Abstract
The irritable colon syndrome presents the family physician with a diagnostic dilemma that tests both diagnostic and physician-patient relationship skills. Although the syndrome is common, it has no pathology, and the pathophysiology does not explain fully its signs and symptoms, which are not distinct, but are similar to those of a number of serious organic conditions. Careful history taking, simple investigations, and the addition of 20g of wheat germ fibre to the patient's daily diet will usually control the symptoms. Regulation or reduction of aggravating factors such as anxiety, depression, dietary intolerance or food allergies, antibiotic use, GI infections, and laxative abuse will also control the symptoms. The family physician who is able to tailor the diagnosis and management of the problem to the individual patient demonstrates the benefits of having an on-going relationship with the patient.
Keywords: irritable colon syndrome, doctor-patient relationship
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Selected References
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- CHAUDHARY N. A., TRUELOVE S. C. The irritable colon syndrome. A study of the clinical features, predisposing causes, and prognosis in 130 cases. Q J Med. 1962 Jul;31:307–322. [PubMed] [Google Scholar]
- CONNELL A. M. The motility of the pelvic colon. II. Paradoxical motility in diarrhoea and constipation. Gut. 1962 Dec;3:342–348. doi: 10.1136/gut.3.4.342. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Feldman W., McGrath P., Hodgson C., Ritter H., Shipman R. T. The use of dietary fiber in the management of simple, childhood, idiopathic, recurrent, abdominal pain. Results in a prospective, double-blind, randomized, controlled trial. Am J Dis Child. 1985 Dec;139(12):1216–1218. doi: 10.1001/archpedi.1985.02140140050025. [DOI] [PubMed] [Google Scholar]
- Harvey R. F., Read A. E. Effect of cholecystokinin on colonic motility and symptoms in patients with the irritable-bowel syndrome. Lancet. 1973 Jan 6;1(7793):1–3. doi: 10.1016/s0140-6736(73)91219-1. [DOI] [PubMed] [Google Scholar]
- Manning A. P., Heaton K. W., Harvey R. F. Wheat fibre and irritable bowel syndrome. A controlled trial. Lancet. 1977 Aug 27;2(8035):417–418. doi: 10.1016/s0140-6736(77)90605-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ritchie J. Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut. 1973 Feb;14(2):125–132. doi: 10.1136/gut.14.2.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Soltoft J., Krag B., Gudmand-Hoyer E., Kristensen E., Wulff H. R. A double-blind trial of the effect of wheat bran on symptoms of irritable bowel syndrome. Lancet. 1976 Feb 7;1(7954):270–272. doi: 10.1016/s0140-6736(76)91402-1. [DOI] [PubMed] [Google Scholar]
