Irritable bowel syndrome: current review on pathophysiology and diagnotic aspects

Until now, Irritable Bowel Syndrome (IBS) has been one of gastrointestinal disorders which have not been fully understood. Clinically, there are some findings that indicate the role of inflammatory process in pathogenesis of IBS; such as, the onset of IBS that occurs after an episode of gastroenteritis (post-infective IBS (PI-IBS)). Although there is less evidence supporting genetic factors in pathogenesis of IBS, there are some reports about serotonin release in the plasma correlated to predominant constipation symptom. In contrast, increased serotonin release in IBS cases correlated to predominant diarrhea symptom. The stress-mast cell axis is one of pathophysiologic pathway that is expected to be able to explain the correlation between stress and characteristics found in IBS symptoms. Psychosocial factor has been well-considered to have important role in pathogenesis of IBS. Diagnosis of IBS is based on history of pain or abdominal discomfort that correlated to abnormal defecation pattern, without any obvious alarm sign. Nowadays, there is no specific laboratory test or physical or biochemical marker pathognomonic for IBS; therefore, clinical symptoms become the main modality in diagnosing IBS. This article will discuss the pathophysiology and diagnosis of IBS which will be helpful for clinicians in the management of IBS in daily practice.