J Korean Med Sci.  2023 Apr;38(16):e126. 10.3346/jkms.2023.38.e126.

Survey-Based Analysis of the Clinical Treatment Status of Irritable Bowel Syndrome in Korea

• Koo HS
• Son HC
• Lee HS
• Goong HJ
• Kim JS
• Kim KB
• Kwon YH
• Kim JH
• Shin HD
• Shin JE
• Jee SR

• KMID: 2541750
• DOI: http://doi.org/10.3346/jkms.2023.38.e126

Abstract

Background
The quality-of-life of patients with irritable bowel syndrome is low; incorrect diagnosis/treatment causes economic burden and inappropriate consumption of medical resources. This survey-based study aimed to analyze the current status of irritable bowel syndrome treatment to examine differences in doctors’ perceptions of the disease, and treatment patterns.
Methods
From October 2019 to February 2020, the irritable bowel syndrome and Intestinal Function Research Study Group of the Korean Society of Neurogastroenterology and Motility conducted a survey on doctors working in primary, secondary, and tertiary healthcare institutions. The questionnaire included 37 items and was completed anonymously using the NAVER platform (a web-based platform), e-mails, and written forms.
Results
A total of 272 doctors responded; respondents reported using the Rome IV diagnostic criteria (amended in 2016) for diagnosing and treating irritable bowel syndrome. Several differences were noted between the primary, secondary, and tertiary physicians’ groups. The rate of colonoscopy was high in tertiary healthcare institutions. During a colonoscopy, the necessity of random biopsy was higher among physicians who worked at tertiary institutions. ‘The patient did not adhere to the diet’ as a reason for ineffectiveness using low-fermentable oligo-, di-, and mono-saccharides, and polyols diet treatment was higher among physicians in primary/secondary institutions, and ‘There are individual differences in terms of effectiveness’ was higher among physicians in tertiary institutions. In irritable bowel syndrome constipation predominant subtype, the use of serotonin type 3 receptor antagonist (ramosetron) and probiotics was higher in primary/secondary institutions, while serotonin type 4 receptor agonist was used more in tertiary institutions. In irritable bowel syndrome diarrhea predominant subtype, the use of antispasmodics was higher in primary/secondary institutions, while the use of serotonin type 3 receptor antagonist (ramosetron) was higher in tertiary institutions.
Conclusion
Notable differences were observed between physicians in primary/secondary and tertiary institiutions regarding the rate of colonoscopy, necessity of random biopsy, the reason for the ineffectiveness of low-fermentable oligo-, di-, and mono-saccharides, and polyols diet, and use of drug therapy in irritable bowel syndrome. In South Korea, irritable bowel syndrome is diagnosed and treated according to the Rome IV diagnostic criteria, revised in 2016.

Keyword

Irritable Bowel Syndrome; Diagnosis; Treatment; Rome IV Diagnostic Criteria

Figure

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  Fig. 1 Drugs used as primary treatment for the treatment of patients with IBS-C and IBS-D (multiple responses).IBS = irritable bowel syndrome, IBS-C = IBS-constipation-predominant, IBS-D = irritable bowel syndrome-diarrhea-predominant.

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