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Irritable Bowel Syndrome: Patterns of Ambulatory Health Care and Resource Use in the United States, 1993–1997

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Abstract

In the mid-1980s irritable bowel syndrome was estimated to result in 2.5 million office-based physician visits per year in the United States. This study investigates more recent patterns of ambulatory care in the United States using data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey for the years 1993–1997. We estimate that there are 11.3 ambulatory physician visits per 1000 US population per year with a diagnosis of irritable bowel syndrome: 92% (2.7 million visits per year) are to office-based physicians, 7% to outpatient departments and 1% to emergency departments. Women account for 74% of visits. Drugs, most commonly gastrointestinal agents and anxiolytics, are prescribed at more than three quarters of all visits; prescribing of multiple drugs is common. Office-based physician visit rates and patterns of drug treatment have not changed markedly since the 1980s. Visit rates increase more steeply with age than previously reported.

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REFERENCES

  1. Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller Lissner SA: Functional bowel disorders and functional abdominal pain. Gut 45(suppl 2):II43–II47, 1999

    Google Scholar 

  2. Drossman DA: The functional gastrointestinal disorders and the Rome II process. Gut 45(suppl 2):II1–II5, 1999

    Google Scholar 

  3. Manning AP, Thompson WG, Heaton KW, Morris AF: Towards positive diagnosis of the irritable bowel. Br Med J 2(6138):653–654, 1978

    Google Scholar 

  4. Drossman DA, Whitehead WE, Camilleri M: Irritable bowel syndrome: A technical review for practice guideline development. Gastroenterology 112(6):2120–2137, 1997

    Google Scholar 

  5. Pace F, Coremans G, Dapoigny M, Muller-Lissner SA, Smout A, Stockbruegger RW, Whorwell PJ: Therapy of irritable bowel syndrome-an overview. Digestion 56(5):433–442, 1995

    Google Scholar 

  6. Drossman DA, Thompson WG: The irritable bowel syndrome: Review and a graduated multicomponent treatment approach. Ann Intern Med 116(12 Pt 1):1009–1016, 1992

    Google Scholar 

  7. Camilleri M: Therapeutic approach to the patient with irritable bowel syndrome. Am J Med 107(5A):27S–32S, 1999

    Google Scholar 

  8. Everhart JE, Renault PF: Irritable bowel syndrome in officebased practice in the United States. Gastroenterology 100(4):998–1005, 1991

    Google Scholar 

  9. Schappert SM: Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 1997. Hyattsville, Maryland: National Center for Health Statistics, 1999

    Google Scholar 

  10. Drossman DA, McKee DC, Sandler RS, Mitchell CM, Cramer EM, Lowman BC, Burger AL: Psychosocial factors in the irritable bowel syndrome. A multivariate study of patients and nonpatients with irritable bowel syndrome. Gastroenterology 95(3):701–708, 1988

    Google Scholar 

  11. Whitehead WE, Bosmajian L, Zonderman AB, Costa PT Jr, Schuster MM: Symptoms of psychologic distress associated with irritable bowel syndrome. Comparison of community and medical clinic samples. Gastroenterology 95(3):709–714, 1988

    Google Scholar 

  12. Kay L, Jorgensen T, Jensen KH: The epidemiology of irritable bowel syndrome in a random population: Prevalence, incidence, natural history and risk factors. J Intern Med 236(1):23–30, 1994

    Google Scholar 

  13. Jones R, Lydeard S: Irritable bowel syndrome in the general population. Br Med J 304(6819):87–90, 1992

    Google Scholar 

  14. Thompson WG, Heaton KW, Smyth GT, Smyth C: Irritable bowel syndrome: the view from general practice. Eur J Gastroenterol Hepatol 9(7):689–692, 1997

    Google Scholar 

  15. Talley NJ, Zinsmeister AR, Melton LJ 3rd: Irritable bowel syndrome in a community: Symptom subgroups, risk factors, and health care utilization. Am J Epidemiol 142(1):76–83, 1995

    Google Scholar 

  16. Thompson WG, Heaton KW, Smyth GT, Smyth C: Irritable bowel syndrome in general practice: Prevalence, characteristics, and referral. Gut 46(1):78–82, 2000

    Google Scholar 

  17. Whitehead WE, Gibbs NA, Li Z, Drossman DA: Is functional dyspepsia just a subset of the irritable bowel syndrome? Baillieres Clin Gastroenterol 12(3):443–461, 1998

    Google Scholar 

  18. Talley NJ, Boyce P, Jones M: Identification of distinct upper and lower gastrointestinal symptom groupings in an urban population. Gut 42(5):690–695, 1998

    Google Scholar 

  19. Agreus L, Svardsudd K, Nyren O, Tibblin G: Irritable bowel syndrome and dyspepsia in the general population: Overlap and lack of stability over time. Gastroenterology 109(3):671–680, 1995

    Google Scholar 

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Hollowell, J., Lundgren, A. & Johansson, S. Irritable Bowel Syndrome: Patterns of Ambulatory Health Care and Resource Use in the United States, 1993–1997. Dig Dis Sci 47, 1115–1121 (2002). https://doi.org/10.1023/A:1015006627788

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  • DOI: https://doi.org/10.1023/A:1015006627788

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