ECCO/CDDW 2017: Irritable Bowel Syndrome

CDDW 2017. A269. Irritable Bowel Syndrome Patient Experience in Canada 

G.P. Attara, J. Gray, G. Aumais

Results: Respondents from every province and territory totalled 2,961. 90% were between 30-69 years of age, 86% female, 97% were adults with IBS. 53% had IBS for more than 10 years. 35% had IBS-D, 18% IBS-C, 41% IBS-M, and 6% unsure. In IBS-C patients, abdominal pain was identified as a distinct predominant symptom. Those with IBS-D experienced many symptoms, with abdominal pain, bloating, urgency, and diarrhea identified as highly concerning. 24% experienced severe abdominal pain in the last 3 months, with severe pain being constant in a high proportion. 62% of patients indicated they experienced pain continuing after bowel movement. The top factors driving patients to see their physician were pain/discomfort and impact of IBS on their personal/professional/daily life. Approximately 93% and 49% of patients consulted with a family doctor and gastroenterologist, respectively, for their IBS. 60% had a colonoscopy. 12% have been hospitalized for IBS. 76% indicated that their symptoms interfere with everyday life and 46% missed work or school due to IBS. Most IBS patients use ≥2 medications on a regular basis to control their symptoms yet only 21% are confident their symptoms are under control. Compounding the issue, 16% are unable to afford any of their prescribed medications, and 26% can only afford some of them.

Conclusion: Canadian IBS patients suffer from multiple symptoms, with the pain experienced by patients being the prime motivating factor to seek care. 79% have symptoms not under control. The conventional standard of care for IBS requires many different treatments to manage the multiple symptoms, with the majority of IBS patients requiring 2 or more treatments on a regular basis. IBS patients experience a wide range of symptoms and comorbidities. It can be a struggle for them to find treatments that are effective and affordable.

CARE Faculty Perspective: IBS is a chronic functional gastrointestinal disorder that affects 13-20% of Canadians. There are a number of symptoms associated with IBS, and research has shown that abdominal pain and bloating are some of the most bothersome symptoms. Lifestyle interventions, such as increased dietary fiber, water intake, and exercise, for the treatment of IBS are universally recommended. However, lifestyle modifications are often not enough.

This study found that one of the main reasons patient seek treatment is due to pain. Linaclotide is approved for both IBS-C and CIC, and has shown to consistently provide abdominal pain relief. In the field of IBS-D, there are no currently approved agents however eluxadoline and rifaximin are currently being reviewed by Health Canada and appear to be promising.