ABSTRACT
The irritable bowel syndrome is the most common gastrointestinal disorder seen by primary-care physicians and specialists in gastroenterology and psychiatry. This chapter summarizes the epidemiological, physiological, and psychological features of the disorder, presents the criteria for diagnosis, and reviews current treatment approaches. Treatment is directed toward education, reassurance, and achievement of a healthier lifestyle. Dietary and behavioral modifications are then discussed, negotiated, and implemented in a manner that permits the patient's participation and, as symptoms improve, increases his or her sense of control over the illness. Psychotherapy should be considered for patients having moderate symptom distress and/or functional impairment. However, some medical patients view a recommendation of psychotherapy with a negative attribution or as a rejection by the medical physician. Therefore, the medical physician must present this approach in a manner that is relevant to the patient, and as part of an overall treatment plan with continued medical care.
