title: The impact of irritable bowel syndrome on health-related quality of life: a Singapore perspective.
abstract: BACKGROUND
  Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. The prevalence of IBS in Asian countries varies from 2.9% to 15.6%. IBS does not result in increased mortality, but is associated with psychological distress and disruption of work and sleep. Consequently, the evaluation of health-related quality of life (HRQoL) is an important outcome measure for patients with IBS since it provides a holistic assessment of the patient's emotional, social and physical function. However, some HRQoL tools can be time-consuming to apply. EQ-5D is a brief HRQoL tool which has been validated in the Western IBS population but has thus far not been used in Asia. This study was conducted to determine whether persons with self-reported symptoms that met the Rome III criteria for IBS had a poorer quality of life than those without these symptoms. We also aimed to determine which specific aspects of quality of life were most affected and whether any risk factors distinguished those with and without IBS.
  
  
  METHODS
  Self-administered questionnaires which included the Rome III diagnostic questionnaire modules for IBS and the EQ-5D questionnaire were obtained from participants of a health symposium in Singapore on 31th October 2010. IBS was diagnosed based on the Rome III Criteria. The main outcome measure was the EQ-5D index score. The relationship between the presence of IBS and the EQ-5D index score, individual dimensions of EQ-5D and demographic risk factors were examined.
  
  
  RESULTS
  449 completed questionnaires were analyzed. The mean EQ-5D index score for IBS was 0.739 which was a significant reduction compared to non-IBS participants [-0.11 (95% CI: -0.15 to -0.07), p<0.001]. Multivariate analysis showed that IBS was significantly associated with younger age and higher education level. Of the five EQ-5D dimensions, IBS sufferers were significantly affected in mobility, anxiety or depression, usual activity and pain. There was a "dose related" increase in likelihood of having IBS with increased severity of pain and anxiety or depression.
  
  
  CONCLUSIONS
  IBS sufferers have significantly poorer quality of life. Assessment of HRQoL in IBS using the EQ-5D should be considered in further studies and routine clinical practice.
authors.affiliation: Department of Gastroenterology and Hepatology, Singapore General Hospital, Duke-NUS Graduate Medical School, Singapore. wangyutien@gmail.com
authors.forename: Yu Tien
authors.initials: YT
authors.lastname: Wang
authors.forename: Hwee Yong
authors.initials: HY
authors.lastname: Lim
authors.forename: David
authors.initials: D
authors.lastname: Tai
authors.forename: Thinesh L
authors.initials: TL
authors.lastname: Krishnamoorthy
authors.forename: Tira
authors.initials: T
authors.lastname: Tan
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Barbier
authors.forename: Julian
authors.initials: J
authors.lastname: Thumboo
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires