Diagnosis and management of moderate-to-severe irritable bowel syndrome with constipation (IBS-C) in the UK: the IBIS-C study

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<span style="font-size: 10pt;">Introduction The IBIS-C study assessed the burden of IBS-C in 6 European countries (France, Germany, Italy, Spain, Sweden, and UK). Here we present the diagnosis and management results for the UK. Method Observational study in patients (pts) diagnosed with moderate-to-severe IBS-C in the last five years (Rome-III criteria) with a 12-month follow-up (6 months retrospective and 6 months prospective, in order to assess health resource utilisation [HRU] prior to and after an active phase of the disease). Moderate- to-severe IBS-C was defined as an IBS-Symptom Severity Score (IBS-SSS) >=175. Results 104 pts were included (79% severe, mean age [+/-SD] 45.5 +/- 14.6 years old, 93% female). Mean time since diagnosis: 2.6 +/- 4.0 years; mean symptom duration: 15.3 +/- 14.9 yrs. Diagnostic procedures were highly variable; the most common were blood tests (72%), colonoscopy (69%), and abdominal ultrasound (55%). At inclusion the most prevalent symptoms were abdominal pain (92%) and bloating (91%). Main ongoing comorbidities were anxiety (50%), chronic pain (44%), headache (40%), insomnia (33%), or dyspepsia (31%). 52% of pts had an average of 3.6 +/- 2.7 diagnostic tests during follow-up, the most common were haematology (29%) and clinical chemistry (29%) blood tests, and colonoscopy (13%). 93% of pts took prescription drugs (90% took prescription drugs for their IBS-C). The most common medication groups were: laxatives (81%), prokinetics (32%), antispasmodics (20%), and analgesics (18%) alone or in combination. Overall, 63% of pts took OTC medication for their IBS-C; the most common were laxatives (37%), prebiotics/ probiotics (14%), and peppermint oil (14%). In addition, 36% of pts received complementary therapies. Overall, marginal improvement was noted in symptom severity (IBS-SSS total score) between baseline (373 +/- 83) and the 6-month visit (324 +/- 113). Conclusion Moderate-to-severe IBS-C symptoms often remain undiagnosed for many years and degree of control does not improve over time even though there is a high degree of prescription medication use. Consequently, moderate-to-severe IBS-C continues to be a burden despite the availability of therapeutic interventions. [Conference abstract]</span>