[Therapy of functional bowel disorders]

The irritable bowel syndrome is the most frequent and most important functional bowel disease. It is characterized by a combination of abdominal pain, alterations of bowel habits (diarrhea, constipation) and meteorism. Probably, visceral hypersensitivity, motility disturbances, food intolerance, immunologic and microbiologic alterations and psychosomatic influences contribute to symptoms. In a relevant subgroup of patients the disease is triggered by bacterial infection. These patients usually have diarrhea-predominant disease. Irritable bowel syndrome can be diagnosed if typical symptoms are present and after relevant organic differential diagnoses have been excluded by selective biochemical investigations, abdominal ultrasonography and, if applicable, by colonoscopy. These diagnostic procedures are an important basis for therapeutic interventions and need to be complemented by clear information about the diagnosis and the benign long-term course of the disease. Medical therapy concentrates on treatment of predominant symptoms, i.e. pain, diarrhea, constipation and meteorism.