Management of the irritable bowel syndrome: a personal view.
One hundred fifty-four of 184 consecutive patients diagnosed as having the irritable bowel syndrome were followed for an average of 29 months. Diagnosis was based on history, physical examination, and sigmoidoscopy. Seventy-eight percent of the patients had some form of gastrointestinal radiologic investigation, the majority ordered by the referring physicians. Treatment was restricted to reassurance, explanation, and a high-fiber diet. Twenty-five patients continued to take or had prescribed by their family physicians antispasmodics, minor tranquilizers, or laxatives. Eleven patients required psychiatric referral or major psychotropic medication. At follow-up, 79% felt their symptoms were better, much better, or gone completely. Outcome was not affected by identified psychiatric problems. During follow-up, an organic cause for symptoms was identified in six patients. The change in diagnosis was the result of clinical suspicion plus failure to respond to conservative therapy.
D000293:Adolescent; D000328:Adult; D000368:Aged; D003109:Colonic Diseases, Functional / Q000175:diagnosis / Q000178:diet therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination