Editorial: preventing unnecessary investigation and surgery in the irritable bowel syndrome—the critical role of the general practitioner

Whorwell, Peter J.

doi:10.1111/apt.14659

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Furthermore, it might prevent some of the considerable number of unecessary investigations and interventions, sometimes of a surgical nature, to which these patients are frequently subjected. 24 J o u r n a l P r e -p r o o f…”

Section: Discussionmentioning

confidence: 99%

Greater Overlap of Rome IV Disorders of Gut-Brain Interactions Leads to Increased Disease Severity and Poorer Quality of Life

Sperber

Freud

Aziz

et al. 2022

Clinical Gastroenterology and Hepatology

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Section: Discussionmentioning

confidence: 99%

Greater Overlap of Rome IV Disorders of Gut-Brain Interactions Leads to Increased Disease Severity and Poorer Quality of Life

Sperber

Freud

Aziz

et al. 2022

Clinical Gastroenterology and Hepatology

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“…It is estimated that around a quarter of patients have severe, refractory symptoms, with significant impairment of quality of life (QoL), detrimental effects on daily functioning, personal and social relationships, workplace productivity, and psychological well‐being including suicidal ideation . These patients are also vulnerable to iatrogenic harm including repeatedly negative investigations, opiate analgesia, and unnecessary surgical interventions, not to mention the associated spiraling healthcare costs . Perhaps unsurprisingly, when we consider the current pathophysiological understanding of FGIDs, among all the heterogeneous treatment options available, approaches targeting 'gut‐brain interactions' including centrally acting neuromodulators and behavioral approaches such as gut‐focused hypnotherapy have shown the most promise.…”

Section: Introductionmentioning

confidence: 99%

Gut‐focused hypnotherapy for Functional Gastrointestinal Disorders: Evidence‐base, practical aspects, and the Manchester Protocol

Vasant

Whorwell

2019

Neurogastroenterology Motil

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Background Despite their high prevalence and advances in the field of neurogastroenterology, there remain few effective treatment options for functional gastrointestinal disorders (FGIDs). It is recognized that approximately 25% of sufferers will have symptoms refractory to existing therapies, causing significant adverse effects on quality of life and increased healthcare utilization and morbidity. Gut‐focused hypnotherapy, when delivered by trained therapists, has been shown to be highly effective in severe refractory FGIDs. However, hypnotherapy continues to be surrounded by much misunderstanding and skepticism. Purpose The purpose of this review is to provide a contemporary overview of the principles of gut‐focused hypnotherapy, its effects on gut‐brain interactions, and the evidence‐base for its efficacy in severe FGIDs. As supplementary material, we have included a hypnotherapy protocol, providing the reader with an insight into the practical aspects of delivery, and as a guide, an example of a script of a gut‐focused hypnotherapy session.

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“…7,8 IBS patients may be referred to several departments for their extraintestinal manifestations to undergo invasive investigations, before IBS is recognized, which may further aggravate their symptoms. 9 Thus, extraintestinal symptoms in IBS need to be recognized and handled appropriately. The aims of the present review were (a) to describe the comorbidity between IBS and extraintestinal manifestations; (b) to explore the mechanisms behind this comorbidity; and (c) to discuss the treatment of extraintestinal manifestations.…”

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confidence: 99%

Extraintestinal manifestations in irritable bowel syndrome: A systematic review

Ohlsson

2022

Therap Adv Gastroenterol

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Background: Irritable bowel syndrome (IBS) is characterized by abdominal pain and altered bowel habits. Further, IBS patients experience a high degree of extraintestinal symptoms. Objectives: The aim of this review was to describe the relation between IBS and extraintestinal manifestations and mechanisms and treatments of these extraintestinal manifestations. Design: The study was performed as a systematic review. Data Sources and Methods: Search terms including extraintestinal manifestations or somatization and IBS were used to scrutinize for publications in Pubmed. In total, 630 publications were identified and 80 were finally included in this review. Results: About 50% of all IBS patients have extraintestinal manifestations in addition to gastrointestinal symptoms. Somatic pain, fatigue, and sleeping disturbances are most common, and most often described in women. Both extraintestinal manifestations and psychological distress are associated with exaggerated gastrointestinal symptoms, impaired quality of life, and difficulties to treat IBS symptoms. The extraintestinal manifestations render an excess of healthcare costs. Varying etiology and pathophysiology to IBS are discussed, and many patients express a general hypersensitivity. Extraintestinal symptoms are seldom documented at clinical healthcare or included in the assessment of treatment outcomes. A good patient-physician relationship and strengthening of coping mechanisms have rendered less gastrointestinal symptoms, psychological distress, and somatization. Altered lifestyle habits may improve both gastrointestinal and extraintestinal symptoms. Pharmacological treatment, including antidepressant drugs, should be considered when lifestyle advice fails. Teamwork between different specialists and healthcare providers may be of importance in the wide range of symptoms and extraintestinal manifestations. Conclusion: Extraintestinal manifestations are common in IBS patients and is associated with worse suffering and difficulties to treat symptoms. Evaluation and treatment of IBS patients should consider also extraintestinal manifestations and their treatment outcome. Establishment of good relationship, strengthening of coping mechanisms, and education in healthier lifestyle habits are crucial in the management of these patients.

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Editorial: preventing unnecessary investigation and surgery in the irritable bowel syndrome—the critical role of the general practitioner

Abstract: Linked Content This article is linked to Clevers et al paper. To view this article visit https://doi.org/10.1111/apt.14612.

Cited by 3 publications

References 11 publications

Greater Overlap of Rome IV Disorders of Gut-Brain Interactions Leads to Increased Disease Severity and Poorer Quality of Life

Greater Overlap of Rome IV Disorders of Gut-Brain Interactions Leads to Increased Disease Severity and Poorer Quality of Life

Gut‐focused hypnotherapy for Functional Gastrointestinal Disorders: Evidence‐base, practical aspects, and the Manchester Protocol

Extraintestinal manifestations in irritable bowel syndrome: A systematic review

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