Managing patients with irritable bowel syndrome in general practiceHow to promote and reinforce self-care activities

In this paper the development and implementation of a set of guidelines for the management of irritable bowel syndrome (IBS) patients in primary care is presented. The guidelines are based on the knowledge that has emerged from research in the past decade on factors that influence the course and prognosis of IBS. These include lifestyle factors, avoidance behaviour and reaction patterns from family and friends. The guidelines contain elements of psychotherapeutic techniques that have been found to be successful in outpatients with IBS. They comprise instructions to promote and reinforce self-care activities. The guidelines have been applied in daily practice by a group of Dutch general practitioners and various aspects of the feasibility of the guidelines are discussed. Copyright (C) 1998 Elsevier Science Ireland Ltd.