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Bridging the Gap Between Patients and Physicians: A Prerequisite for Progress
Physicians and Patients Often Disagree on the Overall Severity of IBS
The current gaps in perception of the impact of irritable bowel syndrome (IBS) symptoms
on sufferers’ lives and well-being are a major barrier to effective treatment. Raising health care
provider awareness of patient-perceived distress is an important step in overcoming this barrier.
The Physician Study exclusively enrolled primary care providers and gastroenterologists,
but other health care team members, including physician assistants, pharmacists, nurse practitioners,
and nurses, are an integral part of the IBS management team. Research is ongoing to
capture the perceptions of these health care professionals and to compare them with those of
IBS patients.48-50
Findings from the Gastrointestinal (GI) Sufferer Study and the Physician Study illustrate
important differences between patients’ and physicians’ perceptions of IBS. The most critical
finding from these studies is that physicians tend to overestimate the severity of IBS with
diarrhea and underestimate the severity of IBS with constipation (Fig. 17). Similar
percentages of patients with IBS with constipation and IBS with diarrhea self-rated their
symptoms as extremely/very severe (53%–57%). In contrast, the majority of physician
responders felt that IBS with diarrhea is a more severe condition than is IBS with constipation.
This finding reinforces the need to raise awareness that IBS with constipation is
equally as severe as is IBS with diarrhea.
![Figure 17. Physicians tend to overestimate the severity of IBS with diarrhea and underestimate the severity of IBS with constipation (GI Sufferer Study and Physician Study: women and men only data were not available]).](images/ir_gap_chart1.gif)
Physicians’ and Patients’ Perceptions of the Causes of IBS May Differ
The GI Sufferer Study and Physician Study revealed that patients and physicians differ in
their opinions regarding the primary and secondary causes of IBS symptoms (Fig. 18).
Respondents were asked to rate the degree to which they felt various causative factors contributed
to their IBS symptoms. Although a prepared list of causes was provided, participants
had the opportunity to add factors not appearing on the list. (Physician responses
reflect causes of IBS and chronic constipation.)
Although IBS is caused by a true physiologic dysfunction,51,52 many patients and health care
professionals believe other factors are involved. While both patients and physicians rated
stress as a major culprit, patients felt that food was also an important factor. Physicians
noted anxiety/depression as a contributor to symptoms. Interestingly, both patients with a
definitive and a probable diagnosis held similar views regarding the factors involved in
IBS symptoms. These findings highlight the fact that many physicians and patients are
unaware of the underlying physiologic abnormalities in IBS. Educational efforts to raise
awareness of IBS as a medical condition with a physiologic basis are crucial.
![Figure 18. Patients’ and physicians’ perceptions of the factors exacerbating IBS often differ (GI Sufferer Study and Physician Study: women and men [women-only data were not available]).](images/ir_gap_chart2.gif)
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