A New Surgical Innovation for Chronic Constipation (Jinling Procedurre):2 years Follow-up
Monika Kowalczyk, MD, Swetang Shah, MD, MPH, Amiya Palit, MD, Lindsay Friedenberg, BS, Frank Friedenberg, MD, MS (Epi). Temple University School of Medicine, Philadelphia, PA. Purpose: Irritable Bowel Syndrome affects 11.6% (3-20%) of the U.S. popu- lation. Limited information exists about the epidemiology of IBS in black Americans. Psychological co-morbidities are likely important contributors to the development of IBS in this population. TRIAGE is a cross-sectional survey of primarily black Americans living an impoverished section of Philadelphia. The aims of this study were to: 1) Estimate the prevalence of IBS in the TRI- AGE database and; 2) Identify factors associated with IBS in this unique study group. Methods: Adults residing in a single zip code of North Philadelphia were recruited using geographical mapping. Invited participants completed a com- prehensive computer-based questionnaire with the assistance of a researcher. We gathered comprehensive demographics, medical history, and diet com- position. We queried lifestyle practices (Alcohol Use Disorder Identification Test-AUDIT, The Drug Abuse Screening Test -DAST, Fagerstrom Tobacco Abuse) as well as the presence of depression (Patient Health Questionnaire- PHQ-9) and post-traumatic stress-PTSDQ. QoL was assessed using SF-36 v2. Subjects completed the entire Rome III survey for functional bowel dis- orders. Data were collected in Microsoft Access and analyzed in IBM SPSS Statistics 19.0. Results: To date, 214 (95.3% black American) subjects have been recruited. Nineteen (8.9%) subjects were found to have IBS by Rome III Criteria. There were no statistical differences with respect to age, income, level of education, smoking, harmful drinking, and drug abuse between those with and without IBS. However, IBS patients were more likely to be female (84.2% vs. 15.8%, p=0.009), divorced (31.6% vs. 8.7%, p=0.003), have depression (72.2% vs. 31.4%, p= 0.002), and have PTSD (42.1% vs. 15.9%, p=0.005). Norm adjusted QoL scores for physical functioning and mental health were substantially lower in those with IBS than unaffected subjects (PF: 39.5 ± 13.4 vs. 47.5 ± 11.0, p=0.004; MH: 40.5 ± 12.8 vs. 49.4± 11.6, p=0.002). Conclusion: Approximately 9% of African-American subjects living in North Philadelphia have IBS comparable to other studied populations. TRIAGE IBS patients were more likely to be female, divorced, have depres- sion, and have a lower QoL in both the mental and physical domains. The prevalence of PTSD in this group was substantial-identification and treat- ment are likely to be paramount in the care of this vulnerable population.