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Irritable bowel syndrome: classification and conceptualization.

Yehuda Ringel1, Douglas A Drossman

  • 1Division of Digestive Diseases and Nutrition, Department of Medicine, University of North Carolina at Chapel Hill, 778 Burnett-Womack, CB# 7080, Chapel Hill, NC 27599-7080, USA. ringel@med.unc.edu

Journal of Clinical Gastroenterology
|August 20, 2002
PubMed
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Irritable bowel syndrome (IBS) is a complex functional gastrointestinal disorder influenced by physiological and psychosocial factors. Understanding these elements is key to improving patient outcomes and quality of life.

Area of Science:

  • Gastroenterology
  • Neurogastroenterology
  • Psychosomatic Medicine

Background:

  • Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits.
  • IBS is recognized as a biopsychosocial condition, involving a complex interplay of physiological, psychological, behavioral, and environmental factors.
  • The Rome classification system categorizes IBS within functional gastrointestinal disorders.

Purpose of the Study:

  • To elucidate the multifactorial nature of irritable bowel syndrome.
  • To identify key contributing factors to the clinical expression and outcomes of IBS.
  • To provide a comprehensive overview of IBS pathophysiology and management considerations.

Main Methods:

  • Review of current literature on IBS pathophysiology and classification.

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  • Analysis of contributing factors including early life events, physiological alterations, and psychosocial influences.
  • Examination of the impact of these factors on IBS clinical presentation and outcomes.

    • Main Results:

    • IBS involves physiological factors like visceral hypersensitivity, altered gut motility, and dysregulated brain-gut communication.
    • Psychosocial elements, including psychiatric comorbidities and trauma history, significantly amplify IBS symptoms and affect outcomes.
    • Early life factors (genetic, environmental) can predispose individuals to developing IBS.
    • Postinfectious events may trigger or exacerbate physiological changes contributing to IBS.

    Conclusions:

    • IBS is a heterogeneous disorder requiring a comprehensive biopsychosocial approach for effective management.
    • Understanding the interplay of physiological and psychosocial factors is crucial for improving symptom relief and health-related quality of life in IBS patients.
    • Future research should focus on personalized treatment strategies targeting specific pathophysiological and psychological domains of IBS.