DO PATIENTS WITH IRRITABLE-BOWEL-SYNDROME IN PRIMARY-CARE REALLY DIFFER FROM OUTPATIENTS WITH IRRITABLE-BOWEL-SYNDROME

Background-Little is known about the comparability of outpatients with irritable bowel syndrome (IBS) and patients with IBS in primary care with regard to severity of complaints, perceived limitations, other as pects of the complaints, and sex differences. Aims-To compare outpatie nts with IBS with primary care patients with IBS. Patients-One hundred and nine patients with IBS were recruited from general practices in A msterdam and 86 patients with IBS were recruited from the outpatient c linic of the Department of Internal Medicine of the University Hospita l in Nijmegen. Methods-Each patient completed a questionnaire on demog raphic variables, abdominal complaints, related complaints, and attrib uted causes of their abdominal complaints. The scores of the two group s were compared by univariate and multivariate analysis. Results-The o utpatient group contained significantly more men, reported more severe abdominal pain, more frequent complaints, more interference with dail y activities, and a higher degree of avoidance of activities (p<0.01) than the primary care group. When each sex was analysed separately, th ese differences remained for female (p<0.01) but not for male patients . Outpatients were more likely to attribute their complaints to somati c causes (p<0.01), whereas primary care patients were more likely to a ttribute their complaints to stress (p<0.01) or their agitated way of life (p<0.05). Multivariate analysis showed that a high severity score , a large number of additional complaints, and a low score On the stre ss attribution were important determinants for being in the outpatient group. Conclusions-Female outpatients consider their complaints to be more serious and interfering than do patients with IBS in primary car e. Male outpatients were comparable to primary care patients with IBS. More research needs to be done into sex specific differences in IBS a nd into the factors that influence the decision to refer a patient wit h IBS.