title: Update on irritable bowel syndrome program of research.
abstract: OBJECTIVE
  This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS).
  
  
  METHODS
  This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model.
  
  
  RESULTS
  IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep.
  
  
  CONCLUSIONS
  The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.
authors.affiliation: Department of Biobehavioral Nursing & Health Systems, University of Washington, Seattle, USA. heit@uw.edu.
authors.forename: Margaret
authors.initials: M
authors.lastname: Heitkemper
authors.affiliation: Department of Biobehavioral Nursing & Health Systems, University of Washington, Seattle, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Jarrett
authors.affiliation: College of Nursing, Keimyung University, Daegu, Korea.
authors.forename: Sang-Eun
authors.initials: SE
authors.lastname: Jun
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015400:Clinical Nursing Research; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D012648:Self Care
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents
keywords: Adults; Diagnosis; Etiology; Irritable bowel syndrome; Treatment