Irritable bowel syndrome in primary health care

Although not a life threatening condition, IBS causes varying degrees of suffering and contributes greatly to the total healthcare bill. Many general practitioners consider contact with IBS patients demanding and difficult. Successful treatment of IBS is considered best achieved through a relationship with mutual understanding between doctor and patient. It is, however, questionnable whether there is a mutual understanding between doctor and patient regarding the condition IBS.

The majority of patients with irritable bowel syndrome (IBS) are diagnosed and treated within primary health care. Often the diagnosis IBS is made after exclusion of all possible alternative diagnoses; a so-called negative diagnosis. This is associated with a time- and resource-consuming use of diagnostic tools and can lead to frustration for both the patient and the doctor. A better approach is the making of a so-called positive diagnosis using the Rome criteria and limited laboratory tests.

• The first part of this project is to investigate the viewpoints and perceptions of the primary health care doctors regarding IBS and to compare if they match with the viewpoints of IBS patients, by means of a Q-methodology study.
• The second part comprises a register study of IBS in Region Örebro in order to investigate the making of a positive diagnosis, including the use of the Rome criteria, in daily primary care clinical practice and the adherence of general practitioners to the recommended diagnostic and therapeutic approaches for IBS.
• The third part comprises the assessment of the unnecessary costs associated with making a negative diagnosis of IBS, such as endoscopic and radiologic evaluations and extensive laboratory tests.