title: [Irritable bowel syndrome: New pathophysiological hypotheses and practical issues].
abstract: In 2015, besides the fact that it still fills the gastroenterologists' offices and impairs patient's quality of life, the irritable bowel syndrome has considerably evolved on several points. The pathophysiology is now organized around a consensual hypothesis called the "brain-gut axis", which gather all the influences of peripheral factors as gut microbiota or local serotonin secretion, on the central pain perception, contributing to visceral hypersensitivity and transit modifications. About the diagnosis, the key message is "avoid over-prescription" of additional tests, and reminds that a positive clinical diagnosis based on Rome III criteria is possible after the elimination of simple clinical warning signs. Finally, the food component, a neglected and historical claim of patients, finally finds a strong scientific rational, with a diet low in fermentable sugar and polyols, that gives positive and reproducible results.
authors.affiliation: Service d'hépato-gastro-entérologie, hôpital Louis-Mourier, AP-HP, 178, rue des Renouillers, 92700 Colombes, France; UMR 1149, centre de recherche sur l'inflammation, université Paris VII, Sorbonne Paris Cité, 16, rue Henri-Huchard, 75018 Paris, France; Faculté Denis-Diderot - Paris 7, 75006 Paris, France. Electronic address: henri.duboc@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Duboc
authors.affiliation: Service d'hépato-gastro-entérologie, hôpital Louis-Mourier, AP-HP, 178, rue des Renouillers, 92700 Colombes, France; Faculté Denis-Diderot - Paris 7, 75006 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Dior
authors.affiliation: Service d'hépato-gastro-entérologie, hôpital Louis-Mourier, AP-HP, 178, rue des Renouillers, 92700 Colombes, France; Faculté Denis-Diderot - Paris 7, 75006 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Coffin
mesh_terms: D000069196:Gastrointestinal Microbiome; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D018377:Neurotransmitter Agents; D010146:Pain / Q000503:physiopathology*
chemical_list: D018377:Neurotransmitter Agents
keywords: Axe cerveau-intestin; Brain-gut axis; Critères de Rome; FODMAP; FODMAPs; Gut microbiota; Hypersensibilité viscérale; Intestin irritable; Irritable bowel syndrome; Microbiote intestinal; ROME criteria; Serotonin; Sérotonine; Visceral hypersensitivity