Sindrom iritabilnog kolona – trauma lekara i pacijenta

Abstract

Introduction: Irritable bowel syndrome represents chronic, functional bowel disorder, without organic substrate, which manifests with abdominal pain, bloating and diarrhea and/or constipation. Diagnosing irritable bowel syndrome includes anamnesis, physical examination and depending on indications, endo-scopic exam as well. Therapy includes medications and psychotherapy, during exacerbations. Case report: Female patient 26 year old, pays a visit to outpatient clinic, due to frequent stools in last couple of weeks. She has 2-4 stools a day, without mucilage or blood in the stool. She feels bloated and experiences abdominal discomfort , which subsides after emptying stool contents. She denies other symptoms and has been perfectly healthy up till now. After the examination we came up with working diagnosis-IBS and the patient was presented with the treatment plan. She disagrees with it and asks for specialist referral. From the first referral, to hospitalization, to making final diagnosis, a year has passed and the final diagnosis has been the same as the diagnosis made by the family medicine specialist. Conclusion: In order for primary care doctors to be health system gate keepers , it takes sufficient time for them to spend with a patient (reduce the number of patients seen daily), greater work autonomy and adequate health legislations, which is possible through systemic changes, as a result of a dialogue of all relevant participants in the health care system.