Targeting Irritable Bowel Syndrome Through Diet and Mechanism-Based Therapies: A Pathophysiological Approach.

Area of Science:

• Gastroenterology
• Immunology
• Microbiology
• Neuroscience

Background:

• Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder with complex causes.
• Current treatments often focus on symptom relief, not underlying biological mechanisms.
• Understanding IBS pathophysiology is key to developing effective, personalized therapies.

Purpose of the Study:

• To review the evidence linking core pathophysiological pathways of IBS with mechanism- and diet-based therapeutic strategies.
• To guide personalized treatment approaches for IBS.
• To highlight a shift towards mechanism-driven management.

Main Methods:

• Literature review of current evidence on IBS pathophysiology and therapeutic strategies.
• Analysis of interactions between serotonergic signaling, microbial dysbiosis, immune activation, epithelial barrier dysfunction, and bile acid malabsorption.
• Evaluation of dietary interventions (e.g., low-FODMAP diets) and pharmacologic therapies targeting specific pathways.

Main Results:

• Core pathophysiological pathways (serotonin, microbes, immunity, barrier function, bile acids) interact to cause IBS symptoms.
• Dietary interventions (low-FODMAP, Mediterranean low-FODMAP), probiotics, psychobiotics, and vitamin D can modulate these pathways.
• Pharmacologic therapies (serotonergic modulators, bile acid sequestrants, neuroimmune agents) target specific mechanisms.

Conclusions:

• Integrating dietary, microbial, neuroimmune, and serotonergic modulation offers a rational, individualized approach to IBS management.
• Mechanism-based therapies are shifting IBS treatment from symptom-focused to targeted interventions.
• This unified framework supports long-term symptom control for IBS patients.