Irritable bowel syndrome (IBS) and chronic constipation (CC) are common functional bowel disorders that are among the most frequent reasons for referral to a gastroenterologist. Diagnosis and management of these conditions can be challenging for both the clinician and the patient for a number of reasons. Diagnosis can be complicated by the lack of a specific diagnostic test and the fact that IBS and CC are multisymptomatic conditions, whereas management can be suboptimal, because the conditions are often undiagnosed and self-managed by the patient. Furthermore, these are chronic conditions that must be managed over the long term, which can often lead to frustration both on the part of the patient and the clinician. As such, the role of the therapeutic clinician-patient relationship in diagnosis and management of these conditions has been attracting increasing attention. A patient-centered approach with a strong focus on effective communication between the clinician and the patient has been recommended for management of functional bowel diseases such as IBS and CC and has been associated with improved outcomes, increased patient satisfaction, and decreased utilization of care. The potential benefit of such practices as asking open-ended questions, actively listening to the patient, and displaying empathy in strengthening the clinician-patient relationship are highlighted in this manuscript. These skills have broad application in clinical medicine and can be used to improve clinician-patient communication in the management of patients with chronic illnesses.
Division of Gastroenterology, University of South Alabama College of Medicine, Mobile, AL
Financial support has been received in this area from Takeda Pharmaceuticals.
J.A.D.P. has served as a consultant, speaker and has had research support from Takeda Pharmaceuticals and Braintree Laboratories and as a consultant for Ironwood Pharmaceuticals. J.L.H. has no conflicts to disclose.
Reprints: Jack A. Di Palma, MD, Division of Gastroenterology, University of South Alabama, USA Pavilion at Infirmary West, 5600 Girby Road, Mobile, AL 36693 (e-mail: firstname.lastname@example.org).