The management of irritable bowel syndrome: a European, primary and secondary care collaboration

Objective To develop recommendations for the diagnosis and management of ir ritable bowel syndrome for European doctors delivering primary care. These recommendations can be adapted by local medical groups according to their l anguage, custom and health-care systems. Methods Twenty-one general practitioners and gastroenterologists from Europ e attended a workshop planned by a steering committee. After a state-of-the -art symposium, four working groups considered the following aspects of irr itable bowel syndrome management: what to tell the patient, diagnosis, non- medical treatment and psychosocial management. Current and future drug mana gement was reviewed by the steering committee. The resulting recommendation s were considered at two plenary sessions during the meeting, and by circul ation of the material during development of the manuscript. Results The process permitted a unique dialogue between general practitione rs and gastroenterologists, in which it was necessary to reconcile the spec ialists' emphasis on thoroughness with the practical, epidemiological and e conomic realities of primary care. Despite this dichotomy, consensus was ac hieved. Conclusions European general practitioners and gastroenterologists have pro duced recommendations that emphasize education of the patient, a positive s ymptom-based diagnosis, diet and lifestyle advice, psychological support an d a critical analysis of current specific psychological and pharmacological treatments. Eur J Gastroenterol Hepatol 13:933-939 (C) 2001 Lippincott Wil liams & Wilkins.