Irritable bowel syndrome and other gastrointestinal disorders: evaluating self-medication in an Asian community setting.

BACKGROUND

Gastrointestinal disorders frequently present symptoms which are often self-treated.

OBJECTIVE

To record demographic profile of patients visiting community pharmacies for self-treatment with medications for gastrointestinal disorders, the number of these patients who fulfilled irritable bowel syndrome diagnostic criteria, and to judge the appropriateness of their treatment requests.

SETTING

Singapore community pharmacies.

METHOD: The multicentre study was conducted using ROME III adapted criteria on adults above 18 years who have self-selected medicinal products for treatment of irritable bowel syndrome or gastrointestinal symptoms in the community pharmacy.

RESULTS

Among those seeking self-medication, 36.8 % fulfilled criteria for irritable bowel syndrome, with irritable bowel syndrome-mixed (16.3 %) being the most prevalent subtype. For patients not fulfilling criteria for irritable bowel syndrome diagnosis, rates for other functional gastrointestinal disorders were constipation (20.5 %), dyspepsia (16.3 %), gastroesophageal reflux disease (12.1 %), diarrhoea (8.9 %), bloating (4.2 %), and heartburn (3.2 %). There were more females with gastrointestinal complaints. Overall, 21.6 % of the total participants had recently sought medical attention for their gastrointestinal complaint. 20 % of patients selected inappropriate medication for their gastrointestinal complaints, and the antacids class had the highest incidence of inappropriate medication use. Possible co-existing relationships were seen between gastroesophageal reflux disease with dyspepsia, irritable bowel syndrome with gastroesophageal reflux disease, irritable bowel syndrome with dyspepsia, and diarrhoea with constipation.

CONCLUSION

Patients who fulfilled criteria for irritable bowel syndrome had a high tendency to self-treat their gastrointestinal symptoms. Constipation complaints were also common. Around one in five patients self-medicated gastrointestinal symptoms inappropriately, with antacids being the most common.