title: Nuances in treating irritable bowel syndrome.
abstract: Irritable bowel syndrome (IBS) is a difficult disease to treat because of its ill-defined triggers, variable clinical course, and unpredictable myriad of symptoms of varying severity. Both doctors and patients are frustrated by the insidious nature of IBS--a nonlethal disorder that destroys lives, relationships, and careers. Traditional therapies are sometimes effective in mild disease but are often self-limiting because they focus primarily on individual symptoms. A combination of lifestyle and diet modifications, pharmacologic agents, and therapeutic interventions is usually necessary to address the multiple symptoms characteristic of IBS. One of the major advancements in the treatment of patients with IBS has been the development of US Food and Drug Administration--approved serotonergic therapeutics that specifically target the underlying causes of IBS and provide multisymptom relief by improving gastrointestinal function. Although they are controversial, alternative treatment approaches that target normalization of intestinal bacterial microflora may be helpful for some patients in whom intestinal bacterial overgrowth is present. Patients who have co-existing pelvic floor dysfunction may benefit from physical therapy. Overall, treatment approaches for IBS should address multisymptom relief and improvement of overall patient well-being.
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Medical College of Cornell University, New York, NY, USA.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Frissora
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology; D000928:Antidepressive Agents / Q000627:therapeutic use; D000930:Antidiarrheals / Q000627:therapeutic use; D002400:Cathartics / Q000627:therapeutic use; D004032:Diet; D004043:Dietary Fiber / Q000008:administration & dosage; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000628:therapy*; D008019:Life Style; D010276:Parasympatholytics / Q000627:therapeutic use; D026741:Physical Therapy Modalities; D019936:Probiotics / Q000627:therapeutic use; D011613:Psychotherapy
chemical_list: D000928:Antidepressive Agents; D000930:Antidiarrheals; D002400:Cathartics; D004043:Dietary Fiber; D005765:Gastrointestinal Agents; D010276:Parasympatholytics