Therapeutic value of a gastroenterology consultation in irritable bowel syndrome |
| |
Authors: | Ilnyckyj A Graff L A Blanchard J F Bernstein C N |
| |
Affiliation: | Departments of Internal Medicine and Clinical Health Psychology, Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. ailnycky@mail.sbgh.mb.ca |
| |
Abstract: | BACKGROUND: Functional patients comprise the largest group in gastroenterology practice. Pharmacological therapy of irritable bowel syndrome is disappointing. One treatment strategy for irritable bowel syndrome emphasizes the physician's role; the physician is promoted as the therapeutic modality. AIM: To determine the therapeutic value of the contemporary approach to irritable bowel syndrome by examining health care utilization and patient morbidity. METHODS: We performed an observational study over 4 years using an administrative database and morbidity scales. Health care utilization was assessed for 2 years pre- and post-intervention. Patient morbidity was assessed at baseline and 1 and 2 years post-intervention. The participants included 70 irritable bowel syndrome patients referred by primary physicians. A structured consultation was performed, establishing a positive diagnosis of irritable bowel syndrome and providing disease conceptualization. RESULTS: Health care utilization for gastrointestinal diagnoses increased in the year prior to the intervention and declined immediately after to baseline; psychiatric and other visits remained unchanged for 4 years. Pain was reduced but other morbidity persisted. CONCLUSIONS: A consultation itself is a therapeutic intervention in irritable bowel syndrome with regard to its impact on societal economic burden. It is associated with a durable decrease in illness-specific health care utilization. It may not address all aspects of irritable bowel syndrome; multiple domains of morbidity demonstrated persistent distress. |
| |
Keywords: | |
本文献已被 PubMed 等数据库收录! |
|