Irritable Bowel Syndrome Care in Catalonia: A Qualitative Study with Healthcare Professionals on the Management of Uncertainty and the Possibilities of Technological and Digital Developments.

BACKGROUND/OBJECTIVES: Irritable bowel syndrome (IBS) is one of the most common disorders of gut-brain interaction and one of the most frequent functional bowel disorders encountered in clinical practice. The lack of reliable biomarkers, coupled with inconsistent clinical presentations and variable therapeutic outcomes, creates a landscape of ongoing uncertainty for clinicians. Against this background, non-pharmacological and technological developments-such as digital health interfaces, sensor technologies, and medical devices-emerge as potential support tools for clinical management. This qualitative study explored how healthcare professionals manage diagnostic and therapeutic uncertainty in IBS across care settings while evaluating the potential role and value of integrating these technological and non-pharmacological innovations into routine practice. METHODS: Fifteen semi-structured interviews were conducted with healthcare professionals involved in IBS care across primary and specialized settings and one expert patient with lived experience in the Barcelona metropolitan area. Data were analyzed using principles of grounded theory. RESULTS: The notion of "catch-all category" articulates four interrelated themes that characterize IBS in clinical practice: persistent clinical uncertainty, pragmatic diagnostic strategies, patient engagement in biopsychosocial and longitudinal management, and the implementation and interpretability of digital and non-pharmacological support. Participants described IBS management as shifting from exclusionary, symptom-based diagnostics toward holistic biopsychosocial and gut-brain-axis models. This transition underscores the necessity for resources that empower patients through education, support clinicians through longitudinal monitoring, and facilitate shared management strategies. CONCLUSIONS: The findings suggest that IBS management is not a single diagnostic act but a longitudinal process of uncertainty management. Future digital or non-pharmacological support tools for IBS should prioritize longitudinal monitoring, clinically interpretable information, and low burden for professionals and patient-professional communication.