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Irritable bowel syndrome: the view from general practice

W G Thompson1, K W Heaton, G T Smyth

  • 1Department of Medicine and General Practice, University of Bristol, Bristol, UK.

European Journal of Gastroenterology & Hepatology
|July 1, 1997
PubMed
Summary

General practitioners diagnose irritable bowel syndrome (IBS) with confidence, often on the first visit, despite unfamiliarity with formal criteria. They prioritize excluding organic disease and use reassurance and medication for treatment.

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Area of Science:

  • Gastroenterology
  • Primary Care Medicine
  • Medical Practice Research

Background:

  • Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder.
  • Understanding general practitioners' (GPs) perspectives on IBS diagnosis and management is crucial for improving patient care.
  • Current diagnostic approaches and treatment strategies in primary care settings require evaluation.

Purpose of the Study:

  • To investigate the perceptions and practices of general practitioners regarding irritable bowel syndrome (IBS).
  • To identify the key attributes, diagnostic challenges, and treatment preferences for IBS in a general practice setting.
  • To assess GPs' confidence levels and concerns when managing IBS patients.

Main Methods:

  • A questionnaire was administered to 43 general practitioners.

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  • The survey covered terminology, diagnosis, and treatment of irritable bowel syndrome.
  • Data were collected from randomly selected GPs to understand their real-world practices.

    • Main Results:

    • GPs demonstrated confidence in diagnosing IBS, often on the initial visit, despite unfamiliarity with the Manning criteria.
    • Excluding organic disease was a primary concern for GPs (63%) and their patients (65%).
    • Referral rates to specialists were low (14%), mainly due to patient dissatisfaction or diagnostic uncertainty; 'explanation and reassurance' was the preferred treatment (77%), alongside multiple drug therapies.

    Conclusions:

    • GPs diagnose IBS with less difficulty than other painful disorders, but standardized diagnostic criteria could enhance confidence.
    • A minority of patients are referred to specialists, often due to unmet expectations; collaborative management strategies are needed.
    • Current drug usage for IBS appears excessive and should be minimized, emphasizing non-pharmacological approaches.