AB444        IRRITABLE BOWEL SYNDROME IN PRIMARY CARE: THE PATIENTS AND DOCTORS PERCEPTION

Author(s): 
Bijkerk CJ, de Wit NJ, Muris JWM, Knottnerus JA, Hoes AW
UTRECHT, THE NETHERLANDS
Text: 
Background:
IBS is the most common GI disease in primary care, though little is known about the patients’ and general practitioners (GPs) perception of the syndrome.
Methods: 142 IBS and 100 GPs received a postal questionnaire. The patients’ survey included questions on symptoms, experiences and expectations of treatment and impact on QOL (measured with the IBSQOL). We enquired GPs about their management of IBS.
Results: 78 (79%) patients and 46 GPs responded. Patients reported bloating (27%) and abdominal pain (27%) as their most bothersome symptoms. 18% reported symptoms consistent with the Rome criteria for IBS. Patients indicated to consider improvement in abdominal pain and bloating as their primary goal for treatment. Treated success was highest for the antispasmodic mebeverine (53%) and psyllium fibres (32%). Patients reported impairment on the IBSQOL, mainly on domains of mental health, emotions, physical role and sexual activity. 41% of the patients reported IBS related absenteeism or indicated less productivity (35%). Almost all GPs start treatment with counselling and reassurance (77%) and dietary advice (93%). More than half (55%) start with medication. GPs stop treatment when the patient is satisfied or when symptoms improve.
Conclusions:
Management of IBS in primary care starts with counselling, reassurance and dietary advice. Drug therapy is in the view of patients more effective than diet interventions. The Rome criteria might be too restrictive for use. GPs and patients reported treatment is effective when overall or symptom improvement is achieved. IBS has an impact on labour activities and social health status.