Abstract

Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with a high population prevalence. The disorder can be debilitating in some patients, whereas others may have mild or moderate symptoms. The most important single risk factors are female sex, younger age and preceding gastrointestinal infections. Clinical symptoms of IBS include abdominal pain or discomfort, stool irregularities and bloating, as well as other somatic, visceral and psychiatric comorbidities. Currently, the diagnosis of IBS is based on symptoms and the exclusion of other organic diseases, and therapy includes drug treatment of the predominant symptoms, nutrition and psychotherapy. Although the underlying pathogenesis is far from understood, aetiological factors include increased epithelial hyperpermeability, dysbiosis, inflammation, visceral hypersensitivity, epigenetics and genetics, and altered brain–gut interactions. IBS considerably affects quality of life and imposes a profound burden on patients, physicians and the health-care system. The past decade has seen remarkable progress in our understanding of functional bowel disorders such as IBS that will be summarized in this Primer.

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Acknowledgements

The research leading to these results has received funding from the People Programme of the European Union's Seventh Framework Programme under REA grant agreement no. 607652 (NeuroGUT), involving of some of the authors. Most of the authors are also engaged in and have received support of the international network COST Action BM1106 GENIEUR (GENes in Irritable Bowel Syndrome Research Network EURope, www.GENIEUR.eu).

Author information

Affiliations

  1. Department of Internal Medicine VI (Psychosomatic Medicine and Psychotherapy), University Hospital Tübingen, Tübingen, Germany.

    • Paul Enck
    • , Juliane Schwille-Kiuntke
    •  & Stephan Zipfel
  2. Wingate Institute of Neurogastroenterology, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

    • Qasim Aziz
    •  & Adam D. Farmer
  3. Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, Bologna, Italy.

    • Giovanni Barbara
  4. Department of Behavioural Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

    • Shin Fukudo
  5. Oppenheimer Center for Neurobiology of Stress, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

    • Emeran A. Mayer
  6. Department of Human Molecular Genetics, University of Heidelberg, Heidelberg, Germany.

    • Beate Niesler
  7. Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas, USA.

    • Eamonn M. M. Quigley
  8. Department of Biochemical Engineering and Biotechnology, Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia.

    • Mirjana Rajilić-Stojanović
  9. Department of Human Biology, Technical University Munich, Freising-Weihenstephan, Germany.

    • Michael Schemann
  10. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

    • Magnus Simren
  11. NIHR Nottingham Digestive Diseases Biomedical Research Unit, University of Nottingham, Nottingham, UK.

    • Robin C. Spiller

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Contributions

Introduction (P.E. and R.C.S.); Epidemiology (P.E. and J.S.-K.); Mechanisms/pathophysiology (G.B., B.N., M.R.-S., M.Schemann and E.A.M.); Diagnosis, screening and prevention (M.Simren); Management (E.M.M.Q., Q.A., A.D.F. and S.Z.); Quality of life (S.F.); Outlook (R.C.S.); Overview of Primer (P.E.).

Competing interests

The authors have received unrestricted research grants from Alfa Wassermann (G.B.), Alimentary Health (E.M.M.Q.), Astellas (S.F.), Boehringer-Ingelheim (M.Schemann), Cadi Group (G.B.), Danone Research (M.Simren), Falk (G.B.), Ferring (M.Simren), IMA (G.B.), Italchimici (G.B.), Ironwood (R.C.S.), Kao (S.F.), Lesaffre (R.C.S.), Lotenzatto (G.B.), Ono Pharmaceuticals (Q.A. and S.F.), Parmalat (G.B.), Pfizer (Q.A.), Pretexin (Q.A.), Rhythme (E.M.M.Q.), Schwabe (M.Schemann), Shire (P.E.), Sofar (G.B.), Steigerwald (M.Schemann), SymbioPharm (P.E.), Therevance (E.M.M.Q.), Vivrant (E.M.M.Q.), Yakult (G.B.) and Zespri (G.B.), have served as a consultant/advisory board members for Actavis (E.M.M.Q.), Albireo (M.Simren), Afa Wassermann (G.B.), Alimentary Health (E.M.M.Q.), Allergan (G.B. and M.Simren), Almirall (A.D.F., E.M.M.Q., G.B., M.Simren, P.E. and R.C.S.), Astellas (S.F.), AstraZeneca (M.Simren and P.E.), Bionorika (M.Schemann), Boehringer-Ingelheim (P.E.), Chr Hansen (M.Simren), Commonwealth (E.M.M.Q. and G.B.), Danone (E.A.M., G.B., M.Simren and R.C.S.), Ferring (P.E.), Glycom (M.Simren), IM Sciences (E.M.M.Q.), Ironwood (G.B.), Italchimici (G.B.), Ipsen (R.C.S.), Kissei (S.F.), Melasci (G.B.), Menarini (G.B.), Noos (G.B.), Parmalat (G.B.), Nestlé (M.Simren), Salix (E.M.M.Q.), Shire (E.M.M.Q., M.Simren and P.E.), Sofar (G.B.), SymbioPharm (P.E.), Synergy (E.M.M.Q. and G.B.), Takeda (M.Schemann), Yakult (G.B.), Yuhan Corp (R.C.S.) and Zenspri (G.B.), and as a speaker for Abbott (S.F.), Alfa Wassermann (G.B.), Almirall (B.N., E.M.M.Q., G.B., M.Simren, P.E. and Q.A.), Astellas (S.F.), AstraZeneca (E.M.M.Q.), Chiesi (P.E.), Danone (G.B.), Falk (B.N. and P.E.), Gruenenthal (P.E. and Q.A.), Heel (P.E.), Ironwood (E.M.M.Q.), Melasci (G.B.), Menarini (G.B. and R.C.S.), Noos (G.B.), Shire (A.D.F., E.M.M.Q., G.B., M.Simren and P.E.), Sofar (G.B.), Steigerwald (M.Schemann), SymbioPharm (P.E.), Takeda (M.Simren), Tillotts (M.Simren) and Yakult (G.B.). J.S.-K., M.R.-S. and S.Z. declare no potential conflict of interests.

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Correspondence to Paul Enck.

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https://doi.org/10.1038/nrdp.2016.14

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