Translational Gap between Guidelines and Clinical Medicine: The Viewpoint of Italian General Practitioners in the Management of IBS

J Clin Med. 2022 Jul 3;11(13):3861. doi: 10.3390/jcm11133861.


Massimo Bellini 1Cesare Tosetti 2 3Francesco Rettura 1Riccardo Morganti 4Christian Lambiase 1Gabrio Bassotti 5Pierfrancesco Visaggi 1Andrea Pancetti 1Edoardo Benedetto 3 6Nicola de Bortoli 1Paolo Usai-Satta 7Rudi De Bastiani 3 8


Author information

1Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, 56010 Pisa, Italy.

2Department of Primary Care, National Health Service, 40046 Bologna, Italy.

3Italian Group for Primary Care Gastroenterology, 32032 Belluno, Italy.

4Clinical Trial Statistical Support Unit, Azienda Ospedaliero Universitaria Pisana, 56010 Pisa, Italy.

5Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia, 06516 Perugia, Italy.

6Gastrointestinal Unit, National Health Service, 87100 Cosenza, Italy.

7Gastroenterology Unit, Brotzu Hospital, 09121 Cagliari, Italy.

8Department of Primary Care, National Health Service, 32032 Belluno, Italy.


Irritable bowel syndrome (IBS) guidelines are generally developed by experts, with the possibility of a translational gap in clinical medicine. The aim of our study was to assess an Italian group of general practitioners (GPs) for their awareness and use of criteria for the diagnosis and management of IBS. For this purpose, a survey was carried out involving 235 GPs, divided into two groups according to their years of activity: 65 "junior general practitioners" (JGPs) (≤10 years) and 170 "senior general practitioners" (SGPs) (>10 years). JGPs were more familiar with the Rome IV Criteria and Bristol Scale than SGPs. Abdominal pain, bowel movement frequency and bloating were the symptoms most frequently used to make a diagnosis. The most probable causes of IBS were reported to be abnormal gastrointestinal motility and psychological triggers. SGPs reported more frequently than JGPs that challenging management and patient's request were motivations for a gastroenterological consultation. The practice of clinical medicine is still far from the guidelines provided by the specialists. Abdominal pain related to defecation and changes in bowel frequency are considered to be the more important symptoms for IBS diagnosis, but most GPs, both JGPs and SGPs, like to consider abdominal bloating as another useful symptom. Involving both gastroenterologists and GPs in developing shared guidelines would be highly desirable in order to improve IBS management strategies in everyday clinical practice.

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