The challenge of irritable bowel syndrome: creating an alliance between patient and physician.
The most important component of the treatment of irritable bowel syndrome (IBS) is to establish a therapeutic physician-patient relationship, coupled with patient education. We describe a stepwise approach to management, including judicious use of invasive tests, and setting realistic treatment goals that address the dominant symptoms, their severity, and psychosocial factors.
Department of Gastroenterology, Cleveland Clinic, Cleveland Clinic Foundation, OH 44195, USA.
B
B
Shen
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E
Soffer
D015746:Abdominal Pain / Q000209:etiology; D000928:Antidepressive Agents / Q000627:therapeutic use; D000930:Antidiarrheals / Q000627:therapeutic use; D002243:Carbolines / Q000008:administration & dosage / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003109:Colonic Diseases, Functional / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003248:Constipation / Q000188:drug therapy / Q000209:etiology; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000188:drug therapy / Q000209:etiology; D004032:Diet; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005769:Gastrointestinal Motility; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D008875:Middle Aged; D010276:Parasympatholytics / Q000627:therapeutic use; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011613:Psychotherapy; D016032:Randomized Controlled Trials as Topic; D012702:Serotonin Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D000928:Antidepressive Agents; D000930:Antidiarrheals; D002243:Carbolines; D018680:Cholinergic Antagonists; D005765:Gastrointestinal Agents; D007211:Indoles; D010276:Parasympatholytics; D012702:Serotonin Antagonists; D017366:Serotonin Receptor Agonists; C090840:alosetron; C105050:tegaserod