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  • Review Article
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Treatments targeting putative mechanisms in irritable bowel syndrome

Nature Clinical Practice Gastroenterology & Hepatology volume 2, pages 82–88 (2005)Cite this article

Abstract

The pathophysiology of irritable bowel syndrome (IBS) is heterogeneous; it is possible for several mechanisms to be disturbed in the same patient. Isolating a single target for pharmacological manipulation is also difficult because of the complexity and overlap of the neural circuitry in the enteric and central nervous system. This review summarizes the rationale and efficacy of current and future therapies for IBS, on the basis of putative pathophysiological models. The modulation of gastrointestinal sensorimotor function, intestinal gas handling, the gastrocolonic reflex, neurohormonal stress responses, central processing of afferent information, and microbial flora are the current frontiers for experimental therapeutics for IBS. Patients presumed to have POSTINFECTIOUS IBS have also been targeted as a distinct group. In the very near future, it is unlikely that a single drug will come to the fore as a suitable and successful treatment for everyone with IBS, but new data on potential therapeutic targets lend hope for the improved long-term management of IBS. Disease modification rather than just symptom-based treatments must remain the goal.

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Figure 1: Localization of potential relevant molecular targets in irritable bowel syndrome with the specific classes of agents discussed in this Review.

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Author information

Authors and Affiliations

  1. Senior Research Fellow Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Program, Mayo Clinic College of Medicine, Rochester, MN, USA

    Filippo Cremonini

  2. Professor of Medicine and Director of the Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Program, Mayo Clinic College of Medicine, Rochester, MN, USA

    Nicholas J Talley

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  1. Filippo Cremonini
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  2. Nicholas J Talley
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Correspondence to Nicholas J Talley.

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Competing interests

NJ Talley declares that he has received research support from Merck, Forest, AstraZeneca, Novartis, and Solvay. He has acted as a consultant for AstraZeneca, Axcan, EBMed, Gianconda, and Theravance.

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Cremonini, F., Talley, N. Treatments targeting putative mechanisms in irritable bowel syndrome. Nat Rev Gastroenterol Hepatol 2, 82–88 (2005). https://doi.org/10.1038/ncpgasthep0096

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