title: Management of the multiple symptoms of irritable bowel syndrome.
abstract: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. A stepwise management approach is advocated for patients with IBS. For a substantial proportion of patients with mild symptoms, general management principles, including making a confident diagnosis and offering explanation, reassurance, and dietary and lifestyle advice, are sufficient. However, many patients continue to have moderate-to-severe symptoms and are not satisfied solely with this approach. In these patients, use of pharmacotherapy on the basis of the predominant symptom (constipation, diarrhoea, pain, or bloating) or combination of symptoms is the next step. For patients with symptoms that are refractory to these initial treatment options and those who have comorbid conditions or psychological symptoms, a combination of therapies should be used, and the use of psychotropic drugs and psychological treatment alternatives is often effective. Finally, the key to successful treatment of patients with IBS is a good physician-patient relationship and use of person-centred care principles.
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: magnus.simren@medicine.gu.se.
authors.forename: Magnus
authors.initials: M
authors.lastname: Simrén
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Törnblom
authors.affiliation: Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Olafur S
authors.initials: OS
authors.lastname: Palsson
authors.affiliation: Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology; D003248:Constipation / Q000188:drug therapy / Q000209:etiology; D003967:Diarrhea / Q000188:drug therapy / Q000209:etiology; D004035:Diet Therapy; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D008019:Life Style; D010817:Physician-Patient Relations; D011613:Psychotherapy; D011619:Psychotropic Drugs / Q000627:therapeutic use
chemical_list: D005765:Gastrointestinal Agents; D011619:Psychotropic Drugs