title: Irritable bowel syndrome in primary care: the patients' and doctors' views on symptoms, etiology and management.
abstract: BACKGROUND
  To facilitate the development of clinical guidelines and to direct future irritable bowel syndrome (IBS) research, insight into the perceptions of patients and general practitioners (GPs) regarding IBS is required.
  
  
  OBJECTIVE
  To compare patients' and GPs' views on the symptomatology, etiology and treatment of IBS.
  
  
  METHODS
  One hundred forty-two IBS patients and 100 GPs were requested to complete a structured questionnaire.
  
  
  RESULTS
  The response rates of the patients and GPs were 80% and 47%, respectively. Abdominal pain and bloating were considered to be the most bothersome symptoms in IBS, by both patients and GPs. Although all patients were diagnosed by their GP as having IBS, and 62% met the Manning criteria, only 18% fulfilled the Rome II criteria for IBS. Patients consider food intolerance and GPs regard lack of fibre as the main etiologic dietary factor. Many IBS patients expect a diagnostic work-up, but GPs generally restrict this to elderly patients. GPs start IBS management with dietary advice (94%), counselling (77%) and drug therapy (55%). Patients expect reassurance (47%) and drug treatment (37%), but dietary interventions are less appreciated (9%).
  
  
  CONCLUSIONS
  Patients and GPs have different perceptions of the efficacy of diagnostic and dietary interventions in IBS. GPs should explore the patients expectations and incorporate these in their approach to IBS patients.
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
authors.forename: Cornelis J
authors.initials: CJ
authors.lastname: Bijkerk
authors.forename: Niek J
authors.initials: NJ
authors.lastname: de Wit
authors.forename: Wim A B
authors.initials: WA
authors.lastname: Stalman
authors.forename: J André
authors.initials: JA
authors.lastname: Knottnerus
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
authors.forename: Jean W M
authors.initials: JW
authors.lastname: Muris
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003109:Colonic Diseases, Functional / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000379:methods; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome