Diagnosis, Pathophysiology and Treatment of Irritable Bowel Syndrome: A Review

Abstract

Worldwide, 10–24% of people suffer with irritable bowel syndrome (IBS), a persistent and crippling functional gastrointestinal illness. In primary care workplaces, the proportion of patients seeking treatment for IBS exceeds 12%, and in gastrointestinal clinics, this category is by far the largest. It is often known that compared to people without this diagnosis, these patients have a lower quality of life and make more use of the healthcare systemIBS's pathogenesis is not clear. The precise cause of IBS remains unknown despite the many possibilities that have been proposed. The three main subtypes of IBS are (1) IBS with constipation (IBS-C), (2) IBS with diarrhea (IBS-D), and (3) mixed IBS (IBS-M). The updated ROME III criteria classify IBS as a clinical diagnostic; IBS-M was formerly referred to as alternating IBS (IBS-A). Patients may appear with different symptoms across IBS subtypes, and those symptoms may evolve over time. Patients list abdominal discomfort, straining, myalgias, urgency, bloating, and a sense of serious sickness as the most upsetting symptoms. Treatment for IBS is challenging due to its complexity and variability.

Reviews and guidelines exist for the treatment of IBS, however they mostly highlight high-priority endpoints and the effectiveness of drugs for IBS symptoms, mainly ignoring lower-priority endpoints. In order to assist physicians in identifying and treating their patients, the goal of this study is to present an extensive evidence-based summary of the diagnosis, pathophysiology and treatment.