Das Reizdarmsyndrom in der hausärztlichen Praxis

Meteorism, abdominal pain and changes in bowel movements are frequent reasons for consultations in the family doctor’s office. They can be signs of irritable bowel syndrome (IBS), a heterogeneous gastrointestinal complex of symptoms, whose cause is not yet fully understood. Careful anamnesis and evidence-based step-by-step diagnostics are the foundation of IBS workup. In diarrhea-dominant IBS and in mixed forms, treatable differential diagnoses are common. There is no standard therapy due to the heterogeneity of the disease. The basis of successful IBS treatment is patient education and the introduction of an individualized biopsychosocial disease model. Diet should be based on individual symptom triggers. Evidence for use of probiotics in IBS is positive. Pharmacological treatment should be considered depending on the leading symptoms. Multimodal therapy concepts are more effective than monotherapies and are best implemented together with patients and in collaboration with specialists.