Irritable bowel syndrome: Physicians' awareness and patients' experience

Ólafsdóttir, Linda Björk; Guðjónsson, Hallgrímur; Jónsdóttir, Heiður Hrund; Jónsson, Jón Steinar; Bjõrnsson, Einar; Þjóðleifsson, Bjarni

doi:10.3748/wjg.v18.i28.3715

Cited by 37 publications

(41 citation statements)

References 30 publications

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“…It has been reported that GEs were generally more knowledgeable in terms of widely accepted standards of care (including clinical guidelines), were using a more resource-intensive approach, and were quicker in adoption of new and effective treatments than PCPs 51–53,69,92,93. It seems that this pattern of differences between generalists and specialists is common in many other disease areas 106.…”

Section: Resultsmentioning

confidence: 99%

“…Evidence-based guidelines suggest that IBS could be confidently diagnosed in the clinic at the time of the first visit using the Rome criteria and a careful history and physical examination. However, data show that PCPs are unfamiliar with recommended diagnostic criteria, and the majority of them still believe that IBS is a “diagnosis of exclusion” 50,92,93. Effective educational interventions are needed to update the perceptions of PCPs regarding IBS and to overcome the inertia of previous practice.…”

Section: Resultsmentioning

confidence: 99%

“…However, many patients suffer ongoing symptoms, and a small proportion of IBS patients were satisfied with the treatment they had been given 92,93. Bulking agents and antispasmodics are the most commonly prescribed medications.…”

Section: The Role Of Pcps In Early Diagnosis and Management Of Patienmentioning

confidence: 99%

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The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases

Gikas¹,

Triantafillidis²

2014

IJGM

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Chronic gastrointestinal disorders are a source of substantial morbidity, mortality, and cost. They are common in general practice, and the primary care physician (PCP) has a central role in the early detection and management of these problems. The need to make cost-effective diagnostic and treatment decisions, avoid unnecessary investigation and referral, provide long-term effective control of symptoms, and minimize the risk of complications constitute the main challenges that PCPs face. The literature review shows that, although best practice standards are available, a considerable number of PCPs do not routinely follow them. Low rates of colorectal cancer screening, suboptimal testing and treatment of Helicobacter pylori infection, inappropriate use of proton pump inhibitors, and the fact that most PCPs are still approaching the irritable bowel disease as a diagnosis of exclusion represent the main gaps between evidence-based guidelines and clinical practice. This manuscript points out that updating of knowledge and skills of PCPs via continuing medical education is the only way for better adherence with standards and improving quality of care for patients with gastrointestinal diseases.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases

Gikas¹,

Triantafillidis²

2014

IJGM

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“…In fact, a small study from Iceland using telephone interviews showed similar fi ndings: only one out of fi ve individuals with IBS symptoms was formally diagnosed with IBS, even though more than half of them saw a physician because of their GI symptoms. Remarkably, these results were irrespective of whether the patients fulfi lled the Manning or Rome III criteria for IBS ( 15 ).…”

confidence: 83%

Editorial: Clinical Implications of Diagnosing Irritable Bowel Syndrome: Do All Roads Need to Lead to Rome?

Keszthelyi

Ringel

2017

American Journal of Gastroenterology

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Irritable bowel syndrome (IBS) is one of the most common diagnoses made by healthcare providers. Yet the majority of patients with IBS are undiagnosed. The study by Sayuk et al. allows insight into the characteristics of different patient groups, e.g., with and without a formal diagnosis of diarrhea predominant IBS (IBS-D). We discuss the questions raised by this study regarding the importance of making a confi dent diagnosis, conveying it to patients and their implications for clinical practice. Am J Gastroenterol 2017; 112:900-902; doi: 10.1038/ajg.2017 Abdominal pain and diarrhea are the leading gastrointestinal (GI) symptoms prompting ambulatory visits in the United States with more than 27 million ambulatory, emergency department, and hospital outpatient clinic visits per year. Abdominal pain and diarrhea are also common leading GI diagnoses in the ambulatory setting, with "abdominal pain" being the most common (over 16.6 million per year) and "diarrhea" the ninth most common (over 2.6 million per year). Interestingly, the diag noses of abdominal pain and diarrhea are more common than the diagnosis of irritable bowel syndrome (IBS; tenth most common diagnosis with 2.4 million diagnoses per year) ( 1 ). Th e fact that these diagnoses are so oft en made does not come as a surprise when considering the high prevalence of GI symptoms in the general population. Although epidemiological data are scarce ( 2 ), the available numbers indicate that a signifi cant portion of the US population-42% of adults ( 3 ) and 23% of children and adolescents ( 4 ) -experience GI symptoms that correspond with at least one of 20 functional GI disorders (FGIDs), including IBS. However, more than half of the individuals with functional bowel symptoms do not seek medical care for their symptoms ( 5 ).Th ese individuals are oft en referred to as non-patient individuals with FGIDs.In this issue of the journal, Sayuk et al. report their fi ndings from an online survey conducted in 1,924 individuals from a general US population who had previously participated in various surveys and had indicated having GI symptoms. Individuals were excluded if they reported having habitual constipation or rectal blood loss in the month prior to participating in the survey. Th e authors found that 1,094 (56.9%) of the respondents met the Rome III criteria for IBS-D and received a formal diagnosis from their health care provider. Th e other 830 (43.1%) individuals fulfi lled the Rome III criteria for the disorder (IBS-D), but had never received a formal diagnosis. Furthermore, over half (53%) of these undiagnosed individuals have never spoken to a physician about their abdominal symptoms, and therefore, have never received a formal diagnosis ( 6 ). Given this considerable proportion, the question arises what factors drive individuals experiencing abdominal symptoms compatible with IBS to consult their health care providers about these symptoms? While most studies have repeatedly shown that abdominal symptom severity is an important determinant in...

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“…Functional gastrointestinal disorders (FGID) remain a therapeutic challenge. In particular, treatment dissatisfaction has been reported by a large proportion of patients with irritable bowel syndrome (IBS) . While clinical trials provide evidence of therapeutic efficacy, the strict enforcement of diagnostic criteria, single agent therapy, and close supervision of subjects, which are typical of randomized controlled trials, do not reflect real world conditions.…”

Section: Introductionmentioning

confidence: 99%

Rome foundation Asian working team report: Real world treatment experience of Asian patients with functional bowel disorders

Xiong

Siah

et al. 2017

J of Gastro and Hepatol

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Irritable bowel syndrome: Physicians' awareness and patients' experience

Abstract: Half of the patients with IBS who consulted a physician received a diagnosis. Awareness and knowledge of diagnostic criteria for IBS differ between SGs and GPs.

Cited by 37 publications

References 30 publications

The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases

The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases

Editorial: Clinical Implications of Diagnosing Irritable Bowel Syndrome: Do All Roads Need to Lead to Rome?

Rome foundation Asian working team report: Real world treatment experience of Asian patients with functional bowel disorders

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