Predictors of health care seeking for irritable bowel syndrome: a population based study

Background—It has been suggested that psychological factors rather than symptoms drive subjects with irritable bowel syndrome (IBS) to seek medical care, but this issue has not been tackled in a population based study.Aim—To identify whether psychological factors or abuse explain health care seeking for IBS.Methods—A sample of residents of Penrith (a Sydney suburb representative of the Australian population) selected randomly from the electoral rolls (that by law include the entire population ⩾18 years) was mailed a validated self-report questionnaire. Measured were gastrointestinal symptoms including the Manning (and Rome) criteria for IBS, health care seeking, neuroticism (Eysenck Personality Questionnaire), psychological morbidity (General Health Questionnaire: GHQ) and sexual, physical and emotional abuse (including the standardised Drossman questions).Results—Among 730 subjects, 96 (13%, 95% confidence interval (CI) 11–16%) had IBS by the Manning criteria. Of those with IBS, 73% (95% CI 63–81%) had sought medical care for abdominal pain or discomfort. Only increasing pain severity (odds ratio (OR) = 2.10, 95% CI 1.11–3.95) and duration of pain (OR=1.53, 95% CI 1.10–2.13) were independently associated with seeking health care for IBS. Pain severity was also predictive of recent care seeking (OR=1.74, 95% CI 1.12–1.96). Neuroticism, psychological morbidity and abuse history were not significant predictors.Conclusion—Psychological factors do not seem to explain health care seeking among community subjects with IBS.