Introduction

Irritable bowel syndrome (IBS) is a condition, frequently encountered in primary care without a single precise diagnosis. Manning et al stated that a diagnosis could be made if a patient had abdominal pain with two or more other specified gastrointestinal symptoms.¹ Generally prevalence is thought to be 10-22% of adults with a slightly greater prevalence in women.² Little is known about those who purchase non-prescription treatments from pharmacies, and the precise symptoms for which they are taken. The aim of this study was to profile the demographic characteristics, symptom profiles and trigger foods for such patients.

Method

A questionnaire was initially pre-piloted by a volunteer group of local IBS sufferers and a pilot was conducted in five local pharmacies. The symptomatology section of the questionnaire was derived from a study of IBS sufferers in Sweden.³ The survey was undertaken in a stratified random sample of 111 Boots stores in England, Scotland and Wales.

Results

286 valid responses were received: 231 (83.4%) were female and 46 (16.6%) were male. Nine (3.1%) respondents were aged 16-20, 45 (16%) aged 21-30, 49 (17%) aged 31-40, 70 (24.4%) aged 41-50, 71 (24.6%) aged 51-60 and 43 (15%) over 60. 237 of 283 respondents (83.7%) had been diagnosed with IBS by a doctor.

The wide range of symptoms reported by patients will be presented. 241 respondents (83.7%) could be positively diagnosed using the Manning criteria. 51 (17.8%) patients reported "alarm" symptoms. Commonly reported trigger factors were spiced foods (148, 46.7%), fatty foods (100, 34.8%), dairy products (75, 26.1%) and alcohol (74, 25.8%). There was a positive correlation between the perceived severity of symptoms and the number of trigger foods (ρ=0.194, p<0.01).

Discussion

The high number of female respondents was anticipated as women are more likely to suffer from IBS, and are considered to be more likely to purchase OTC products. Most patients who purchase OTC IBS treatments do so after diagnosis, often previously having the same drug on prescription. The numbers of patients reporting alarm symptoms is high, indicating that questioning about such symptoms may need to be part of the protocol for selling such products.

References

1. Manning AP, Thompson WG, Heaton KW, Morris AF. Towards positive diagnosis of the irritable bowel. BMJ 1978; 2: 653-654.

2. Lynn RB, Friedman LS. Irritable Bowel Syndrome. New Eng. J. Med. 1993; 329: 1940-1945.

3. Agreus L, Talley NJ, Svardsudd G, Tibblin G, Jones MP. Identifying dyspepsia and irritable bowel syndrome: The value of pain or discomfort and bowel habit descriptors. Scand. J. Gastroenterol. 2000; 2 (6138): 142-150.