Common gastroenterological problems. The irritable bowel syndrome

The irritable bowel syndrome is one of the commonest conditions seen in gastroenterology clinics. The diagnosis is suggested by the presence of longstanding colonic symptoms without any deterioration in the patient's general condition but depends essentially on the exclusion of any underlying organic disease. Particular care is required before attaching this label to middle-aged and elderly patients presenting with bowel symptoms for the first time. The most important aspects of treatment are firm reassurance, a simple explanation of symptom production and sympathetic follow-up. Drug therapy plays a comparatively minor role although a variety of preparations are helpful in individual cases. Reinvestigation is rarely indicated unless the symptom complex changes or the patient loses weight.