The value of a general therapeutic approach in subjects with irritable bowel syndrome.
BACKGROUND
The general therapeutic approach is the cornerstone in the management of irritable bowel syndrome, but the effect is poorly documented.


OBJECTIVE
To evaluate the effect of the general therapeutic approach for irritable bowel syndrome.


METHODS
Subjects with irritable bowel syndrome identified in a public screening were included. Scores for abdominal symptom (range 0-12), musculoskeletal pain and mood disorders were calculated. After exclusion of other disorders, a doctor presented irritable bowel syndrome as a positive diagnosis, gave information, reassurance and lifestyle advice, but no pharmacotherapy. A dietician gave dietary advice. There was a follow-up after 6 months.


RESULTS
Sixty-five persons (females/males: 44/21) with mean age 49 years (range 31-76) were included, 31 (48%) were recommended dietary changes. Twenty subjects (31%) had satisfactory relief of symptoms after 6 months. The scores for abdominal symptom was reduced from 3.1 to 2.2 (P = 0.007), the reduction was 2.2 in the diarrhoea-predominant group given advice compared with 0.4 in the other subjects (P = 0.035). Previous consultations for the complaints, visits for psychiatric disorders, and presence of mood disorders were predictors of persistent complaints.


CONCLUSIONS
There was a significant relief of symptoms after 6 months, those with psychological co-morbidity responded less well. The effect of dietary advice was only seen in those with diarrhoea-predominant irritable bowel syndrome.
Monsbakken
K W
KW
Department of Medicine, Innlandet Hospital Health Authority, Gjøvik, Norway.
Vandvik
P O
PO
Farup
P G
PG
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003967:Diarrhea / Q000178:diet therapy*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome