Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Allergy Unit

Student research

Patient perceptions of treatments for functional bowel disorders

Wendy Stuart-Smith
Master of Nutrition and Dietetics, The University of Sydney
Supervisors: Kim Faulkner-Hogg, Anne Swain, Warwick Selby, Robert Loblay,
October 2000

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Functional bowel disorders, including irritable bowel syndrome (IBS) are heterogeneous in terms of pathogenesis and presentation. Consequently, the therapies prescribed for the management of symptoms are equally diverse. However, long term and patients' perceptions of the efficacy of these treatments are often not well understood.

To investigate patients' perspectives on efficacy of management practices used for functional bowel disorders, including irritable bowel syndrome (IBS).

A questionnaire was posted to all patients with IBS or functional bowel disease who attended the Allergy Unit, and/or a Private Gastroenterology Practice at Royal Prince Alfred Hospital, between January 1998 and December 1999. Questions focused on medical and alternative therapies trialled by the patient, and the perceived short and long-term efficacy of the therapies. Responses were analysed using Excel and SPSS to perform ANOVAs and t-tests.

Data from 97 patients was analysed. Perceptions of treatment efficacy were very varied. Patients in this study perceived dietary manipulation, mostly in the form of elimination of specific chemicals from the diet, was most effective in reducing symptoms. Medication was also important. Relaxation techniques, although not perceived to be of greatest importance, were a common second choice of therapy. High fibre diets did not rate highly, although data about high fibre diets was incomplete.

The perceived efficacy of treatments is personal, and probably reflects the specific mechanisms underlying the symptoms in an individual. Most people have trialled a number of therapies (av. 9.4, range 1-37), before finding one or a combination which works to bring some relief from their symptoms. The large percentage of patients from both practices rating dietary manipulation as most important for symptom relief suggests food intolerance should be investigated more thoroughly for a substantial subgroup of this population.