4 - Current state of management and organisation of care

Summary

This chapter considers the unmet need for care among patients with bodily distress syndromes. From the patient's perspective the three unmet needs are: limited awareness and understanding of irritable bowel syndrome (IBS) as a medical condition; simple, non-invasive diagnostic procedures; and affordable, readily available treatments. Follow-up studies have shown that left untreated, bodily distress syndromes continue to be associated with disability and high healthcare costs. The chapter discusses the relevant services in Belgium and Germany highlighting the different types of service which might address the needs of patients with severe bodily distress disorders. The German psychosomatic model applies currently to German-speaking countries only. The situation in Belgium is more typical of most European countries. In a few other places, such as Aarhus, Denmark, there is a specialised service for severe disorders and well-established training for general practitioners.