Irritable bowel syndrome

The term irritable bowel syndrome (IBS) is relatively modern, but people have had similar symptoms for millennia. Initially thought to exist only in the mind, the disorder has gained legitimacy through the identification of causes and improved diagnosis. By Amber Dance.

The involvement of intestinal bacteria in gut-brain communication could help to explain the mysteries of irritable bowel syndrome, but the search continues for definitive evidence.

The latest iteration of the Rome criteria should improve diagnosis of irritable bowel syndrome, says Brian E. Lacy.

Many people with irritable bowel syndrome feel that they benefit from dietary interventions, but researchers still lack a full understanding of how food can inflame this disorder.

For years, researchers have tried to find biomarkers that could aid the diagnosis of irritable bowel syndrome, and point to its underlying causes. But will one test ever be enough?

Peter Whorwell is Director of the South Manchester Neurogastroenterology Service and a gastroenterologist at the University Hospital of South Manchester, UK. He has been researching and treating patients with irritable bowel syndrome (IBS) for more than 35 years, and has seen the depths of despair that this condition can cause.

Infections have long been thought to cause irritable bowel syndrome, but it has not been clear how. It seems that pathogens might be changing the behaviour of our gut microbiota.

Drugs for irritable bowel syndrome have so far been limited, but a promising stream of options could soon enter the market.

There is a long list of unknowns about the causes and symptomatology of irritable bowel syndrome (IBS). But the research challenges can be distilled into four key areas.

In the past decade we have witnessed an explosion in the quantity and quality of research in the functional gastrointestinal disorders. I discuss 10 top original research papers that, unless recent, have been highly cited, published in a high-impact journal and have probably shifted thinking in the field.

Irritable bowel syndrome is a gastrointestinal disorder that can be mild in some patients, but debilitating in others. This PrimeView focuses on the complex aetiology and current understanding of the molecular pathophysiology, involving intestinal permeability, microbiota, inflammation and visceral sensitivity, among other factors.

Placebo analgesia is increasingly appreciated in many difficult to treat chronic functional gastrointestinal disorders such as IBS. However, investigations of interactions between psychological and biological placebo factors are still in early stages. Now, technologies have been developed that enable neural mechanisms of placebo analgesia to be studied more directly in humans.

Intestinal microbes can have important effects on our health. Here, the authors analyse the gut microbiota composition in 1,000 western adults and find that certain bacteria are either abundant or nearly absent, and that these alternative states are associated with ageing and overweight.

IBS is the most common brain–gut disorder and a major cause of chronic abdominal pain. Here, Mayer and colleagues describe the key components of the gut–brain–microbiota axis in IBS and present a systems-based view of how these components interact to integrate the central, peripheral and behavioural IBS-related alterations.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with a high prevalence. Enck et al. describe the association between IBS and other gastrointestinal, somatic and psychiatric conditions, as well as the current view on the pathophysiology, and diagnostic and management options.