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Functional diarrhea.

Michael J G Farthing1

  • 1St George's, University of London, Cranmer Terrace, London, UK. m.farthing@sgul.ac.uk

Current Gastroenterology Reports
|September 20, 2005
PubMed
Summary

Functional diarrhea, often part of irritable bowel syndrome (IBS), is increasingly understood through new mechanisms like 5-hydroxytryptamine (5-HT) and inflammation. Emerging therapies show promise but require further research.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Pathophysiology

Background:

  • Functional diarrhea is a key symptom of irritable bowel syndrome (IBS) and can occur in isolation.
  • Recent research is advancing the understanding of IBS pathophysiology and symptom generation.
  • Intestinal infection, 5-hydroxytryptamine (5-HT), and subclinical inflammation are implicated in IBS development, especially post-infectious IBS.

Purpose of the Study:

  • To review recent advancements in understanding the pathogenesis of functional diarrhea and IBS.
  • To discuss the implications of these advancements for novel therapeutic strategies.
  • To evaluate the efficacy and limitations of current and emerging treatments for functional diarrhea.

Main Methods:

  • Literature review of recent studies on functional diarrhea and irritable bowel syndrome (IBS) pathogenesis.

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  • Analysis of the role of 5-hydroxytryptamine (5-HT) and subclinical inflammation.
  • Evaluation of therapeutic interventions including 5-HT(3) antagonists, prednisolone, probiotics, and herbal remedies.

    • Main Results:

    • A strong association between intestinal infection and IBS, and the role of 5-HT, are confirmed.
    • Persistent subclinical inflammation is an emerging factor, particularly in post-infectious IBS.
    • 5-HT(3) antagonists show efficacy in diarrhea-predominant IBS but have risks; prednisolone is ineffective; probiotics and herbal remedies show early promise.

    Conclusions:

    • Understanding the pathophysiology of functional diarrhea has led to new therapeutic approaches.
    • While 5-HT(3) antagonists offer benefits, their use is restricted. Prednisolone is not effective.
    • Further large-scale trials are needed to validate the efficacy of probiotics and herbal remedies for functional diarrhea.