Economic And Quality-Of-Life Burden Of Moderate-To-Severe Irritable Bowel Syndrome With Constipation (Ibs-C) In Spain: The Ibis-C Study

Abstract

Objectives: 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 Spanish cohort. Methods: Observational, retrospective- prospective (6 months each) study in patients diagnosed with moderate-tosevere IBS-C in the last five years (Rome-III criteria). Moderate-to-severe IBS-C was defined as an IBS-Symptom Severity Score (IBS-SSS) ≥ 175. Results: 112 patients were included (58% severe, mean age [±SD] 46.8 ± 13.7 years, 86% female). Mean time since diagnosis: 2.3 ± 2.7 years; mean symptom duration: 9.6 ± 9.9 years. Diagnostic procedures were highly variable; the most common were blood tests (71%), colonoscopy (56%) and abdominal ultrasound (54%). At inclusion the most prevalent symptoms were constipation (84%), abdominal pain (80%), abdominal distention (80%) and bloating (59%). Main ongoing comorbidities were dyspepsia (41%), anxiety (38%), depression (21%), headache (25%), or insomnia (25%). 58% of patients had an average of 4.1 ± 2.5 diagnostic tests during follow-up. 85% of patients took pharmacological medication (80% took some pharmacological medication for their IBS-C). The most common prescription drugs were plantago ovata (35%), otilonium bromide (22%), macrogol plus electrolites (13%) and cinitapride tartrate (10%). Likewise, common drug combinations were laxative monotherapy (21%), laxatives and antispasmodics (14%), and antispasmodic monotherapy (5%). In addition, 30% of patients received complementary therapies. Overall, marginal improvement was noted in symptom severity (IBS-SSS total score) between baseline (315±83) and the 6-month visit (234±98). Conclusions: Moderate-to-severe IBS-C symptoms often remain undiagnosed for many years. With frequent visits to health care professionals IBS-C continues to be a burden despite the availability of therapeutic interventions. Finally, current health care resource utilization is high even though there is a high degree of prescription medication use.