Quality of life in irritable bowel syndrome

Quality-of-life (QOL) assessment is becoming increasingly important in the evaluation of the impact of disease and the effect of therapy. This is part icularly so for irritable bowel syndrome (IBS) where there is often a tende ncy for a chronic clinical course, but with no associated mortality. Instru ments used to study quality of life may be generic or disease specific, and care needs to be taken to ensure that the instrument used has been adequat ely validated for the purpose intended. Several disease-specific instrument s [Irritable Bowel Syndrome Quality of Life (IBS-QOL, IBSQOL) and Functiona l Digestive Disorders Quality of Life (FDDQL)], in addition to generic meas ures, are now available for use in IBS. Quality of life in patients with IBS is surprisingly poor, particularly in the population seeking healthcare, where it can be compared with conditions which carry a high mortality, such as ischaemic heart disease, heart failu re and diabetes mellitus. Pain severity appears to be an important factor i n determining quality of life in IBS, although bowel disturbance and psycho logical difficulties are also likely to be important. There is limited data on the effect of treatment of IBS on quality of life. Improvement has been reported with dietry modification, drug treatments an d hypnotherapy. It is likely that, in the future, QOL measures will become increasingly used as secondary end-points in therapeutic trials in IBS.