title: New insights into the pathogenesis and treatment of irritable bowel syndrome.
abstract: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders (FGID), characterized by abdominal pain and a change in stool form that cannot be explained by structural abnormalities. Its prevalence ranges from 9 to 23% of the worldwide population. The pathophysiology of IBS is diverse and not well understood. Biopsychosocial concept assumes that the disease is a product of psychosocial factors and altered at multiple levels of gut physiology interactions. Some aetiological factors have been identified, yet. One of the most important is the disruption of brain-gut mutual communication that leads to visceral hypersensitivity. Also genetic and epigenetic factors are involved. Chronic stress may predispose to IBS as well as exacerbate its symptoms. Both quantitative and qualitative disorders of the gut microbiota are observed. There is also a relationship between the IBS symptoms and the intake of a specific type of food products. In the diarrhoea type of IBS the role of previous gastrointestinal infection is demonstrated. Recent studies have suggested that visceral hypersensitivity in patients with IBS may be secondary to the activation of the immune cells and low-grade inflammation. Clinical symptoms of IBS include abdominal pain and change in bowel habits as well as somatic and psychiatric comorbidities. IBS is diagnosed on the basis of Rome Diagnostic Criteria. Recently, their newest version (Rome IV) has been presented. The aim of this review is to summarize the past decade progress in IBS diagnosis, main pathophysiological aspects and therapeutic management strategy.
authors.affiliation: Chair and Department of Paediatrics, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland. Electronic address: smina@poczta.onet.pl.
authors.forename: Joanna
authors.initials: J
authors.lastname: Oświęcimska
authors.affiliation: Department of Paediatric Endocrinology, Prof. Stanisław Szyszko Independent Public University Hospital No 1 in Zabrze, Medical University of Silesia in Katowice, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szymlak
authors.affiliation: Institute of Medicine, Jan Grodek State Vocational School in Sanok, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Roczniak
authors.affiliation: Chair and Department of Psychiatry, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Girczys-Połedniok
authors.affiliation: Chair and Department of Paediatrics, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Kwiecień
mesh_terms: D000818:Animals; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000473:pathology* / Q000628:therapy*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Diagnosis; Gut-brain axis; Irritable bowel syndrome; Pathogenesis; Treatment