The DOI matches its Crossref record; 106 of the 106 references it cites were found in a registry or an index.
The Irritable Bowel Syndrome: Review and a Graduated Multicomponent Treatment Approach
Abstract
The irritable bowel syndrome is a common chronic disorder having a broad clinical spectrum of severity. Although only a small proportion of those afflicted seek medical help for their symptoms, a subset have severe and intractable symptoms. A positive diagnosis should be established from the history and physical examination; endoscopic and radiologic investigations should be minimized. We suggest that the physician also assess the severity of the illness based on its symptomatic and functional features and the patient's behavioral response. Classifying the disorder in this manner permits a graduated treatment approach that emphasizes education, reassurance, and dietary adjustment for mild symptoms. Moderate symptom severity requires, in addition, identification and modification of factors exacerbating symptoms, psychotherapeutic and behavioral techniques and, if a certain symptom type predominates, pharmacologic agents directed toward the presumed gastrointestinal motor dysfunction. For severe symptoms, physician-based behavior modification and psychopharmacologic agents are helpful. When the disorder is intractable, referral may be needed, for example, to a pain treatment center. In all cases, the skillful physician must ensure continued psychosocial support to enhance coping and continued focus on the palliative aspects of care rather than on cure.
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“Clinical guidelines recommend that IBS patients should be referred to psychological treatments if they show anxiety, activity disruption or poor coping strategies [7,57].”
Citations
Cites
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Items 301–309 of 309
Lutz-Vorderbrügge, A., & Schulte-Bockholt, A. (2003) · Humana Press eBooks · doi:10.1007/978-1-59259-314-9_27
Smith, R. P. (1998) · Springer eBooks · doi:10.1007/978-1-4757-2943-6_16
(2016) · Elsevier eBooks · doi:10.1016/b978-3-437-21833-0.16001-2
Defining treatment resistance in the irritable bowel syndrome
Rajagopalan, M. (1997) · Gut · doi:10.1136/gut.41.5.723-a
Gastrointestinale Erkrankungen
Kapfhammer, H. (2022) · Springer eBooks · doi:10.1007/978-3-662-65873-4_6
Klocek, A., & Řiháček, T. (2023) · Counselling Psychology Quarterly · doi:10.1080/09515070.2023.2292212
“…stress disorders, Rahman et al., 2016; social phobia; Turner, Beidel, Cooley, Woody, & Messer, 1994; subjective wellbeing; Roth, Suldo, & Ferron, 2017; irritable bowel syndrome complaints; Drossman & Thompson, 1992, or fibromyalgia; Häuser, Bernardy, Arnold, Offenbächer, & Schiltenwolf, 2009).”
Liao, K.-F., Tsai, H.-Y., Chen, C., Hsu, T., Hsu, C., Ho, T.-Y., Liu, D.-H., Kao, C., Wang, C., & Hsieh, A. (2024) · Journal of the Chinese Medical Association · doi:10.1097/jcma.0000000000001083
SMITH, R. (2005) · Elsevier eBooks · doi:10.1016/b978-84-458-1311-9.50193-2
Metadata
- Authors
- Drossman, D. A., & Thompson, W. G.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1992-06-15
- Volume
- 116
- Issue
- 12_Part_1
- Pages
- 1009-1016
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2072613337
- Cited by
- 309
- References
- 105
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 7 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 5 · 2015: 5 · 2014: 4 · 2013: 8 · 2012: 9
- FWCI
- 4.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- irritable bowel syndrome, symptom severity classification, dietary change, psychotherapy, behavior change, psychopharmacology, gastrointestinal motility, psychosocial support, palliative care
- MeSH terms
- Colonic Diseases, Functional, Combined Modality Therapy, Constipation, Diarrhea, Humans, Psychotherapy, Pain Management
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