Patients with IBS commonly use narcotics
(3 May 2010: VIDYYA MEDICAL NEWS SERVICE) -- Doctors often unnecessarily treat irritable bowel syndrome (IBS) with narcotics. A course of treatment is generally inadvisable because it does not improve functional status and may have adverse long term effects, according to a new study. Women are about twice as likely as men to suffer from IBS.
Researchers, led by Spencer D. Dorn, MD, assistant professor of medicine, University of North Carolina (UNC), surveyed nearly 1,800 patients who had seen a physician for Rome III criteria defined IBS. They looked at demographic characteristics, clinical features including subtype, duration, severity, most troublesome symptom, quality of life, psychological factors such as anxiety and depression, overall satisfaction with care, and medications currently used.
The study, conducted by researchers at the UNC Center for Functional GI disorders and the International Foundation for Functional GI Disorders, found that 325 patients, or 18 percent, reported currently using narcotics. These patients reported more abdominal pain, poorer health quality, more IBS-related limitations, more hospitalizations and surgeries, and that they were more likely to use antidepressants and antacid medications.
"Although narcotics are commonly used, they may have deleterious long term effects, including narcotic bowel syndrome and sometimes drug dependency," said Dr. Dorn. Instead, Dr. Dorn and his UNC colleagues recommend an integrative approach that emphasizes patient education, self management over time, non-narcotic symptom-based therapies, and sometimes antidepressants and/or psychotherapy.
"In the current U.S. health-care system, clinicians often lack the time, infrastructure and incentives needed to provide integrative care to patients with chronic conditions, including IBS," said Dr. Dorn. "Instead, very often physicians take the path of least resistance. Narcotic prescriptions are a quick and easy way to get patients out of their office, even though the long term effects can be harmful." He added that physicians have to resolve to finding better training and incentives to treat patients who would otherwise benefit from more integrative treatments.
Dr. Dorn said the findings are especially important since the U.S. accounts for just 4 percent of the world's population and more than 80 percent of the narcotics prescribed worldwide.
Dr. Dorn will present these data on Monday, May 5 at 8 a.m. CT in Hall F, Ernest N. Morial Convention Center.
Digestive Disease Week® 2010 (DDW®) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases, the AGA Institute, the American Society for Gastrointestinal Endoscopy and the Society for Surgery of the Alimentary Tract, DDW takes place May 1 – May 5, 2010 in New Orleans, LA. The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.
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