O Guideline, Primary Care, General Practitioners

Full list of author information is available at the end of the articleBackground Irritable bowel syndrome (IBS) is the commonest of the functional gastrointestinal disorders [1], with an esti-mated prevalence of 10 % [2]. It is a chronic, relap-sing and often life-long disorder, characterized by the presence of abdominal pain/discomfort associated with defaecation, a change in bowel habit, the sensation of abdominal distension, and may include associated non-colonic symptoms. As with other ‘medically unexplained symptoms ’ (MUS) people with persistent symptoms of IBS have poor physical function, impaired quality of life and high healthcare costs [3]. There is evidence of im-pairment of health-related quality of life (QOL) [4,5] and qualitative studies have highlighted how symptoms im-pact on daily functioning, personal and social relation-ships, self-image and psychological well-being [6,7]. The main predictors for chronicity are psychological distress