Irritable bowel syndrome: update on pathogenesis and management

Area of Science:

• Gastroenterology
• Neurogastroenterology
• Psychiatry

Background:

• Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder impacting primary care globally.
• Emerging research highlights the critical role of brain-gut interactions in IBS pathogenesis.
• Serotonin (5-hydroxytryptamine, 5-HT) and its receptors (5-HT3, 5-HT4) are key players in gastrointestinal function and IBS.

Purpose of the Study:

• To review the current understanding of IBS pathophysiology, focusing on brain-gut axis alterations.
• To discuss the diagnostic criteria and therapeutic strategies for managing IBS patients.
• To explore the role of serotonin pathways and psychological factors in IBS.

Main Methods:

• Literature review of recent studies on IBS pathophysiology, diagnosis, and treatment.
• Analysis of the role of the brain-gut axis, neurotransmitters (serotonin), and psychological influences.
• Examination of current diagnostic criteria (Rome criteria) and therapeutic approaches.

Main Results:

• Altered bidirectional communication between the central and enteric nervous systems is central to IBS.
• Visceral hyperalgesia in IBS may stem from altered receptor sensitivity and central modulation.
• The Rome criteria provide a standardized approach for IBS diagnosis and subtyping.

Conclusions:

• Effective IBS management requires a holistic approach, addressing gastrointestinal symptoms, non-bowel symptoms, and psychological well-being.
• Physician-patient relationship and reassurance are crucial after diagnosis.
• Dietary modifications, pharmacological agents targeting serotonin pathways, and psychological treatments are valuable therapeutic options.