Published 13 November 2008, doi:10.1136/bmj.a2213
Cite this as: BMJ 2008;337:a2213

Editorials

Treatment of irritable bowel syndrome in primary care

Ispaghula, antispasmodics, and peppermint oil should be considered

The first 150 words of the full text of this article appear below.

Irritable bowel syndrome is a common condition with a community prevalence of 10-15% of the general population.^{1 2} The annual incidence in primary care is around 0.8%, and the prevalence of patients diagnosed in primary care is about 3-4%.³ The disorder is difficult to treat, hence the wide range of treatments used—dietary exclusion, fibre supplements, and probiotics; antispasmodic drugs, antidiarrhoeal agents, and laxatives; antidepressants, hypnotherapy, and cognitive behavioural therapy. This unusual spectrum of drug and non-drug treatments also highlights our ignorance about the cause of the condition. In the linked systematic review (doi:10.1136/bmj.a2313), Ford and colleagues summarise the effects of three different agents—fibre, antispasmodic drugs, and peppermint oil—in people with the syndrome.⁴

In the 1990s a range of new agents acting on 5-hydroxytryptamine type 3 and type 4 receptors in the enteric nervous system held considerable therapeutic promise. Most of them, however, failed to find a place in the . . . [Full text of this article]

¹ Department of General Practice and Primary Care, King’s College London, London SE11 6SP

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