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  • Title: The general practitioner's approach to irritable bowel syndrome: from intention to practice.
    Author: Bellini M, Tosetti C, Costa F, Biagi S, Stasi C, Del Punta A, Monicelli P, Mumolo MG, Ricchiuti A, Bruzzi P, Marchi S.
    Journal: Dig Liver Dis; 2005 Dec; 37(12):934-9. PubMed ID: 16243592.
    Abstract:
    BACKGROUND: Although general practitioners play a critical role in the management of irritable bowel syndrome because they deal with the most patients, guidelines are developed mainly by specialists. AIMS: To evaluate the clinical features of irritable bowel patients and the general practitioners' approach to irritable bowel syndrome in Italy. SUBJECTS AND METHODS: A questionnaire focusing on the management of this syndrome was completed by 28 general practitioners. Clinical features and diagnostic and treatment measures taken in 229 patients were analysed. RESULTS: Only 35.7% of the general practitioners were familiar with the Rome II criteria. Changes in bowel habits and abdominal pain/discomfort were the most common symptoms. Constipation (74.2%) was more frequent as the main symptom than diarrhoea. Routine blood tests (76.4%) and abdominal ultrasound (42.2%) were requested more frequently than colonoscopy (31.1%). At least one specialist consultation was recommended in 63.3% of patients. Drugs (mainly antispasmodics) were prescribed more frequently for diarrhoea (91.4%) than for constipation (55.7%). CONCLUSIONS: General practitioners are little acquainted with the Rome II criteria. Diagnostic tests and specialist consultations are often recommended; antispasmodics are the most frequently prescribed drug. Guidelines should be developed together by general practitioners and gastroenterologists to effectively manage patients at a lower cost.
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