title: [How extensively should irritable bowel syndrome be investigated? Expensive bowel sounds in the abdomen].
abstract: Its high prevalence, chronic course, sometimes very troubling symptoms and rather limited therapeutic options, make the irritable bowel syndrome (IBS) one of the most common conditions seen by the family doctor, internist and gastroenterologist. IBS is characterized by abdominal pain accompanied by altered bowel movements and a facultative association with abdominal distension. IBS runs a chronic recurrent course punctuated by relatively symptom-free phases, and an overall good prognosis for survival (quoad vitam). Visceral hypersensitivity, altered gastrointestinal motility, psychosocial factors, and neurotransmitter imbalance are under discussion as underlying pathophysiology. An orienting medical history, clinical examination and exclusion of such alarm symptoms as weight loss, general debility and rectal bleeding, must be followed by a rational choice of further diagnostic measures.
authors.affiliation: Medizinische Klinik, Stadtspital Triemli, Zürich, Schweiz.
authors.forename: M
authors.initials: M
authors.lastname: Fliegner-Baia
authors.forename: J
authors.initials: J
authors.lastname: Keller
authors.forename: P
authors.initials: P
authors.lastname: Layer
mesh_terms: D003109:Colonic Diseases, Functional / Q000175:diagnosis* / Q000191:economics / Q000209:etiology; D003365:Costs and Cost Analysis; D003937:Diagnosis, Differential; D005858:Germany; D006801:Humans; D010348:Patient Care Team / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics*