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Irritable bowel syndrome in general practice: prevalence, characteristics, and referral
Open accessAbstract
BACKGROUND AND AIMS: Little is known about the prevalence, symptoms, diagnosis, attitude, and referral to specialists of patients with irritable bowel syndrome (IBS) in general practice. This study aimed to determine these characteristics. METHODS: 3111 patients attending 36 general practitioners (GPs) at six varied locations in and near Bristol, UK, were screened to identify those with a gastrointestinal problem. These patients (n=255) and their doctors were given questionnaires. Six months later the case notes were examined to reach criteria based diagnoses of functional bowel disorders. RESULTS: Of 255 patients with a gastrointestinal complaint, 30% were judged to have IBS and 14% other functional disorders. Compared with 100 patients with an “organic” diagnoses, those with IBS were more often women and more often judged by their GP to be polysymptomatic and to have unexplained symptoms. The majority of patients with IBS (58%) were diagnosed as such by the GP; 22% had other functional diagnoses. Conversely, among 54 patients diagnosed as having IBS by the GPs, the criteria based diagnosis was indeed functional in 91%; only one patient had organic disease (proctitis). More patients with IBS than those with organic disease feared cancer. In most some fear remained after the visit to the doctor. On logistic regression analysis, predictors of referral to a specialist (29% referred) were denial of a role for stress, multiple tests, and frequent bowel movements. CONCLUSIONS: Half the patients with gut complaints seen by GPs have functional disorders. These are usually recognised, and few patients are referred. In IBS, cancer fears often remain, suggesting unconfident diagnosis or inadequate explanation.
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“Nevertheless, lower gastrointestinal symptoms frequently prompt people to present to primary care, 81 accounting for approximately 1 in 12 of all consultations.82”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [82]
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“Most patients with IBS are diagnosed and managed by general practitioners in community settings and are never referred to secondary care, even if they have ongoing troublesome symptoms.82”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [82]
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“The similar prevalence of disease conditions described in this study to previously published experience is also in support of the appropriate case definition [24].”
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Metadata
- Authors
- Thompson, W. G., Heaton, K. W., Smyth, G. T., & Smyth, C.
- Affiliations
- University of Ottawa (CA)
- Corresponding author
- Thompson, W G
- ORCID
- Thompson, W G
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2000-01-01
- Volume
- 46
- Issue
- 1
- Pages
- 78-82
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1727778
- OpenAlex
- W2137007351
- Cited by
- 477
- References
- 21
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 10 · 2023: 12 · 2022: 6 · 2021: 9 · 2020: 11 · 2019: 10 · 2018: 18 · 2017: 17 · 2016: 17 · 2015: 14 · 2014: 22 · 2013: 21 · 2012: 22
- FWCI
- 25.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Keywords
- irritable bowel syndrome, functional bowel disorders, general practice, prevalence, specialist referral, fear of cancer, diagnostic criteria, proctitis
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Attitude to Health, Colonic Diseases, Functional, England, Family Practice, Female, Follow-Up Studies, Humans, Male, Mass Screening, Middle Aged, Neoplasms, Referral and Consultation, Cohort Studies, Prevalence
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