The Prevalence, Comorbidity, Management and Costs of Irritable Bowel Syndrome.

Abstract

Insufficient data are available on the administrative incidence and prevalence of irritable bowel syndrome (IBS) in Germany, as well as on its comorbidities, diagnostic evaluation, treatment, and costs. We analyzed routine data from a statutory health insurance carrier with approximately eight million insurees. IBS was identified from the ICD-10 codes K58.0, K58.9, and F45.32 (outpatient care by a physician, outpatient and inpatient care in a hospital). The cumulative incidence for the year 2017 was determined by the exclusion of insurees who had carried the diagnosis of IBS in any of the preceding 12 years. The frequencies of comorbid diseases and of diagnostic and therapeutic measures were compared with those of persons in age- and sex- matched control groups without IBS. In 2017, the administrative incidence of IBS was 0.36%, and its prevalence was 1.34%. Persons with IBS were often documented as having other gastrointes- tinal diseases, headache, back pain, and mental disorders. There was evidence for the insufficient use of ultrasound and colonoscopy and for the excessive use of computed tomography and magnetic resonance imaging for diagnostic evaluation. The costs of medical care for insurees with IBS in the year of their initial diagnosis were higher than those of other insurees without the diagnosis of IBD (€ 3770 vs. € 2788) and rose in each of the eight years preceding the initial diagnosis. Patients with IBS in Germany are likely not receiving sufficient diag- nostic evaluation in conformity with the relevant guidelines. The high prevalence of comorbid mental disorders and other pain syndromes implies that the complaints of patients with IBS need to be more comprehensively evaluated and treated.