Irritable bowel syndrome: Doctor`s and patient`s trauma

Abstract

Introduction: Irritable bowel syndrome represents chronic, functional bowel disorder, without organic substrate, which manifests with abdominal pain, bloating and diarrhea and/or constipation. Diagnosing irritable bowel syndrome includes anamnesis, physical examination and depending on indications, endoscopic exam as well. Therapy includes medications and psychotherapy, during exacerbations. Case report: Female patient 26 year old, pays a visit to outpatient clinic, due to frequent stools in last couple of weeks. She has 2-4 stools a day, without mucilage or blood in the stool. She feels bloated and experiences abdominal discomfort, which subsides after emptying stool contents. She denies other symptoms and has been perfectly healthy up till now. After the examination we came up with working diagnosis-IBS and the patient was presented with the treatment plan. She disagrees with it and asks for specialist referral. From the first referral, to hospitalization, to making final diagnosis, a year has passed and the final diagnosis has been the same as the diagnosis made by the family medicine specialist. Conclusion: In order for primary care doctors to be health system gate keepers, it takes sufficient time for them to spend with a patient (reduce the number of patients seen daily), greater work autonomy and adequate health legislations, which is possible through systemic changes, as a result of a dialogue of all relevant participants in the health care system.