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.
Shen
B
B
Department of Gastroenterology, Cleveland Clinic, Cleveland Clinic Foundation, OH 44195, USA.
Soffer
E
E
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