Practice patterns in management of irritable bowel syndrome: A questionnaire survey

Abstract

Aim: The present study was conducted to determine the practice pattern in the management of irritable bowel syndrome (IBS) in an Indian setting, using a questionnaire survey, among doctors managing IBS patients. Methods: The respondents were recruited by sending survey invitations using e-mail or text messages that contained information about the survey and its purpose. Four hundred doctors practicing in states of Madhya Pradesh and Tamil Nadu were contacted. The responses were tabulated in Microsoft Excel sheet. Data were analyzed using numbers and percentages. Results: A total of 60 responses were obtained with a response rate of 15%. About 93.3% noted an overlap of IBS symptoms with other disorders of gut–brain interaction (DGBI) disorders. The most common type of IBS reported was IBS-constipation (16, 26.7%), IBS-diarrhea (14, 23.3%), IBS-mixed (14, 23.3%), and IBS-undifferentiated (4, 6.7%). Ultrasound abdomen was done by 50%, colonoscopy/sigmoidoscopy by 60%, and blood tests by 83.3% of all respondents before labeling a case as IBS. Nearly half (46.7%) of the respondents noted that their patients had worsening of symptoms with milk. Trained dieticians for prescribing low fermentable oligosaccharide, disaccharide, monosaccharide, and polyol diet were not available with majority of the respondents (38, 63.3%). Majority of the respondents (58, 96.7%) reported that they looked for psychological modifiers in patients. Almost all (83.3%) stressed the need for multidisciplinary approach, the need for Indian diagnostic criteria, and dietary modifications as per Indian needs. Conclusions: There is a need for Indian consensus on the diagnosis of DGBI, IBS, and overlap disorders and dietary recommendations region wise to manage our patients.