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PWE-251 Diagnosis and management of moderate-to-severe irritable bowel syndrome with constipation (IBS-C) in the UK: the IBIS-C study
  1. Y Yiannakou1,
  2. M Eugenicos2,
  3. DS Sanders3,
  4. A Emmanuel4,
  5. P Whorwell5,
  6. F Butt6,
  7. S Bridger7,
  8. N Arebi8,
  9. A Millar9,
  10. V Kaushik10,
  11. M Rance11,
  12. J Mackinnon12,
  13. J Bertsch12,
  14. J Fortea11,
  15. J Tack13
  1. 1University Hospital of North Durham, Durham
  2. 2Western General Hospital, Edinburgh
  3. 3Royal Hallamshire Hospital, Sheffield
  4. 4University College Hospital, London
  5. 5Wythenshawe Hospital, Manchester
  6. 6South Tyneside NHS Trust, South Shields
  7. 7Dorset County Hospital, Dorchester
  8. 8St Mark’s Hospital, Harrow
  9. 9North Middlesex University Hospital, London
  10. 10Royal Blackburn Hospital, Blackburn, UK
  11. 11Almirall S. A
  12. 12TFS Develop S. L, Barcelona, Spain
  13. 13University Hospital Gasthuisberg, Leuven, Belgium

Abstract

Introduction The IBIS-C study assessed the burden of IBS-C in 6 European countries (France, Germany, Italy, Spain, Sweden, and UK). Here we present the diagnosis and management results for the UK.

Method Observational study in patients (pts) diagnosed with moderate-to-severe IBS-C in the last five years (Rome-III criteria) with a 12-month follow-up (6 months retrospective and 6 months prospective, in order to assess health resource utilisation [HRU] prior to and after an active phase of the disease). Moderate-to-severe IBS-C was defined as an IBS-Symptom Severity Score (IBS-SSS) ≥175.

Results 104 pts were included (79% severe, mean age [±SD] 45.5 ± 14.6 years old, 93% female). Mean time since diagnosis: 2.6 ± 4.0 years; mean symptom duration: 15.3 ± 14.9 yrs. Diagnostic procedures were highly variable; the most common were blood tests (72%), colonoscopy (69%), and abdominal ultrasound (55%). At inclusion the most prevalent symptoms were abdominal pain (92%) and bloating (91%). Main ongoing comorbidities were anxiety (50%), chronic pain (44%), headache (40%), insomnia (33%), or dyspepsia (31%). 52% of pts had an average of 3.6 ± 2.7 diagnostic tests during follow-up, the most common were haematology (29%) and clinical chemistry (29%) blood tests, and colonoscopy (13%). 93% of pts took prescription drugs (90% took prescription drugs for their IBS-C). The most common medication groups were: laxatives (81%), prokinetics (32%), antispasmodics (20%), and analgesics (18%) alone or in combination. Overall, 63% of pts took OTC medication for their IBS-C; the most common were laxatives (37%), prebiotics/probiotics (14%), and peppermint oil (14%). In addition, 36% of pts received complementary therapies. Overall, marginal improvement was noted in symptom severity (IBS-SSS total score) between baseline (373 ± 83) and the 6-month visit (324 ± 113).

Conclusion Moderate-to-severe IBS-C symptoms often remain undiagnosed for many years and degree of control does not improve over time even though there is a high degree of prescription medication use. Consequently, moderate-to-severe IBS-C continues to be a burden despite the availability of therapeutic interventions.

Disclosure of interest Y. Yiannakou Conflict with: Grants: Shire; Medtronic. Speaker fees: Almirall; Shire; Sucampo, M. Eugenicos Conflict with: Consultant/Advisory Board Member: Almirall; Astellas; Dr Falk Pharma; NAPP; and Shire., D. Sanders Consultant for: Almirall, A. Emmanuel Conflict with: Advisory Board and Educational Talk honoraria: Almirall., P. Whorwell Conflict with: Consultant/research grant support: Almirall; Chr. Hansen; Danone Research; Ironwood; Salix; Shire; Sucampo., F. Butt: None Declared, S. Bridger: None Declared, N. Arebi: None Declared, A. Millar Conflict with: The hospital received payment from Almirall for the conduct of the study, V. Kaushik Conflict with: Advisory Board and Educational Talk honoraria: Almirall. Meeting support: Cooks; Tillotts; AbbVie, M. Rance Employee of: Almirall, J. Mackinnon Employee of: TFS Develop S. L, contracted by Almirall S. A to conduct the study, J. Bertsch Employee of: TFS Develop S. L, contracted by Almirall S. A to conduct the study, J. Fortea Employee of: Almirall, J. Tack Conflict with: Grants/research support: Abbott; Novartis; Shire. Honoraria/consultancy fees: Almirall; AstraZeneca; Danone; GI Dyamics; GlaxoSmithKline; Ironwood; Janssen; Menarini; Novartis; Rhythm; Shire; Takeda; Theravance; Tsumura; Will Pharma; Zeria. Speaker fees: Abbott; Almirall; AstraZeneca; Janssen; Menarini; Novartis; Shire; Takeda; Zeria.

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