Irritable bowel syndrome: a management strategy

In the development of a management strategy for irritable bowel syndrome (I BS) patients we must consider the great number of people with the condition , most of whom do not consult doctors for it. Furthermore, we must be aware of the hidden agenda of those that do. The cause of IBS is unknown, and co nsequently cure of this chronic recurrent condition is not likely. Moreover , the disorder is very costly, drawing precious resources from the care of more serious diseases. In this chapter I propose a management strategy base d on a firm diagnosis of IBS using a minimum of tests, consideration of the patient's agenda, the use of dietary advice, the strategic use of drugs on ly in resistant cases, a graded therapeutic response and continuing care. T here is no specific treatment. The doctor-patient interaction is most impor tant to allay patients' fears and concerns, assist them with psychosocial d ifficulties, and provide the caring support known to maximize the 'placebo' effect of any treatment.