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British Society of Gastroenterology guidelines for the management of the irritable bowel syndrome
  1. J Jonesa,
  2. J Boormanb,
  3. P Cannc,
  4. A Forbesd,
  5. J Gomboronee,
  6. K Heatonf,
  7. P Hunging,
  8. D Kumarh,
  9. G Libbyi,
  10. R Spillerj,
  11. N Readk,
  12. D Silkl,
  13. P Whorwellm
  1. aDivision of Gastroenterology, University Hospital, Nottingham, UK, bLetchworth, Herts SG6 1DG, UK, cCleveland General Hospital, Middlesborough, Cleveland, UK, dSt Mark's Hospital, Northwick Park, UK, eDigestive Diseases Research Centre, St Bartholomew's Hospital, London, UK, fDepartment of Medicine, University of Bristol, Bristol, UK, gCentre for Health Studies, University of Durham, Durham, UK, hSt George's Hospital, Tooting, London, UK, iDepartment of Gastroenterology and Psychological Medicine, St Bartholomew's Hospital, London, UK, jDivision of Gastroenterology, University Hospital, Queen's Medical Centre, Nottingham, UK, kDepartment of Human Physiology and Nutrition, University of Sheffield, Northern General Hospital, Sheffield, UK, lDepartment of Gastroenterology and Nutrition, Central Middlesex Hospital, London, UK, mDepartment of Medicine, Withington Hospital, University Hospital of South Manchester, UK
  1. Dr R Spiller, Division of Gastroenterology, C Floor, South Block, University Hospital, Nottingham NG7 2UH, UK. Email:Robin.Spiller{at}

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1.0 Preface


These guidelines were compiled by a multidisciplinary group at the request of the chairman of the British Society of Gastroenterology's Clinical Services Committee. The prime targets for these guidelines are consultant gastroenterologists, specialist registrars in training, and general practitioners. The purpose is to identify and inform the key decisions to be made in the management of patients thought to have functional diseases of the gut. As these comprise the commonest conditions seen by gastroenterologists, the working party represented a wide spectrum of practitioners in gastroenterology, including gastroenterologists from both district general hospitals and tertiary referral centres, as well as primary care practitioners, psychiatrists, psychologists, and dietitians.


Compared with producing guidelines for the management of well defined diseases such as peptic ulcer where there is a clear disease entity, an obvious end point, and highly effective treatments, drawing up guidelines for functional gastroenterological disorders has had many difficulties. Clinical trials have been difficult to design as the conditions being treated are highly variable with many possible end points, and most therapies only marginally more effective than placebo. Early trials were difficult to evaluate because of inadequate patient definition so that many questions have yet to be addressed with good quality randomised controlled clinical trials. Most of our recommendations are therefore supported by clinical experience rather than randomised controlled clinical trials. Finally, because functional diseases, although potentially debilitating, are non-fatal there are few uniformly available audit measures such as mortality or survival times by which to judge or compare different treatment regimens in different areas of clinical practice.


The co-chairmen were approached by the chairman of the British Society of Gastroenterology's Clinical Services Committee and invited to form a working party. Members were chosen to be broadly representative of clinicians and academics with a long term interest and publication record in the …

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  • Correction

    The authors of the Guidelines for the management of the irritable bowel syndrome (Gut 2000;47(suppl II):ii1�ii19) would like to correct a statement in table 1. It has been drawn to the authors' attention that, although the pharmaceutical companies did support these meetings, they did not instigate them and had no control over the content of the final publication of the Rome II criteria.

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