ORIGINAL ARTICLE A cost analysis of functional bowel disorders in Iran Delnaz Roshandel & Mohammadreza Rezailashkajani & Sepideh Shafaee & Mohammad Reza Zali Accepted: 5 September 2006 / Published online: 25 October 2006 # Springer-Verlag 2006 Abstract Background and aims The objective of this work is to eval- uate the health care utilization and cost of different types of functional bowel disorder (FBD) in a population of Iranian patients and compare the costs in consulters and non- consulters. Materials and methods A consecutive sample of 1,023 patients in an outpatient gastroenterology clinic in central Tehran were interviewed, using two questionnaires based on the Rome II criteria, from December 2004 to May 2005 to detect FBD patients and to determine the frequency of health resource utilization (physician visit, hospitalization, laborato- ry tests, imaging studies, and drugs) and productivity loss (days off work or with low functionality) due to FBD symptoms in the past 12 months. Societal perspective was used and cost per person per year was estimated in purchasing power parity dollars (PPP$). Results The direct costs (for consulters, non-consulters; data presented in this order) were: irritable bowel syndrome (IBS; $92.04, $1.04), unspecified functional bowel disorder (FBD; $100.94, $0.39), functional constipation ($57.23, $1.04), and functional abdominal bloating ($71.35, $0.63). Indirect costs (for consulters, non-consulters) were: IBS ($811.85, $669.09), unspecified FBD ($705.85, $263.47), functional constipation ($587.48, $97.49), and functional abdominal bloating ($147.88, $38.60). Total yearly costs of IBS and functional constipation for urban adult population of Iran were roughly estimated at 2.94 billion PPP$ and 89.2 million PPP$, respectively. Conclusions As proven in developed countries, FBD and especially IBS seem to put a heavy burden on the economy of a developing country like Iran. Further population-based studies are needed for more precise estimations. Keywords Functional bowel disorder . Colonic diseases . Functional . Irritable bowel syndrome . Cost analysis . Economics . Medical Background Functional bowel disorders (FBD) are functional gastroin- testinal disorders with symptoms attributable to the mid- or lower gastrointestinal tract. They include irritable bowel syndrome (IBS), functional abdominal bloating (FAB), functional constipation (FC), functional diarrhea (FD), and unspecified functional bowel disorder (UFBD). The diag- nosis always presumes the absence of a structural or biochemical explanation for the symptoms, and it is based mainly on symptom evaluation and clinical criteria, as well as the ruling out of organic disturbances [1]. FBD are commonly encountered disorders and two different popu- lation-based studies in Canada and Israel have reported the prevalence of FBD as 41.6 and 26%, respectively, considering Rome II criteria, which is the latest validated diagnostic criteria for FBD [2, 3]. Most of the studies about FBD have focused on IBS and only a few studies have addressed other types of FBD. Different prevalences of IBS were reported in different areas. The study of Hoseini-Asl and Amra [4] in Shahre- kord, Iran reported the prevalence of IBS (defined by Rome Int J Colorectal Dis (2007) 22:791–799 DOI 10.1007/s00384-006-0226-2 D. Roshandel : M. Rezailashkajani (*) : S. Shafaee : M. R. Zali Health Informatics Department, Research Center for Gastroenterology and Liver Disease, Taleghani Hospital, Shaheed Beheshti Medical University, Parvaneh Street, Velenjak, Tehran, Iran e-mail: docreza@yahoo.com