Irritable bowel syndrome: making sense of it all

Though the basic science of the irritable bowel syndrome is far from certai n, and the clinical science is often confusing, it is still possible to mak e some sense of the syndrome in a clinical context. These common complaints of altered bowel patterns, pain and bloating are extremely common and vary greatly in the impact they have on persons' lives. From 'non-patients' who do not present for medical care to those who seek referral to multiple spe cialists, the spectrum is well known. If sense is to be made, the physician must understand the patient's major symptoms, how and to what degree they disturb their lifestyle, what is the patient's knowledge about and understa nding of the syndrome, what has been done before, and why the patient is no w presenting. What are the expectations and potential frustrations anticipa ted with this present consultation? A positive diagnostic approach can be taken but care is necessary to assuag e lingering fears of organic disease, to correct misconceptions of the synd rome, to settle existing frustrations of the patient, and to educate. With these approaches, managing irritable bowel syndrome can be rewarding, though demanding.