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Cited by 309Gastrointestinal motility and disordersInfant Health and DevelopmentPsychosomatic Disorders and Their Treatments

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

Drossman, Douglas A., Thompson, W. Grant·1992·Annals of Internal Medicine
DOI 10.7326/0003-4819-116-12-1009
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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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Crossref · 10.7326/0003-4819-116-12-1009

Cites

106 of 106 references verified0 citation errors · 0 not checkable

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Citations

Cites

Research works printed but not linked: 26

  1. Voltaire . In: Strauss MB; ed. Familiar Medical Quotations. Boston: Little Brown and Co.; 1968:394.
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Metadata

Authors
Drossman, D. A., & Thompson, W. G.
Affiliations
University of North Carolina at Chapel Hill (US)
ORCID
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
DOI
10.7326/0003-4819-116-12-1009
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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