Uploaded by gurlyguy on Oct 21, Managing Irritable Bowel Syndrome Irritable bowel syndrome IBS --also called irritable or spastic colon--is a common functional intestinal disorder characterized by recurrent abdominal discomfort and abnormal bowel function. The discomfort often begins after eating and goes away after a bowel movement. The symptoms can include cramps, bloating, constipation, diarrhea, and a feeling of incomplete emptying. IBS occurs in about one in five Americans, more commonly in women, and more often at times of emotional stress.
Soares RLS contributed to the manuscript. This article has been cited by other articles in PMC. Abstract Irritable bowel syndrome IBS remains a clinical challenge in the 21st century. Its can affect up to one in five people at some point in their lives, and has a significantly impact of life quality and health care utilization.
The prevalence varies according to country and criteria used to define IBS. Various mechanisms and theories have been proposed about its etiology, but the biopsychosocial model is the most currently accepted for IBS. The complex of symptoms would be the result of the interaction between psychological, behavioral, psychosocial and environmental factors.
The diagnosis of IBS is not confirmed by a specific test or structural abnormality. It is made using criteria based on clinical symptoms such as Rome criteria, unless the symptoms are thought to be atypical.
Secure positive evidence of IBS by means of specific disease marker is currently not possible and cannot be currently recommended for routine diagnosis.
There is still no clinical evidence to recommend the use of biomarkers in blood to diagnose IBS. However, a number of different changes in IBS patients were demonstrated in recent years, some of which can be used in the future as a diagnostic support.
IBS has no definitive treatment but could be controlled by non-pharmacologic management eliminating of some exacerbating factors such certain drugs, stressor conditions and changes in dietary habits.
The traditional pharmacologic management of IBS has been symptom based and several drugs have been used. However, the cornerstone of its therapy is a solid patient physician relationship. This review will provide a summary of pathophysiology, diagnostic criteria and current and emerging therapies for IBS.
Irritable bowel syndrome IBS remains a clinical challenge in the 21st century. Various mechanisms and theories have been proposed about its etiology, but the biopsychosocial model is the most currently accepted.
Traditional management of IBS has been symptom based and several drugs have been used. Irritable bowel syndrome IBS is the most prevalent FGID noted in the general population worldwide and also the most common reason for referral to gastroenterology clinics[ 1 - 4 ].
Even though it was described to years ago, IBS remains a clinical challenge in the 21st century[ 56 ]. Its can affect up to one in five people at some point in their lives, and has a significantly impact of life quality and health care utilization[ 78 ].
The prevalence varies according to country and criteria used to define IBS[ 9 - 21 ].
Various mechanisms and theories have been proposed about its etiology, but the biopsychosocial model is the most currently accepted for IBS[ 22 ]. The complex of symptoms would be the result of the interaction between psychological, behavioral, psychosocial and environmental factors[ 23 - 27 ].
There is no definitive treatment for IBS and the traditional management has been symptom based but recent developments in the understanding of complex interaction between the gut, immune system and nerve system have led to an expanded arsenal of therapeutic options for relief of both bowel movement-related symptoms and pain[ 30 - 34 ].
However, a strong doctor-patient relationship is the key for effective treatment of patients and realistic expectations. This review will provide a summary of pathophysiology, diagnostic criteria and current and emerging therapies for IBS[ 35 - 39 ].
Various mechanisms [gastrointestinal GI dismotility[ 4041 ] visceral hypersensitivity[ 4243 ] intestinal mucosa activation[ 44 - 48 ], Increased intestinal permeability[ 49 - 54 ], have been proposed about the IBS pathophysiology.
Studies suggest interplay between luminal factors e. However, the biopsychosocial model[ 22252636 ] is the most currently theory accepted for IBS. The complex of symptoms would be the result of the interaction between psychological, behavioral, psychosocial and environmental factors Since fifty years ago, several theories have proposed regarding the etiology of IBS of which the most important are as follows.
Despite this no predominant pattern of motor activity has emerged as a marker for IBS[ 57 - 60 ] and the relevance of these motor function alterations to symptoms has yet to be established. However, pharmacological stimulation of gut motility in IBS patients appears to reduce gas retention and improve symptoms.
These data suggest that a motility disorder could be associated with this complaint in some patients[ 6162 ]. Role of serotonin in the pathophysiology of IBS.
Serotonin 5-HT plays a critical role in the regulation of GI motility, secretion and sensation. It is an important signaling molecule in the gut targeting enterocytes, smooth muscles and enteric neurons.
Most of the body serotonin is present in enterochromaffin cells.
Serotonin activates both intrinsic and extrinsic primary afferent neurons to, respectively initiate peristaltic and secretory reflexes and to transmit information to the central nervous system.
It is inactivated by the serotonin reuptake transporter SERT in the enterocytes or neurons[ 22243032 ]. Altered serotonin signaling could lead to intestinal and extra intestinal symptoms in IBS.
However, exogenous serotonin application evokes so many responses that it is difficult to determine which is physiologically relevant. Therapeutic agents targeting altered serotonin signaling may provide new effective treatment for patients with IBS[ 62 - 65 ]. Evidences and not evidences of visceral hypersensitivity in IBS Visceral hypersensitivity is considered to be one of the main factors that cause symptoms in IBS patients and increased sensation in response to stimuli is a frequent finding in IBS patients[ 424365 - 68 ].The Burden of Illness of Irritable Bowel Syndrome: Current Challenges and Hope for the Future DARRELL HULISZ, RPh, PharmD health care resources.
KEYWORDS: Irritable bowel syndrome, Economic burden, Social impact, Diagnosis, Health care utilization, Symptoms, Treatment. Irritable bowel syndrome (IBS) is a common chronic disorder characterised by altered bowel habits and abdominal pain, discomfort, bloating, constipation or diarrhoea or both.
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Cirrhosis is a liver condition that causes irreversible scarring on the liver. There are no symptoms in the early stages, but they develop as the disease progresses. There is no cure, but early. Published: Mon, 5 Dec This essay aims to provide a comprehensive account of the gastrointestinal disorder, Irritable Bowel Syndrome.
The aetiology, pathology, and prognosis of the disorder will be described, along with details pertaining to its epidemiology.