Epidemiology

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Chronic abdominal pain is one of the most common pediatric complaints,3 accounting for

2-4% all of pediatric office visits.4 Symptoms consistent with irritable bowel syndrome (IBS), one of the most common functional bowel disorders, occur in 14% of all high-school students and 6% of all middle-school students.5 IBS is more prevalent than other medical conditions such as hypertension, asthma and diabetes that tend to receive greater medical attention.6 As many patients with IBS do not seek medical attention, assessing the prevalence of IBS is often difficult. Current estimates suggest that only one in four patients with symptoms of IBS seek medical care for their symptoms.7 Population-based studies of adults have shown IBS-type symptoms in 13-15% of adult females, with abdominal pain reported as the most common complaint.8 Reports from Kenya, Poland, Russia, India and Pakistan reveal that, although the relative frequency of an organic etiology for chronic pain may differ in various regions of the world, functional abdominal pain is probably a universal problem.9-12 A Malaysian study in 1500 schoolchildren found evidence of chronic abdominal pain in 10% of children, concluding that, in spite of differences in diet, customs and culture, the overall prevalence of this entity was similar across regions.13 A Danish study also demonstrated that 15% of children aged 9-12 years had recurrent abdominal pain.14

Quality of life in patients with IBS is substantially poorer than in the general population or in those suffering from asthma or migraine.15 Costs related to functional bowel disorders are also enormous, with direct and indirect medical expenses associated with IBS being estimated as up to US$ 30 billion a year, comparable to those of asthma, stroke, hypertensive disease, migraine and arthri-tis.16-18 IBS also has a high impact on a patient's productivity, as a result of missed working days.19 A recent survey of adult patients suffering from

IBS showed that 15% believed that IBS would stop them from finding a long-term partner, 16% had turned down a date in fear of the embarrassment that may result from intimacy, and 17% stated that they had a relationship ending as a consequence of IBS.20 The survey also revealed that 12% of respondents had to give up working, while 35% of employed respondents reported having lost work time due to IBS. In addition to the direct and indirect costs, IBS patients are affected by intangible costs and social stigma. In 14% of cases, IBS symptoms were not accepted as a valid reason for absence by their employers. One-third of the patients with IBS had refrained from applying for promotions for positions involving multiple meetings and presentations.20

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Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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