Division of Gastroenterology, University of South Alabama College of Medicine, Mobile, AL 36693, USA.
J Clin Gastroenterol. 2012 Oct;46(9):748-51. doi: 10.1097/MCG.0b013e31825a2ff2.
Irritable bowel syndrome (IBS) and chronic constipation (CC) are common functional bowel disorders that are among the most frequent reasons for referral to a gastroenterologist. Diagnosis and management of these conditions can be challenging for both the clinician and the patient for a number of reasons. Diagnosis can be complicated by the lack of a specific diagnostic test and the fact that IBS and CC are multisymptomatic conditions, whereas management can be suboptimal, because the conditions are often undiagnosed and self-managed by the patient. Furthermore, these are chronic conditions that must be managed over the long term, which can often lead to frustration both on the part of the patient and the clinician. As such, the role of the therapeutic clinician-patient relationship in diagnosis and management of these conditions has been attracting increasing attention. A patient-centered approach with a strong focus on effective communication between the clinician and the patient has been recommended for management of functional bowel diseases such as IBS and CC and has been associated with improved outcomes, increased patient satisfaction, and decreased utilization of care. The potential benefit of such practices as asking open-ended questions, actively listening to the patient, and displaying empathy in strengthening the clinician-patient relationship are highlighted in this manuscript. These skills have broad application in clinical medicine and can be used to improve clinician-patient communication in the management of patients with chronic illnesses.
肠易激综合征（IBS）和慢性便秘（CC）是常见的功能性肠病，是最常见的转介给胃肠病学家的原因之一。由于多种原因，这些疾病的诊断和管理对临床医生和患者来说都是具有挑战性的。诊断可能因缺乏特定的诊断测试以及 IBS 和 CC 是多症状疾病这一事实而变得复杂，而管理可能不理想，因为这些疾病通常未被诊断，并且由患者自行管理。此外，这些是需要长期管理的慢性疾病，这常常会导致患者和临床医生感到沮丧。因此，治疗临床医生-患者关系在这些疾病的诊断和管理中的作用引起了越来越多的关注。建议采用以患者为中心的方法，重点关注临床医生与患者之间的有效沟通，以管理 IBS 和 CC 等功能性肠病，这与改善结果、提高患者满意度和减少护理利用有关。在本文中强调了提出开放式问题、积极倾听患者意见和表现出同理心等实践在加强医患关系方面的潜在益处。这些技能在临床医学中有广泛的应用，可以用于改善慢性病患者管理中的医患沟通。
