Irritable bowel syndrome: management of expectations and disease

[摘要] WILLIAM Osler described the 19th century version of irritable bowel syndrome (IBS), then known as mucous colitis, as occurring principally in psychiatrically-disordered young women and accompanied by the passage of mucus with the appearance of frog spawn.1 Osler's close linkage of psyche and soma in IBS persisted for almost a century and in the 1970s the condition, then labelled spastic colitis, was still seen as having a very substantial psychiatric component, particularly because no gold standard or diagnostic test for the condition was available. Diagnostic progress was made when Adrian Manning elaborated his well-known eponymous diagnostic criteria in Bristol in 1978,2 although little aetiological progress was made until the last decade. The 1990s saw the development of the Rome I3 and Rome II4 criteria for the diagnosis of IBS and also an explosion of research interest into peripheral and central neuroenteric and neuropsychological mechanisms involved in the control and perception of gut motility and nociception.

[学科分类] 卫生学