Irritable bowel syndrome: Physicians' awareness and patients' experience

Table 1 Manning, Rome I, II and III criteria for irritable bowel syndrome[5-7,9]

Manning

Pain eased after BM

Looser stools at onset of pain

More frequent BM at onset of pain

Abdominal distension

Mucus throughout rectum

Feeling of incomplete emptying

Rome I criteria

3 mo or more of continuous or recurrent symptoms

Abdominal pain or discomfort

Relieved with defecation; and/or

Associated with a change in frequency of stool; and/or

Associated with a change in consistency of stool; and

Two or more of the following, at least 25% of occasions or days

Altered stool frequency (> 3 BMs/d or < 3/wk)

Altered stool form (lumpy/hard or loose/watery stool),

Altered stool passage (straining, urgency, tenesmus)

Passage of mucus

Bloating or feeling of abdominal distension

Rome II criteria

At least 12 wk (which need not be consecutive)

In the preceding 12 mo, of abdominal discomfort or pain that has two out of three features

Relieved with defecation; and/or

Onset associated with a change in frequency of stool, and/or

Onset associated with a change in form (appearance) of stool

Rome III criteria

Recurrent abdominal pain or discomfort at least 3 d/mo

In the last 3 mo association with two or more of the following:

Improvement with defecation

Onset associated with a change in frequency of stool

Onset associated with a change in form (appearance) of stool

BM: Bowel movement.

Table 2 Awareness of the disorder, diagnosis and treatment in interviewer-diagnosed patients n (%)

	All patients (n = 94)
Diagnosed with IBS	20 (22.2)
Knowledge of IBS	37 (39.4)
Seen a physician because of IBS symptoms	37 (39.4)
Satisfied with treatment for IBS	12 (12.8)
IBS affects daily activities	40 (42.6)
Think they will be cured of IBS	29 (30.9)
Think they will always suffer from IBS	27 (28.7)
Takes medication for IBS	11 (11.7)
Uses untraditional medication	15 (16.0)
Thinks dietary modification is important for the treatment of IBS	52 (55.3)

IBS: Irritable bowel syndrome.

Table 3 Diagnosis of patients with irritable bowel syndrome (%)

	All patients	SG	GP
	n = 801	n = 9	n = 70
Patients history	79	78	80
Physical examination	38	22	41
Exclusion of other diseases	38	44	35
IBS criteria	22	33	19
Gastrointestinal endoscopy	7	22	6

¹One physician did not list his profession; IBS: Irritable bowel syndrome; SG: Specialists in gastroenterology; GP: General practitioners.

Table 4 Most common irritable bowel syndrome symptoms (%)

	GPs	SGs
Abnormal bowel movements	61	100
Abdominal pain	86	67
Bloating	20	56
Gas	9	11
Passage of mucus	5	0
Incomplete evacuation with defecation	5	11

SG: Specialists in gastroenterology; GP: General practitioners.

Table 5 Treatment of irritable bowel syndrome (%)

	GPs	SGs
Medication
Mebeverine	89	86
Husk	31	43
Chlordiazepoxide and clidinium	29	14
Antidepressants	7	14
Other medicines	9	14
Lifestyle
Food	98	86
Relaxation	14	14
Exercise	16	14
Education about IBS	90	86
Do not know/something else	27	14

IBS: Irritable bowel syndrome; SG: Specialists in gastroenterology; GP: General practitioners.