Introduction There have been considerable advances in evidence synthesis concerning management of irritable bowel syndrome (IBS) in the last 5 years, with guidelines for its management in primary care published by the National Institute of Health and Care Excellence (NICE). We examined beliefs about IBS management among primary care physicians.
Methods This was a cross-sectional web-based questionnaire survey of 275 primary care physicians registered with three clinical commissioning groups in Leeds, UK. We e-mailed a link to a SurveyMonkey questionnaire, containing 18 items, to all eligible primary care physicians. Participants were given 1 month to respond, with a reminder sent out after 2 weeks.
Results One-hundred and two (37.1%) primary care physicians responded. Eighty-four (82.4%) of the respondents confirmed that they used clinical symptoms or signs elicited during the history and physical examination to diagnose IBS, with only 10 (9.8%) using the Rome criteria, and 4 (3.9%) the Manning criteria. A further 4 participants stated that they referred to a Gastroenterologist to confirm the diagnosis. Seventy (68.6%) primary care physicians agreed or strongly agreed that IBS was a diagnosis of exclusion, with only 5 (4.9%) strongly disagreeing with this statement. More than 80% checked coeliac serology often or always in suspected IBS. Between 56% and 76% believed soluble fibre, antispasmodics, peppermint oil, and psychological therapies were potentially efficacious therapies (table). The respondents were less convinced that antidepressants or probiotics were effective. Despite perceived efficacy of psychological therapies, 80% stated these were not easily available. Levels of use of soluble fibre, antispasmodics, and peppermint oil were in the range of 40% to >50%. Most primary care physicians obtained up-to-date evidence about IBS management from NICE guidelines.
Conclusion Most primary care physicians still believe IBS is a diagnosis of exclusion, and many are reluctant to use antidepressants or probiotics to treat IBS. More research studies addressing diagnosis and treatment of IBS based in primary are required.
Disclosure of Interest None Declared.
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