Work Productivity and Activity Impairment in Patients with Common Gastrointestinal Motility and Sensory Disorders

Abstract

Purpose: To assess work productivity and activity impairment in patients with irritable bowel syndrome (IBS), chronic constipation (CC), functional dyspepsia (FD), and gastroesophageal reflux disease (GERD) in a primary care setting. Methods: The validated Work Productivity and Activity Impairment (WPAI) index, adapted for GI diseases, was administered to 400 patients in the US between April and October 2005, with one of the following: IBS with constipation, CC, or FD (Rome II criteria), or GERD, as confirmed by their primary care physician. Patients were excluded if they had organic GI disease, underwent surgery that disrupted normal GI anatomy, or were ≤18 years of age. Scores were expressed as percent of impairment/productivity loss resulting from GI symptoms (higher scores indicated greater impairment and less productivity) and were compared between cohorts using Kruskal-Wallis and paired t-tests. Results: This study included 86 IBS, 39 CC, 36 FD, and 239 GERD patients. Mean age was 51 years, 69% of patients were women, 82% were white, and 67% worked at least part-time. IBS patients reported the greatest (30.9%) and GERD patients reported the smallest (16.8%) loss in overall work productivity attributed to GI symptoms, equivalent to losses of 1.5 and 0.8 days in a 40-hour workweek, respectively. All conditions caused significantly more presenteeism than absenteeism (18.3% vs 6.1%, p < 0.001). On average, CC patients reported the greatest impairment in daily activities.TableConclusions: Patients who visit primary care physicians with symptoms of IBS, CC, FD, or GERD experience considerable productivity loss and activity impairment. Patients with GERD reported the least impairment from their symptoms.