[The Dutch College of General Practitioners' 'Irritable bowel syndrome' standard; reaction from the field of gastroenterology].

The definition of 'irritable bowel syndrome' (IBS) as given by the Dutch College of General Practitioners' standard may be too broad to define IBS. Coeliac disease should be added to the differential diagnosis of IBS. Attention should be given to subjects with an increased familial risk of colorectal cancer. Based on the results of thorough investigations, the role of disturbed motility, visceral hyperalgesia, modified cerebrovisceral perception, induction by infectious diseases and contributing psychological factors should be recognised as pathophysiologically relevant for IBS. When treating patients, making a positive diagnosis of IBS, explaining possible pathophysiological factors and exploring contributing factors is much more important than simply giving reassurance. Medical therapy is of limited value, but may relieve symptoms in selected patients.