Irritable bowel syndrome diagnosed in primary care

Background: IBS is the most common functional gastrointestinal disorders and affects approximately 10-20 % of the general population and is widespread in all societies and socio-economic groups. Although the disorder does not have a life-threatening course, it still seriously affects the patients in their everyday life.

Aim: The general aims of this thesis were to estimate the occurrence of irritable bowel syndrome in the general population and to achieve a better understanding of present treatment of this disorder and impact on every-day life in those suffering from IBS.
Material and methods: The LIPS study comprises two parts. Part I was a retrospective register study where the data collection was based on computerised medical records at three selected Primary Health Care centres in a defined region. Part II was a population based case-control study. The identified IBS cases from part I constitute the cases, while their control groups were randomly selected from the population census register in the same area as the cases. Data in part II were collected by means of a postal questionnaire to cases and controls. The study was conducted in Linköping, a city located in the south-east of Sweden with 135 000 inhabitants.
Results: The female IBS patients reported lower influence on planning their work and working hours as well as fewer opportunities to learn new things at their work compared to their controls, even after adjustments in multiple logistic regressions for potential confounders like; mood, sleeping problems and perceived health. The female IBS patients had considerably lower HRQOL in all dimensions compared to their controls, even when compared to male patients. Younger female IBS cases (18-44 years) reported lower mental health on the SF-36 scale than the older IBS female cases (p=0.015). In the multivariate analysis these variables, lack of influence on planning the work, family history of IBS, anxiety and sleeping disturbance displayed an association with being diagnosed with IBS in women. In men, lack of influence on working pace, family history of IBS was associated with an IBS diagnosis…


1. Functional gastrointestinal problems in the general population
1.1 Definition functional gastrointestinal disorder
1.2 Historical perspective
1.3 Clinical definition, diagnosing and health utilization
1.3.1 The etiology, pathophysiology and possible mechanism of IBS
1.4 Diagnostic criteria
1.5 Diagnosis setting in primary care
1.6 Health care utilization
2. Epidemiological perspective and impact on health
2.1 Public health perspective
2.1.1 Gender perspective
2.2 Psychosocial factors associated to IBS
2.2.1 Coping with IBS
2.3 Health and health-related quality of life
2.3.1 The concept of health and health-related quality of life
2.3.2 Health-related quality of life in different cultures
2.4 Treatment today
2.5 Referral
3. Aims of the study
3.1 General aims
3.2 Specific aims
4. Materials and Methods
4.1 The Linköping IBS Populations Study (LIPS)
4.2 Study design
4.2.1 Study population, part I (paper 1, II)
4.2.2 Consulting incidence
4.3 Study population, part II (paper III, IV, V)
4.3.1 The LIPS cases and controls
4.4 Postal questionnaire and instruments used in part II
4.4.1 Questions on everyday work demands and control
4.4.2 Stress, sick leave and co-morbidity
4.4.3 Health Related Quality of Life questionnaire – SF-36
4.4.4 The Hospital Anxiety and Depression scale (HAD)
4.4.5 Sleeping problems
4.5 Comparison of LIPS data and Greek data
4.5.1 The Greek IBS cases and controls
4.5.2 The Swedish IBS cases and controls
4.6 Statistical analysis
4.6.1 Paper I, II
4.6.2 Paper III, V
4.6.3 Paper IV
5. Results
5.1 Paper I
5.2 Paper II
5.3 Paper III
5.4 Paper IV
5.5 Paper V
6. Discussion
6.1 Conclusion
6.2 Further research
Summary in Swedish

Author: Olsen Faresjö, Åshild

Source: Linköping University

Download URL 2: Visit Now

Leave a Comment