IBS (Irritable Bowel Syndrome)


Up to 25% of patients in a gastroenterology clinic complain suffer from abdominal symptoms compatible with an irritable bowel syndrome (IBS).
IBS remains an elusive diagnosis that is based on exclusion of identifiable gross pathology and inclusion of symptoms regarded as typical for IBS. Different sets of diagnostic criteria have been developed over the years; the most widely used being the ROME questions, currently available in their third iteration.
Patients are often informed that “they have nothing” and need to “learn to live with that” which is not useful for many, especially severe cases.
Apart from the diagnostic challenge for doctors and patients (Which test to do? Which doctor to consult? Consultation of specialized doctors? They found nothing – repeat the exam? Has everything been done?) there is the therapeutic challenge (Is food causing it? Can I manage it on my own or do I need dietary advice? Which medication to take? How long? Side effects? Multiple medications? Psychologist needed? Physiotherapist needed?) and the coping challenge (What is wrong with me? Why me? Is this a life-long disease? Will it affect my work ability? Can my partner take it? Will I get colon cancer, eventually? Can I get pregnant?).
Whereas many patients can be treated with little or no medication and some dietary advice, others need multiple medications, specialized dietary advice, specialized testing, repeated instructions, psychological support and even physiotherapy. The combination of which is found only in few specialized centers.

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