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Preface
Women’s health research has emerged from its early emphasis on reproduction to address a much
more complex array of women’s health issues. We now understand how sex plays a major
role in the underlying causes and effects of heart disease, musculoskeletal disorders, and
metabolic/digestive disorders. Among the latter, irritable bowel syndrome (IBS) is one of the
least understood and most frustrating—for patients as well as for the medical community.
Approximately 60% to 75% of Americans with IBS are women. Despite research to date,
scientists are still unable to explain the predominance of IBS in women. Since the National
Institutes of Health mandated that women be included in clinical trials in 1990, differences
in the way disease states manifest in men and women have been noted. Sex differences in
reproductive hormones, pain perception, stress response, and gastrointestinal function may
partially explain a woman’s increased susceptibility to IBS. Despite these findings, definitive
evidence explaining the true reasons why IBS affects women more often than men remains
elusive. In addition to these findings, cultural differences in health-care–seeking behaviors
and differences in reporting habits and symptom-response profiles between the sexes also
have been observed. A closer examination of the differences in presentation of IBS in women and
men is clearly warranted. This report attempts to capture the unmet needs of women with IBS.
Experts now understand that IBS has a complex biologic basis with a physiologic cause, yet
most Americans still do not recognize IBS as a common medical disorder. This lack of
awareness was confirmed in a telephone survey of 1,000 adults conducted in May 2002 (see
the Appendix for a brief overview of the methodology). Participants were asked to rank 5
conditions (asthma, coronary heart disease, depression, diabetes, and IBS) in order of their
prevalence. Although IBS affects approximately 1 in 6 Americans, only 1.2% of respondents
correctly identified IBS as the most prevalent of these 5 conditions.
Although the consequences of IBS for patients may not always be obvious to health care
providers or the general public, its impact on people living with the symptoms of abdominal pain
or discomfort, bloating, and constipation or diarrhea, is all too real. There is a growing body
of medical literature that describes the many ways IBS can significantly reduce a person’s
quality of life, causing as much distress as do conditions such as asthma and migraine headaches.
Discomfort from the symptoms of IBS may be intolerable for many patients, yet few medical
treatments provide adequate relief for the multiple symptoms of this troubling disorder.
Instead, IBS remains underrecognized, and diagnosis can be elusive as patients shuffle from
physician to physician in search of relief from these often debilitating symptoms. These
patients struggle with pain, isolation, and frustration. Physicians and other health care
providers (eg, physician assistants, nurse practitioners, nurses) themselves often struggle to
identify the disorder and, once they do so, they have a limited array of treatment options
from which to choose.
A disturbing picture emerges of IBS patients who must plan their days around their access
to a bathroom. They often miss social events, work or school. They also visit physicians
more frequently than do healthy individuals. The societal toll mounts dramatically—the
condition costs the United States health care system as much as $30 billion annually in
direct and indirect costs.1,2
This report offers a timely and compelling look at the significant impact of IBS symptoms on
patient’s lives; unmet needs of IBS patients; the urgency to help remove the communication
barriers between physicians and patients with a common language to describe IBS and
its symptoms; and the need for greater public understanding of the heavy burden IBS
places on women.
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