Bijkerk Cornelis J, de Wit Niek J, Stalman Wim A B, Knottnerus J André, Hoes Arno W, Muris Jean W M
University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
Can J Gastroenterol. 2003 Jun;17(6):363-8; quiz 405-6. doi: 10.1155/2003/532138.
To facilitate the development of clinical guidelines and to direct future irritable bowel syndrome (IBS) research, insight into the perceptions of patients and general practitioners (GPs) regarding IBS is required.
To compare patients' and GPs' views on the symptomatology, etiology and treatment of IBS.
One hundred forty-two IBS patients and 100 GPs were requested to complete a structured questionnaire.
The response rates of the patients and GPs were 80% and 47%, respectively. Abdominal pain and bloating were considered to be the most bothersome symptoms in IBS, by both patients and GPs. Although all patients were diagnosed by their GP as having IBS, and 62% met the Manning criteria, only 18% fulfilled the Rome II criteria for IBS. Patients consider food intolerance and GPs regard lack of fibre as the main etiologic dietary factor. Many IBS patients expect a diagnostic work-up, but GPs generally restrict this to elderly patients. GPs start IBS management with dietary advice (94%), counselling (77%) and drug therapy (55%). Patients expect reassurance (47%) and drug treatment (37%), but dietary interventions are less appreciated (9%).
Patients and GPs have different perceptions of the efficacy of diagnostic and dietary interventions in IBS. GPs should explore the patients expectations and incorporate these in their approach to IBS patients.
为促进临床指南的制定并指导未来肠易激综合征（IBS）的研究，需要深入了解患者和全科医生（GP）对IBS的看法。
比较患者和全科医生对IBS症状、病因及治疗的观点。
要求142例IBS患者和100名全科医生完成一份结构化问卷。
患者和全科医生的回复率分别为80%和47%。腹痛和腹胀被患者和全科医生均视为IBS中最困扰人的症状。尽管所有患者均被其全科医生诊断为患有IBS，且62%符合曼宁标准，但只有18%符合IBS的罗马II标准。患者认为食物不耐受是主要病因饮食因素，而全科医生则认为膳食纤维缺乏是主要病因饮食因素。许多IBS患者期望进行诊断性检查，但全科医生通常仅对老年患者进行此项检查。全科医生开始对IBS进行管理时采用饮食建议（94%）、咨询（77%）和药物治疗（55%）。患者期望得到安慰（47%）和药物治疗（37%），但对饮食干预的认可度较低（9%）。
患者和全科医生对IBS诊断和饮食干预的疗效有不同看法。全科医生应探究患者的期望，并将其纳入对IBS患者的治疗方法中。
