Functional Bowel Disease is Bad for You!

abstract & commentary

Synopsis: In this community-based study from Australia, Koloski and colleagues found that functional gastrointestinal disorders are associated with a significant impairment in quality of life in the community.

Source: Koloski NA, et al. Am J Gastroenterol 2000;95:67-71.

Koloski and colleagues set out to evaluate the effect of functional gastrointestinal (GI) complaints on quality of life in the community. A random sample of 4500 subjects, representative of the Australian population, was mailed a questionnaire on GI symptoms in the past 12 months. Quality of life was assessed using the SF-12 instrument. The diagnosis of functional disorders was based on the Rome criteria. Approximately 34.6% of the responders satisfied criteria for a diagnosis of a functional GI disorder. Among those with functional disorders, there was significant impairment of mental and physical functioning. When they examined those who had sought medical attention for their symptoms, these measures of quality of life were further impaired. However, even among those who did not seek help from a physician (so-called nonpatients), quality of life was still inferior to that of the control subjects. Koloski et al conclude that functional GI disorders are associated with a significant impairment in quality of life in the community and especially so among those who consult for health care.

Comment by Eamonn M. M. Quigley, MD

Functional GI disorders represent a major challenge for all practicing clinicians. These disorders are not associated with significant mortality or physical morbidity; therefore, there has been an unfortunate tendency to downplay their significance. These and several other studies go some way toward illustrating how these "functional" disorders can affect function. In contrast to many prior studies performed in a hospital setting or in special centers, this is a truly community-based study. This renders its findings even more important. While, as shown by others, those who sought medical attention had a greater impairment in quality of both mental and physical health, these parameters were also significantly impaired even among nonpatients. For these reasons, measures of quality of life have now become de rigeur in any study of therapy in functional gastrointestinal disease. These findings also serve as yet another reminder to us, as clinicians, that these symptoms must be taken seriously!

Suggested Reading

1. Whitehead WE, et al. Dig Dis Sci 1996;41:2248-2253.

2. Veldhuyzen van Zanten SJO, et al. Gut 1999;45(supplement 2):69-77.