PATIENT-PERCEIVED SEVERITY OF IRRITABLE-BOWEL-SYNDROME IN RELATION TOSYMPTOMS, HEALTH RESOURCE UTILIZATION AND QUALITY-OF-LIFE

Aim: In this study of patients with irritable bowel syndrome (IBS), we evaluated the relationship between patient-rated severity of IBS and patients' physical and psychological symptoms, health care resource us e and quality of life. Methods: One hundred and twenty-six patients di agnosed with IBS were administered a series of questionnaires, includi ng the Bowel Symptom Checklist, the Symptom Checklist-90 R (a psycholo gical symptom checklist), the IBSQOL (a disease-specific quality of li fe instrument), the SF-36 (a general health status instrument), and a health resource utilization assessment that measured health care use, time loss from work, impact on productivity, and days worked with symp toms. Results: No relationship was found between IBS severity and gast rointestinal symptoms, except for a feeling of unpassed stool. IBS sev erity was also not related to psychological symptom severity. Direct t raditional indicators of resource use (e.g, physician visits, hospital admissions and emergency room visits) were not significantly associat ed by severity level; however, indirect measures of resource use (e.g, number of days with pain, productivity and number of bed days) were r elated to severity. Quality of life was clearly associated with percei ved IBS severity. Patients who rated themselves as very severe reporte d the lowest scores and had the poorest health for all quality of life dimensions measured. Conclusions: These findings suggest that perceiv ed IBS severity is defined by the limitations the disease imposes, rat her than by the symptoms. Patients with reduced productivity and decre ased functioning for most of the quality of life indicators were those who rated their IBS as very severe.