Neuropathophysiology of irritable bowel syndrome.
Widespread symptoms associated with the irritable bowel syndrome (IBS) are abnormal defecation and abdominal pain, both of which can be exacerbated by psychogenic stress. Disordered defecation may present as diarrhea or constipation. A subgroup of IBS patients alternate from one to the other over time. Urgency to stool often accompanies the diarrheal-state, and patients with the constipation-predominant form of IBS report straining and the feeling of incomplete evacuation. Basic scientific research aims for improved understanding of the physiology and pathophysiology of the digestive systems from which the arrays of IBS symptoms emerge. The key systems for the defecation-related symptoms are the intestinal secretory glands, the musculature, and the nervous system that controls and integrates their activity. Abdominal pain and discomfort arising from these systems adds the dimension of sensory neurophysiology. This review details current concepts of the underlying pathophysiology in terms of the physiology of intestinal secretion, motility, nervous control, sensing function, immuno-neural communication, and the brain-gut axis.
Departments of Physiology and Cell Biology and Internal Medicine, Ohio State University College of Medicine and Public Health, Columbus, Ohio, USA. wood.13@osu.edu
Jackie D
JD
Wood
D015746:Abdominal Pain / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology; D003109:Colonic Diseases, Functional / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D003248:Constipation / Q000503:physiopathology; D003967:Diarrhea / Q000503:physiopathology; D005769:Gastrointestinal Motility; D006801:Humans; D007422:Intestines / Q000294:innervation; D008407:Mast Cells; D016472:Motor Neuron Disease / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000503:physiopathology