Health-related quality of life, work productivity and health care resource use associated with constipation predominant irritable bowel syndrome

Curr Med Res Opin. 2011 Nov;27(11):2213-22. doi: 10.1185/03007995.2011.623157. Epub 2011 Sep 28.


Objectives: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. Prevalence estimates of IBS vary widely, from 10 to 15%, in the U.S. However, few studies have examined constipation predominant IBS (IBS-C), a subtype of IBS. The aim of this study was to assess the effect of IBS-C on health-related quality of life (HRQOL), work productivity and activity impairment, and health care resource use.

Methods: Using data from the 2007 U.S. National Health and Wellness Survey, IBS-C patients (n = 789) were compared to a propensity-score matched comparison group (n = 789). Differences between the groups were examined on HRQOL (SF-12v2), work productivity and activity impairment (WPAI questionnaire), and self-reported resource use in the last 6 months.

Results: Patients with IBS-C reported significantly lower levels of HRQOL (physical component summary score: 41.55 [95% CI: 40.72-42.37] versus 44.49 [95% CI: 43.67-45.31]; mental component summary score: 40.58 [95% CI: 39.75-41.40] vs. 45.87 [95% CI: 45.04-46.70]) and significantly higher mean levels of presenteeism (31.72% [95% CI: 28.25%-35.61%] vs. 21.43% [95% CI: 19.03%-24.15%]), overall work impairment (35.54% [95% CI: 31.76%-39.76%] vs. 25.29% [95% CI: 22.59%-28.30%]), and activity impairment (45.78% [95% CI: 43.08%-48.66%] vs. 33.03% [95% CI: 31.08%-35.11%]) than matched comparators (all P values < 0.01). Patients with IBS-C reported significantly more provider visits (8.07 [95% CI: 7.38-8.82] vs. 5.55 [95% CI: 5.07-6.08]) and emergency room visits (0.57 [95% CI: 0.46-0.70] vs. 0.36 [95% CI: 0.29-0.45]) in the past 6 months (all Ps < 0.01). No statistically significant differences between the groups were observed in absenteeism or the number of the days hospitalized.

Conclusions: IBS-C was associated with poorer HRQOL, greater work productivity loss and activity impairment, and greater healthcare resource use. Limitations include the study's cross-sectional design and its self-reported nature. Nevertheless, improved management of IBS-C may reduce the humanistic and economic burden of the condition and benefit patients, employers, and the healthcare system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Constipation / etiology*
  • Cross-Sectional Studies
  • Delivery of Health Care / statistics & numerical data*
  • Efficiency
  • Employment
  • Female
  • Health Surveys
  • Humans
  • Income
  • Irritable Bowel Syndrome / complications*
  • Irritable Bowel Syndrome / economics
  • Middle Aged
  • Quality of Life*
  • United States