Bellini Massimo, Tosetti Cesare, Rettura Francesco, Morganti Riccardo, Lambiase Christian, Bassotti Gabrio, Visaggi Pierfrancesco, Pancetti Andrea, Benedetto Edoardo, de Bortoli Nicola, Usai-Satta Paolo, De Bastiani Rudi
Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, 56010 Pisa, Italy.
Department of Primary Care, National Health Service, 40046 Bologna, Italy.
J Clin Med. 2022 Jul 3;11(13):3861. doi: 10.3390/jcm11133861.
Irritable bowel syndrome (IBS) guidelines are generally developed by experts, with the possibility of a translational gap in clinical medicine. The aim of our study was to assess an Italian group of general practitioners (GPs) for their awareness and use of criteria for the diagnosis and management of IBS. For this purpose, a survey was carried out involving 235 GPs, divided into two groups according to their years of activity: 65 “junior general practitioners” (JGPs) (≤10 years) and 170 “senior general practitioners” (SGPs) (>10 years). JGPs were more familiar with the Rome IV Criteria and Bristol Scale than SGPs. Abdominal pain, bowel movement frequency and bloating were the symptoms most frequently used to make a diagnosis. The most probable causes of IBS were reported to be abnormal gastrointestinal motility and psychological triggers. SGPs reported more frequently than JGPs that challenging management and patient’s request were motivations for a gastroenterological consultation. The practice of clinical medicine is still far from the guidelines provided by the specialists. Abdominal pain related to defecation and changes in bowel frequency are considered to be the more important symptoms for IBS diagnosis, but most GPs, both JGPs and SGPs, like to consider abdominal bloating as another useful symptom. Involving both gastroenterologists and GPs in developing shared guidelines would be highly desirable in order to improve IBS management strategies in everyday clinical practice.
肠易激综合征（IBS）指南通常由专家制定，在临床医学中可能存在转化差距。我们研究的目的是评估一组意大利全科医生（GPs）对IBS诊断和管理标准的知晓情况及使用情况。为此，我们开展了一项调查，涉及235名全科医生，根据他们的从业年限分为两组：65名“初级全科医生”（JGPs）（≤10年）和170名“高级全科医生”（SGPs）（>10年）。与SGPs相比，JGPs对罗马IV标准和布里斯托量表更为熟悉。腹痛、排便频率和腹胀是最常用于诊断的症状。据报告，IBS最可能的病因是胃肠动力异常和心理诱因。与JGPs相比，SGPs更频繁地报告说，具有挑战性的管理和患者的要求是进行胃肠病咨询的动机。临床医学实践仍与专家提供的指南相差甚远。与排便相关的腹痛和排便频率的变化被认为是IBS诊断中更重要的症状，但大多数全科医生，包括JGPs和SGPs，都倾向于将腹胀视为另一个有用的症状。为了改善日常临床实践中的IBS管理策略，非常希望胃肠病学家和全科医生共同制定共享指南。
