[Therapeutic management of irritable bowel syndrome in the family doctor's practice - probiotics and phytotherapeutics are often used successfully]

MMW Fortschr Med. 2020 Jul;162(Suppl 5):7-13. doi: 10.1007/s15006-020-0658-6. Epub 2020 Jul 17.
[Article in German]

Abstract

Background: Irritable bowel syndrome (RDS) is one of the most common functional disorders of the gastrointestinal tract in primary care. As pathophysiology is still insufficiently understood and there is no causal therapeutic approach, therapy is still a challenge in daily practice.

Method: As part of a nationwide survey in written form, primary care physicians (general practitioners and internists) were contacted by postal service and asked to complete a questionnaire on RDS. The focus was on the therapeutic management of RDS patients and personal experience with the various drug therapy options.

Results: A total of 487 doctors from all federal states participated in this survey. According to the doctors, more than 70% of RDS patients present with multiple symptoms and report a severe to very severe reduction in quality of life (78%). Doctors considered stress (76%), a change in the intestinal microbiome (56%), poor nutrition (35%) and visceral hypersensitivity (26%) to be the main causes of RDS. The drugs most commonly recommended by the specialist were antispasmodics (44%), phytotherapeutics (38%) and probiotics (37%). In contrast, only 54% of the GPs surveyed were satisfied with the success of spasmolytic therapy, but 75% were satisfied with phytotherapeutic agents and probiotics. More than 60% of the respondents were dissatisfied with tricyclic antidepressants. The high consultation intensity (72%) and expectations of the patients (73%) as well as their changing symptoms (49%) were identified by the doctors as the greatest challenges in daily practice.

Conclusion: Probiotics and phytotherapeutics are often a successful option for treating patients with irritable bowel syndrome in primary care.

Keywords: IBS; herbal preparation; irritable bowel syndrome; primary care; probiotics.

MeSH terms

  • Gastrointestinal Microbiome*
  • Humans
  • Irritable Bowel Syndrome* / therapy
  • Physicians, Family
  • Probiotics* / therapeutic use
  • Quality of Life