[Patient-doctor relationship in the irritable bowel syndrome. Results of a French prospective study on the influence of the functional origin of the complaints].
The attention given by the physician and the quality of the patient-physician relationship mainly determine the outcome of a consultation. Care seeking is a main characteristic of patients with functional bowel disorders, including irritable bowel syndrome (IBS), while patients with suspected organic disease (Org) would rather expect a precise answer about their condition. The aim of this study was thus to evaluate the outcome of the consultation with a gastroenterologist in IBS patients, as compared to a group of patients with suspected organic disease.


METHODS
A prospective multicenter cross-sectional study "one given week" included 158 patients consulting for the first time 18 gastroenterologists. Patients were consulting for abdominal pain and were classified as IBS or Org on the basis of the physician's clinical impression. Questionnaires including 27 common questions were distributed to the patients and the physicians at the end of the consultation and filled separately.


RESULTS
The diagnosis of IBS was done in 110 patients and that of Org in 48. Groups were comparable for the characteristics, the intensity and the frequency of attacks of abdominal pain. The index of satisfaction of the patients was not different between groups (IBS: 8.7 +/- 1.4; Org: 9.1 +/- 1.4; P=0.16). The intensity of abdominal pain was reported in the same range by the patient (IBS: 5.1 +/- 2.9; Org: 4.5 +/- 2.8) and the physician (IBS: 4.6 +/- 2.3; Org: 4.8 +/- 2.6) in both groups. Digestive and extra-digestive symptoms were quoted equally by physicians, whatever the group the patient belonged to. Information given by the physician on diagnosis and therapy were equally well perceived by patients of both groups. However, the physician tended to evaluate the efficacy of the prescribed therapy to be lower in IBS (7.1 +/- 2.0) than in Org patients (8.0 +/- 1.7; P<0.01).


CONCLUSIONS
In this study, the consultation with a gastroenterologist is equally well perceived by IBS and Org patients and it seems to meet the expectancy of the patient in most cases. However, the physician appeared less confident in the efficacy of the therapy proposed to IBS patients.
Siproudhis
Laurent
L
Groupe d'Etude du S2I, Rennes, France. laurent.siproudhis@chu-rennes.fr
Delvaux
Michel
M
Chaussade
Stanislas
S
Charles
Françoise
F
Guyot
Philippe
P
Weber
Jacques
J
Fioramonti
Jean
J
Ottignon
Yves
Y
Zerbib
Frank
F
Dyard
François
F
D000328:Adult; D000368:Aged; D003109:Colonic Diseases, Functional / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D003196:Computer Graphics; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D011446:Prospective Studies; D013223:Statistics as Topic; D011795:Surveys and Questionnaires