Irritable bowel syndrome
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Understanding Irritable Bowel Syndrome (IBS)
Overview of Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits, including diarrhea and constipation1 5 7. It affects between 5% and 10% of the population at any given time and is more prevalent in young adult women and individuals with psychological comorbidities1. The condition significantly impacts the quality of life and work productivity of those affected7 10.
Pathophysiology and Risk Factors
Gut-Brain Interaction and Visceral Hypersensitivity
The pathophysiology of IBS is complex and not fully understood. Key mechanisms include disordered communication between the gut and the brain, leading to motility disturbances, visceral hypersensitivity, and altered central nervous system (CNS) processing1 5. Psychological stress and disorders also play a significant role in modulating the illness experience and clinical outcomes2 3.
Microbiota and Immune Function
Emerging research highlights the role of gastrointestinal microbiota and immune function in IBS. Alterations in gut microbiota, increased intestinal permeability, and low-grade inflammation are implicated in the development of IBS symptoms5 9. Infections, both bacterial and viral, can trigger IBS, and therapies targeting the microbiota, such as probiotics and non-absorbable antibiotics, show promise in managing the condition9.
Genetic and Environmental Factors
Genetic predispositions, along with environmental factors such as diet and life events, contribute to the onset and severity of IBS. These factors can enhance epithelial permeability and elicit mucosal microinflammation, further complicating the disorder5 9.
Diagnosis and Management
Diagnostic Criteria
IBS is diagnosed based on clinical history and symptom-based criteria, such as the Rome III criteria, which focus on the frequency and nature of symptoms7 8. Alarm symptoms like weight loss, rectal bleeding, and family history of gastrointestinal diseases necessitate further investigation to rule out other conditions1 8.
Treatment Approaches
Lifestyle and Dietary Modifications
Initial management of IBS often involves lifestyle and dietary changes. Increasing soluble fiber intake and avoiding trigger foods can alleviate symptoms. Probiotics and specific diets, such as low FODMAP, are also beneficial for some patients6 7 9.
Pharmacological Treatments
Pharmacotherapy is tailored to the predominant symptoms of IBS. Antispasmodics and antidiarrheals are used for diarrhea-predominant IBS, while prokinetics and high-fiber diets are recommended for constipation-predominant IBS. Central neuromodulators and drugs targeting opioid or 5-HT receptors are reserved for severe cases1 6 7.
Psychological Therapies
Given the significant role of psychological factors in IBS, therapies such as cognitive-behavioral therapy (CBT) and other resilience-enhancing interventions are crucial. These approaches help patients manage stress and improve their overall quality of life2 3.
Conclusion
IBS is a multifaceted disorder requiring a holistic approach to diagnosis and management. Understanding the interplay between gut-brain interactions, microbiota, and psychological factors is essential for developing effective treatments. While current therapies focus on symptom management, ongoing research into the underlying mechanisms of IBS holds promise for more targeted and effective interventions in the future.
Sources and full results
Most relevant research papers on this topic
Irritable bowel syndrome
Irritable bowel syndrome is a common condition with symptoms including abdominal pain and changes in stool form or frequency, and is often diagnosed through clinical history and empathetic treatment.
Rigorous Journal
Highly CitedIrritable Bowel Syndrome and Resilience
Resilience-enhancing interventions may improve health and stress response in people with irritable bowel syndrome.
Systematic ReviewAGA technical review on irritable bowel syndrome.
IBS is a common functional gastrointestinal disorder characterized by abdominal pain and disturbed defecation, and its psychosocial factors play a significant role in modulating the illness experience and clinical outcome.
Highly CitedPPARγ: A turning point for irritable bowel syndrome treatment.
PPAR- activation shows potential as a target for IBS treatment, improving gut barrier, reducing inflammation, and reducing pain.
Systematic ReviewIrritable bowel syndrome: emerging paradigm in pathophysiology.
IBS symptoms involve multiple factors, requiring a holistic approach to effective treatment and understanding underlying mechanisms.
Rigorous JournalHighly CitedManagement Options for Irritable Bowel Syndrome
Lifestyle modification, diet changes, probiotics, and pharmacotherapy can effectively manage irritable bowel syndrome, but new treatments are needed to relieve pain without adverse effects.
Highly CitedIrritable bowel syndrome: Epidemiology, diagnosis and treatment: An update for health‐care practitioners
Current treatment approaches for irritable bowel syndrome include pharmacological treatments, lifestyle changes, and complementary and alternative therapies, with promising results.
Highly CitedIrritable bowel syndrome: a clinical review.
IBS diagnosis relies on symptom-based criteria and an individualized, holistic approach that combines dietary, lifestyle, medical, and behavioral interventions.
Systematic ReviewHighly CitedA Review of Microbiota and Irritable Bowel Syndrome: Future in Therapies
Targeting gut microbiota through prebiotics, probiotics, synbiotics, non-absorbable antibiotics, diets, and fecal transplantation shows promise for improving diagnosis, prevention, and treatment of irritable bowel syndrome.
Rigorous JournalHighly CitedReview article: the economic impact of the irritable bowel syndrome
IBS significantly impacts patients' quality of life and healthcare resources, despite no attributable mortality.
Rigorous JournalHighly Cited