title: Patients with irritable bowel syndrome: health status and use of health care services.
abstract: BACKGROUND
  The reason for consulting a physician is more related to illness behaviour than to the severity of complaints. Yet, little is known about the course of complaints, the health care seeking behaviour, and psychosocial factors influencing these items in patients with irritable bowel syndrome (IBS) attending the general practitioner (GP).
  
  
  OBJECTIVE
  To study health status, lifestyle, and use of health care services of patients with IBS in order to indicate problem areas accessible for intervention strategies.
  
  
  METHODS
  Structured interviews of 53 patients with IBS aged 15 years and older compared with a general population of 12,975 in the same age range, all drawn from the Dutch National survey of Morbidity and Intervention in General Practice.
  
  
  RESULTS
  Patients with IBS revealed a lower grade of education (P < 0.001), poorer health (P < 0.001), a higher mean complaint score (8.3 versus 4.0, P < 0.001), a higher score on the General Health Questionnaire (P < 0.001), a higher score on the biographic problem list (BIOPRO, 2.3 versus 1.4, P < 0.001), and more absence from work (32% versus 18% in two months, P < 0.01). Patients with IBS consulted the family physician (1.6 versus 0.8 in three months, P < 0.001), the physical therapist (30% versus 15% in one year, P < 0.001), and the alternative therapist (32% versus 15% in five years, P < 0.001) more often than those without.
  
  
  CONCLUSIONS
  The study shows an excess of comorbidity, psychosocial problems, use of health care services, and absence owing to disease in patients with IBS. Special guidelines and training of GPs to apply a more integral approach may reduce the cost of health care and may lead to a more favourable course in patients with IBS.
authors.affiliation: Netherlands Institute of Primary Healthcare (NIVEL), Utrecht, The Netherlands.
authors.forename: G A
authors.initials: GA
authors.lastname: Donker
authors.forename: M
authors.initials: M
authors.lastname: Foets
authors.forename: P
authors.initials: P
authors.lastname: Spreeuwenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003109:Colonic Diseases, Functional / Q000628:therapy*; D000529:Complementary Therapies; D005194:Family Practice; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors