Doctor’s Reassurance & Irritable Bowel Syndrome (IBS)
As we have reported in The Inside Tract® many times, doctors have modified the clinical diagnosis criteria for irritable bowel syndrome (IBS) over time, but the fundamental nature remains that this is a functional disorder of the gastrointestinal tract, which results in altered bowel habit and abdominal pain.
New research shows that if a doctor reassures a patient that IBS is a chronic and recurring disorder, which does not lead to more serious disease or cancer, then the patient’s quality of life improves. In this study, published recently in the Journal of Psychosomatic Research, the authors state, “Patients want to be heard and understood and to be given information about their disease.”
Irritable bowel syndrome is the most frequent functional gastrointestinal disorder throughout the world, ranging in prevalence from 5-25%. It is the most frequent reason for referral to a gastroenterologist and the fourth most common gastrointestinal-related outpatient diagnosis among internal medicine and general practice physicians. IBS is costly to society in terms of work and school absenteeism, presenteeism, and excessive use of health resources. Its toll on quality of life for sufferers is similar to those with cirrhosis of the liver, kidney insufficiency and/or type 2 diabetes. Surprisingly, despite its high frequency, only one third of suffers seek medical care for the troublesome symptoms.
In this study, fifty-five people with IBS (46 female, 9 male), seen at a clinic in Mexico City, completed several questionnaires. The predominant IBS symptom for seeking medical care for 78% of the patients was abdominal pain, 11% were concerned that they might have cancer, 33% had impairment of daily function, and 60% said they had symptom stressfulness. Excessive diagnostic testing increases a patient’s stress level. Impairment of daily function and symptom stress were the two factors most likely to lower quality of life. The questionnaires allowed for multiple reasons for seeking care.
The authors concluded that if a doctor reassures a patient when first diagnosed with IBS regarding the long-term safeness of this disorder, then the patient will feel better about the uncomfortable and troublesome IBS symptoms, leading to improved quality of life. While the symptoms might remain severe, patients fare better when reassured that IBS does not lead to disease that is more serious or cancer, even if symptoms do not change.
What Is Presenteeism?
A play on the word absenteeism, presenteeism is a new term coined this century meaning the lost productivity that occurs when employees come to work but are not fully contributing due to illness or inattention. While absenteeism costs are obvious, in that 100% percent of the worker’s productivity is lost each day the worker is not on the job, the cost of presenteeism is a hidden cost because the worker is on the job and being paid 100%, but might not be performing up to the usual degree or accomplishing the anticipated amount.