 症状、生活质量和医疗保健消费的数据。
共纳入 5931 名受试者；274 名（4.6%）IBS 患者和 5657 名（95.3%）非 IBS 对照者。IBS 患者报告他们因 GI 和其他健康问题看医生的次数更多，并且使用药物和腹部手术的频率更高（不包括阑尾切除术）。有医疗保险或可以获得免费公共医疗保健（调整后的优势比（AOR）4.49，95%置信区间（CI）1.31-15.44），其次是腹胀的高频率（AOR 2.65，95%CI 1.42-4.93）和年龄的增加（AOR 1.02，95%CI 1.01-1.05）与成为 IBS 就诊者独立相关，而医生诊断为 IBS 的患者更有可能是女性，并且报告腹痛是他们最困扰的 GI 症状，而不是其他 IBS 就诊者。
IBS 患者的医疗保健利用率高于非 IBS 对照组，包括药物使用和腹部手术。此外，有和没有 IBS 诊断的就诊者在性别分布和症状特征上存在差异。因此，需要意识到 IBS 患者存在不必要的医疗和手术治疗的可能性，以及医生存在与性别相关的诊断偏见。
