AIM: To study if and how physicians use the irritable bowel syndrome (IBS) diagnostic criteria and to assess treatment strategies in IBS patients. METHODS: A questionnaire was sent to 191 physicians regarding IBS crit...AIM: To study if and how physicians use the irritable bowel syndrome (IBS) diagnostic criteria and to assess treatment strategies in IBS patients. METHODS: A questionnaire was sent to 191 physicians regarding IBS criteria, diagnostic methods and treatment. Furthermore, 94 patients who were diagnosed with IBS underwent telephone interview. RESULTS: A total of 80/191 (41.9%) physicians responded to the survey. Overall, 13 patients were diag-nosed monthly with IBS by specialists in gastroenterology (SGs) and 2.5 patients by general practitioners (GPs). All the SGs knew of the criteria to diagnose IBS, as did 46/70 (65.7%) GPs. Seventy-nine percent used the patient's history, 38% used a physical examination, and 38% exclusion of other diseases to diagnose IBS. Only 18/80 (22.5%) physicians used specific IBS criteria. Of the patients interviewed, 59/94 (62.8%) knew they had experienced IBS. Two out of five patients knew IBS and had seen a physician because of IBS symptoms. Half of those received a diagnosis of IBS. A total of 13% were satisfied with treatment. IBS affected daily activities in 43% of cases. CONCLUSION: Half of the patients with IBS who consulted a physician received a diagnosis. Awareness and knowledge of diagnostic criteria for IBS differ between SGs and GPs.展开更多
Background:Abdominal pain-related functional gastrointestinal disorder(AP-FGID)comprises of 4 main conditions:functional dyspepsia,irritable bowel syndrome,abdominal migraine and functional abdominal pain.AP-FGIDs are...Background:Abdominal pain-related functional gastrointestinal disorder(AP-FGID)comprises of 4 main conditions:functional dyspepsia,irritable bowel syndrome,abdominal migraine and functional abdominal pain.AP-FGIDs are diagnosed clinically based on the Rome IV criteria for FGIDs of childhood.There is limited evidence for pharmacological therapies.Data sources:This review article discusses non-pharmacological management of AP-FGID based on the current literature including systematic reviews,randomized controlled trials,cohort and case control studies.We aim to provide a comprehensive overview on the available evidence for the pediatricians and pediatric gastroenterologists involved in managing children with AP-FGID.Results:Managing AP-FGIDs can be challenging.This should follow a stepwise approach with focused history,identification of“red flag”signs and symptoms,physical examination and investigations done following initial consultation.Family needs explaining that there is nothing seriously wrong with the child’s abdomen.This explanation and reassurance can achieve symptom control in large number of cases.Non-pharmacological interventions are delivered through lifestyle and dietary changes and bio-psychosocial therapies.Dietary interventions vary depending on the type of AP-FGID.Bio-psychosocial therapies such as hypnotherapy,cognitive behavioral therapy and yoga aim at stress reduction.Conclusion:There is increasing evidence for use of non-pharmacological interventions in children with AP-FGID.展开更多
基金Supported by In part by the Medical Research Fund of the National Hospital of Icelandthe Medical Research Fund of Wyeth, Iceland+3 种基金Actavis, IcelandAstraZeneca, Iceland GlaxoSmithKline, Icelandand the Icelandic College of Family Physicians
文摘AIM: To study if and how physicians use the irritable bowel syndrome (IBS) diagnostic criteria and to assess treatment strategies in IBS patients. METHODS: A questionnaire was sent to 191 physicians regarding IBS criteria, diagnostic methods and treatment. Furthermore, 94 patients who were diagnosed with IBS underwent telephone interview. RESULTS: A total of 80/191 (41.9%) physicians responded to the survey. Overall, 13 patients were diag-nosed monthly with IBS by specialists in gastroenterology (SGs) and 2.5 patients by general practitioners (GPs). All the SGs knew of the criteria to diagnose IBS, as did 46/70 (65.7%) GPs. Seventy-nine percent used the patient's history, 38% used a physical examination, and 38% exclusion of other diseases to diagnose IBS. Only 18/80 (22.5%) physicians used specific IBS criteria. Of the patients interviewed, 59/94 (62.8%) knew they had experienced IBS. Two out of five patients knew IBS and had seen a physician because of IBS symptoms. Half of those received a diagnosis of IBS. A total of 13% were satisfied with treatment. IBS affected daily activities in 43% of cases. CONCLUSION: Half of the patients with IBS who consulted a physician received a diagnosis. Awareness and knowledge of diagnostic criteria for IBS differ between SGs and GPs.
文摘Background:Abdominal pain-related functional gastrointestinal disorder(AP-FGID)comprises of 4 main conditions:functional dyspepsia,irritable bowel syndrome,abdominal migraine and functional abdominal pain.AP-FGIDs are diagnosed clinically based on the Rome IV criteria for FGIDs of childhood.There is limited evidence for pharmacological therapies.Data sources:This review article discusses non-pharmacological management of AP-FGID based on the current literature including systematic reviews,randomized controlled trials,cohort and case control studies.We aim to provide a comprehensive overview on the available evidence for the pediatricians and pediatric gastroenterologists involved in managing children with AP-FGID.Results:Managing AP-FGIDs can be challenging.This should follow a stepwise approach with focused history,identification of“red flag”signs and symptoms,physical examination and investigations done following initial consultation.Family needs explaining that there is nothing seriously wrong with the child’s abdomen.This explanation and reassurance can achieve symptom control in large number of cases.Non-pharmacological interventions are delivered through lifestyle and dietary changes and bio-psychosocial therapies.Dietary interventions vary depending on the type of AP-FGID.Bio-psychosocial therapies such as hypnotherapy,cognitive behavioral therapy and yoga aim at stress reduction.Conclusion:There is increasing evidence for use of non-pharmacological interventions in children with AP-FGID.
