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The value of a general therapeutic approach in subjects with irritable bowel syndrome.

Monsbakken KW, Vandvik PO, Farup PG

Department of Medicine, Innlandet Hospital Health Authority, Gjøvik, Norway.

BACKGROUND: The general therapeutic approach is the cornerstone in the management of irritable bowel syndrome, but the effect is poorly documented. AIM: 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.

Published 12 January 2005 in Aliment Pharmacol Ther, 21(1): 21-7.
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