No abstract

No abstract

Clinicians should be aware of the extensive impact of IBS on sufferers' daily life and the frustration that results from repeatedly trying treatments with little effect. Clearly explaining the guidelines for diagnosing IBS and the range of treatment options may help patients to make sense of the diagnostic and treatment processes. The personal EM should be addressed during the consultation with the IBS patient, ensuring that any successive medical interventions match with the patients' disease perception.

Introduction and aimsIn 2004-05, Niger suffered a food crisis during which global attention became focused on high levels of acute malnutrition among children and high rates of infant and child mortality. In response, decentralised emergency nutrition programmes, targeted mainly at children under five, were introduced into many of the affected areas of southern Niger. Nearly two years later (at the time of writing), the emergency nutrition programmes are still operating widely, albeit with reduced admissions over recent months. Acute malnutrition has decreased among children under five during the past year, but it still remains very prevalent. Emergency nutrition programmes have reported high rates of non-cured discharges and drop-outs from the programme (FEWS NET, 2006, p. 6;Unicef Niger, 2006). It is widely accepted that the 2004-05 emergency was in fact an extreme manifestation of a long-term problem, and that a much broader response is required to tackle it (Baro and Deubel, 2006).In this context Concern Worldwide, one of the agencies delivering the humanitarian programme, commissioned an anthropological study early in 2006 with the aim of improving our understanding of the social context of child malnutrition and, in particular, to examine care practices and household decision making in relation to the nutritional vulnerability of children. In this paper, we aim:

GPs' diagnostic procedures and EMs for IBS are at odds with patient expectations and current guidelines. Shared discussion of what patients believe to be triggers for symptoms, ways of coping with symptoms and the role of medication may be helpful.