Carmona-Sánchez R

Language: Spanish
References: 21
Page: 222-226
PDF size: 62.07 Kb.

ABSTRACT

Background: It is still unknown whether the treatment and control of conditions that coexist with irritable bowel syndrome (IBS) change the utilization of healthcare resources for this disease. Objectives: To determine whether the treatment of subclinical hypothyroidism in patients with IBS decreased the use of healthcare resources and work absenteeism. Material and methods: Patients with IBS and subclinical hypothyroidism (cases) and patients with IBS and no hypothyroidism (controls) were diagnosed during a three-year period. Other conditions were ruled out by means of a group of tests. Four years later, a survey on the associated medical events, the use of healthcare resources, and work absenteeism during the previous year was applied. Controls were age- and gender-matched at a 2:1 control: case ratio. Results: Fourteen cases and 28 controls were studied, all of them females, with a mean age of 46 years. The survey was conducted 4 years after the initial diagnosis in both groups. No significant differences were found between both groups in the following: the proportion of the patients who had received medical treatment for IBS (79% of cases vs 82% of controls), the prescription of psychotropics (36% vs. 36%, respectively), the proportion seen in the emergency room due to gastrointestinal complaints (21% vs. 18%, respectively), job absenteeism (7% vs 11%, respectively), and the proportion of patients who underwent abdominal surgery (14% vs. 11%, respectively). The mean number of visits to the doctor due to gastrointestinal complaints within the year prior to the interview was similar in both groups (3.1 for cases vs. 3.4 for controls). Conclusions: The detection and treatment of subclinical hypothyroidism do not modify the utilization of healthcare resources in IBS.

REFERENCES

1. Camilleri M, Prather CM. The irritable bowel syndrome: mechanisms and a practical approach to management. Ann Intern Med 1992; 116: 1001-8.

2. Schmulson M. Colon irritable. En: Villalobos JJ, Valdovinos MA, Olivera MA, editores. Principios de gastroenterología. 1a. Ed. México: Méndez Editores; 2001, p. 501-10.

3. Schmulson-Wasserman MJ, Valdovinos-Díaz MA. Utilización de recursos médicos por los pacientes con síndrome de intestino irritable en un hospital de tercer nivel. Rev Gastroenterol Méx 1998; 63: 6-10.

4. Valenzuela J, Alvarado J, Cohen H, et al. Un consenso Latinoamericano sobre el síndrome del intestino irritable. Gastroenterol Hepatol 2004; 27: 325-43.

5. Schmulson M, Valenzuela J, Alvarado J y cols. Consenso Latinoamericano sobre el síndrome del intestino irritable: algoritmo de diagnóstico y tratamiento. Gastroenterol Hepatol 2004; 27: 335-6.

6. Carmona-Sánchez R, Navarro-Cano G. El valor diagnóstico de la investigación limitada en pacientes con síndrome de intestino irritable. Rev Gastroenterol Méx 2004; 69: 24-29.

7. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology 2006; 130: 1480-91.

8. Cuevas-Ramos D, Pérez-Enríquez B. Disfunción tiroidea subclínica. Consideraciones diagnósticas y terapéuticas. Rev Invest Clin 2006; 58: 608-16.

9. American Gastroenterological Association Patient Care Committee. Irritable bowel syndrome: a technical review for practice guideline development. Gastroenterology 1997; 112: 2120-37.

10. Camilleri M. Management of the irritable bowel syndrome. Gastroenterology 2001; 120: 652-8.

11. Schmulson MW, Chang L. Diagnostic approach to the patient with irritable bowel syndrome. Am J Med 1999; 107: 20S-26S.

12. Brandt LJ, Bjorkman D, Fannerty MB, et al. Systematic review on the management of irritable bowel syndrome in North America. Am J Gastroenterol 2002; 97(Suppl.): S7.

13. Brandt LJ, Locke GR, Olden K, et al. An evidence-based approach to the management of irritable bowel syndrome in North America. Am J Gastroenterol 2002; 97 (Suppl.): S13-S15.

14. Hamm LR, Sorrells SC, Harding JO, et al. Additional investigations fail to alter the diagnosis of irritable bowel syndrome in subjects fulfilling the Rome criteria. Am J Gastroenterol 1999; 94: 1279-82.

15. Tolliver BA, Herrera JL, DiPlama JA. Evaluation of patients who meet clinical criteria for irritable bowel syndrome. Am J Gastroenterol 1994; 89: 176-8.

16. Sanders DS, Carter MJ, Hulstone DP, et al. Association of adult celiac disease with irritable bowel syndrome: a case-control study in patients fulfilling the ROME II criteria referred to secondary care. Lancet 2001; 358: 1504-8.

17. Locke GR 3rd, Murray JA, Zinsmeister AR, Melton LJ 3rd, Talley NJ. Celiac disease serology in irritable bowel syndrome and dyspepsia: a population-based case-control study. Mayo Clin Proc 2004; 79: 476-82.

18. Collins SM, Ismail M. Irritable bowel syndrome. In: Irvine EJ, Hunt RH (eds.). Evidence-based gastroenterology. 1st. Ed. Hamilton, Ontario: BD Decker Inc; 2001, p. 194-206.

19. Ladenson PW, Singer PA, Ain KB, et al. American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Intern Med 2000; 160: 1573-5.

20. Helfand M, Redfern CC. Screening for thyroid disease: An update. Ann Intern Med 1998; 129: 144–58.

21. Cash BD, Schoenfeld P, Chey WD. The utility of diagnostic test in irritable bowel syndrome patients: A systematic review. Am J Gastroenterol 2002; 97: 2812-19.