The Irritable Bowel Syndrome: Understanding and Treating a Biopsychosocial Illness Disorder

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Abstract
Although the irritable bowel syndrome (IBS) is the most common functional digestive disorder, physicians often regard the IBS patient as difficult to understand and treat. This “difficulty” relates to uncertainty fostered by the lack of specific diagnostic criteria, the fact that the degree of illness (functional impairment) is not fully explained by symptom severity or chronicity, and that traditional medical treatments are not always successful. Futhermore, many patients exhibit behaviors that frustrate the physician. By integrating the psychosocial dimensions of illness into the assessment of these patients, we can better understand the disorder. Psychosocial factors determine who among those with irritable bowel symptoms sees a physician. With regard to treatment, dietary and pharmacologic agents are not of proven efficacy, and a behavioral component in the overall treatment plan is logical. This article provides data to support the idea that a multidisciplinary approach in research, clinical assessment, and treatment is needed to improve our understanding of IBS and effect optimal patient care.