ABSTRACT
Background: Irritable bowel syndrome with constipation (IBS-C) is a chronic disorder of gut-brain interaction (DGBI) that has a significant negative impact on patients. The objective of this study was to examine disease burden and care-seeking behavior of IBS-C patients during the COVID-19 pandemic. Methods: A cross-sectional, on-line, general health survey collected data on US adults aged >18 from Aug – Oct 2020. IBS-C patients were defined using Rome IV criteria for IBS-C and matched 1:1 by age, sex, region, and comorbidity score to the general population. Health outcomes comparing IBS-C patients vs controls included anxiety (using Generalized Anxiety Disorder scale [GAD-7]), depression (using Patient Health Questionnaire 9 [PHQ-9]), health-related quality of life (HRQoL) (using Veterans RAND 12-item Health Survey [VR-12]), and work productivity using study-specific questions. Mean frequencies were compared with ANOVA and proportions with chi-square tests. For IBS-C patients, care-seeking behavior included healthcare visits in the past 12 months, canceled visits due to COVID-19, and medication use (prescription vs over-the-counter (OTC)). Commonly reported bothersome symptoms and the impact of COVID-19 on the worsening of IBS-C symptoms were also assessed descriptively. Results: Of 7,214 survey participants, 138 met Rome IV criteria for IBS-C. Matching resulted in a sample of 130 IBS-C patients and 130 controls. Mean age of IBS-C patients was 45.1 (SD 15.1) years, with the majority being female (79.2%) and white (82.3%). IBS-C patients had a significantly higher proportion of moderate-to-severe anxiety and depression and significantly lower HRQoL versus controls (see Table). Absenteeism and presenteeism in the past 7 days were also significantly higher among IBS-C patients vs controls. 53.4% percent of IBS-C patients sought care from a healthcare provider in the past year for their IBS symptoms and nearly a quarter of IBS-C patients reported cancelling healthcare visits due to COVID-19. 25.4% of IBS-C patients reported taking a prescription medication whereas 68.5% reported currently taking an OTC for their IBS-C symptoms. The most common bothersome symptoms in the past 7 days included abdominal discomfort, abdominal pain, straining, abdominal bloating and incomplete bowel movements. Over a third of IBS-C patients indicated their symptoms worsened during the COVID-19 pandemic. Conclusions: There remains a considerable disease burden and unmet need for IBS-C patients, with patients suffering from multiple bothersome symptoms and low rates of prescription medication use. COVID-19 seems to have worsened IBS symptoms for many patients (Table Presented) (Table Presented)