Irritable bowel syndrome

Context. Irritable bowel syndrome (IBS) concerns physicians, because of its chronicity, its only symptomatic diagnosis and its hypothetical pathophysiology. It affects the quality of life of patients. Objective. To provide a didactic overview of how to recognize and manage irritable bowel syndrome in general practice. Methods. Narrative review of the literature Results. The diagnosis is only based on the interview, which finds abdominal pain, at least one day a week, associated with at least 2 of the following points: a relation with defecation, a change in the frequency of stools, a change in the appearance of stools. A colonoscopy is solely justified in case of clinical (family history of colon cancer, onset after 50 years, blood in the stools, weight loss, nocturnal symptoms, recent onset or change in symptoms) or biological "red flags" (CBC, CRP, anti-transglutaminase antibodies). The management is based on an educational approach: explaining the syndrome, its chronicity and the modest effectiveness of the treatments; gathering the patients' fears and main objectives. Personalized lifestyle measures and some drugs aim to relieve and preserve quality of life, but avoiding over-medicalization. Building a lasting and solid relationship despite chronicity and therapeutic limits is an objective of care in itself. Knowing the concrete consequences of IBS on the patients' experience, having an understanding attitude in case of patients' differing views, and giving the commitment to relieve as much as possible, is contributing to this objective. Conclusion. The available therapeutic options do not change the IBS prognosis. A constructive approach of patients with IBS can help the general practitioners to better accompany them.