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.
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is characterized by abdominal pain and altered bowel habits, often including bloating. The condition is common and can substantially affect quality of life and cause considerable economic burden. Intense research efforts into understanding the mechanisms that underlie IBS (including the role of the gut microbiota, gut–brain axis, genetics and immune system) are ongoing and new approaches for effective treatment are being developed, including dietary management and novel drugs.
This Nature Reviews Gastroenterology & Hepatology and Nature Reviews Disease Primers Web Collection on IBS presents a selection of articles from leaders in the field, covering key aspects of the pathogenesis, diagnosis and management of IBS.
IBS affects up to 15% of the population and continues to provide the medical profession with diagnostic and therapeutic challenges. The pathophysiology is complex and until it is better understood management strategies will necessarily remain rather empirical.
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.
Evidence is mounting that molecular mechanisms underlie gut dysfunction and symptom generation in IBS. Although it is still an uphill struggle, this mounting evidence is a good starting point for the discovery of one or more IBS biomarkers.