Irritable Bowel Syndrome - current state of knowledge
DOI:
https://doi.org/10.12775/QS.2024.23.55045Keywords
irritable bowel syndrome, constipation, diarrhea, abdominal pain, diagnostics, treatmentAbstract
Introduction and objective: Irritable bowel syndrome (IBS) is a common gastroenterological disorder affecting 9% to 23% of the population worldwide. The disease causes recurrent abdominal pain and abnormal bowel movements without visible anatomical or biochemical changes and diagnosis is often difficult. The purpose of this paper is to analyze the current knowledge of the pathophysiology, risk factors, diagnosis and treatment of IBS.
Review methods: The literature available in the PubMed database was reviewed using the following key words: "irritable bowel syndrome," "constipation," "diarrhea", "abdominal pain", "diagnostics", "treatment". 49 articles were included in the review and 80% were from 2016-2024.
Current state of knowledge: The pathophysiology of IBS is not fully understood, but it is recognized that the disease is a disorder of the gut-brain axis. It can lead to abnormal secretion of serotonin and dopamine, which affects symptoms. The diagnosis of IBS is based on the Rome IV Criteria, defining the characteristics and severity of symptoms.
Summary: IBS is a disorder that significantly affects quality of life. Diagnosis is based on the exclusion of organic diseases and meeting certain criteria. Treatment includes both dietary modification and pharmacotherapy aimed at relieving symptoms. Despite advances in research, the pathophysiology of IBS is still not fully understood, making it difficult to develop effective treatments.
References
Adriani A, Ribaldone DG, Astegiano M, et al. Irritable bowel syndrome: the clinical approach. Panminerva Med. 2018; 60(4): 213-222. https://doi.org/10.23736/S0031-0808.18.03541-3.
Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology. 2002; 122(4): 1140-56. https://doi.org/10.1053/gast.2002.32392.
Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA. 2015; 313(9): 949-58. https://doi.org/10.1001/jama.2015.0954.
Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014; 20(22): 6759-73. https://doi.org/10.3748/wjg.v20.i22.6759.
Ford AC, Sperber AD, Corsetti M, et al. Irritable bowel syndrome. Lancet. 2020; 396(10263): 1675-1688. https://doi.org/10.1016/S0140-6736(20)31548-8.
Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology. 2021; 160(1): 99-114. https://doi.org/10.1053/j.gastro.2020.04.014.
Fagoonee S, Pellicano R. Does the Microbiota Play a Pivotal Role in the Pathogenesis of Irritable Bowel Syndrome? J Clin Med. 2019; 8(11): 1808. https://doi.org/10.3390/jcm8111808.
Chojnacki C, Blonska A, Kaczka A, et al. Evaluation of serotonin and dopamine secretion and metabolism in patients with irritable bowel syndrome. Pol Arch Intern Med. 2018; 128(11): 711-713. https://doi.org/10.20452/pamw.4364.
Staudacher HM, Black CJ, Teasdale SB, et al. Irritable bowel syndrome and mental health comorbidity-approach to multidisciplinary management. Nat Rev Gastroenterol Hepatol. 2023; 20(9): 582-596. https://doi.org/10.1038/s41575-023-00794-z.
Zhou Q, Zhang B, Verne GN. Intestinal membrane permeability and hypersensitivity in the irritable bowel syndrome. Pain. 2009; 146(1-2): 41-6. https://doi.org/10.1016/j.pain.2009.06.017.
Mei L, Zhou J, Su Y, et al. Gut microbiota composition and functional prediction in diarrhea-predominant irritable bowel syndrome. BMC Gastroenterol. 2021; 21(1): 105. https://doi.org/10.1186/s12876-021-01693-w.
Houghton LA, Atkinson W, Whitaker RP, et al. Increased platelet depleted plasma 5-hydroxytryptamine concentration following meal ingestion in symptomatic female subjects with diarrhoea predominant irritable bowel syndrome. Gut. 2003; 52(5): 663-70. https://doi.org/10.1136/gut.52.5.663.
Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012; 10(7): 712-721. https://doi.org/10.1016/j.cgh.2012.02.029.
Petersen MW, Schröder A, Jørgensen T, et al. The unifying diagnostic construct of bodily distress syndrome (BDS) was confirmed in the general population. J Psychosom Res. 2020; 128: 109868. doi:10.1016/j.jpsychores.2019.109868.
Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis. Gastroenterology. 2017; 152(5): 1042-1054. https://doi.org/10.1053/j.gastro.2016.12.039.
Mulak A, Smereka A, Paradowski L. Novelties and modifications in Rome Criteria IV. Clinical Gastroenterology-Progress and Standards. 2016; 8: 52-61.
Drossman D, Chang L, Chey L, et al. Rome IV Criteria. Rome Foundation. https://theromefoundation.org/rome-iv/rome-iv-criteria/ (accessed: 2024.08.06).
Bonetto S, Fagoonee S, Battaglia E, et al. Recent advances in the treatment of irritable bowel syndrome. Pol Arch Intern Med. 2021; 131(7-8): 709-715. https://doi.org/10.20452/pamw.16067.
Blake MR, Raker JM, Whelan K. Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2016; 44(7): 693-703. https://doi.org/10.1111/apt.13746.
Masuy I, Pannemans J, Tack J. Irritable bowel syndrome: diagnosis and management. Minerva Gastroenterol Dietol. 2020; 66(2): 136-150. https://doi.org/10.23736/S1121-421X.19.02640-0.
El-Serag HB, Pilgrim P, Schoenfeld P. Systemic review: natural history of irritable bowel syndrome. Aliment Pharmacol Ther. 2004; 19(8): 861-70. https://doi.org/10.1111/j.1365-2036.2004.01929.x.
Camilleri M. Diagnosis and Treatment of Irritable Bowel Syndrome: A Review. JAMA. 2021; 325(9): 865-877. doi: 10.1001/jama.2020.22532.
Rydzewska G. Polish and American guidelines for IBS. Simple diagnosis-what treatment? Termedia. https://www.termedia.pl/gastroenterologia/Polskie-i-amerykanskie-wytyczne-dotyczace-IBS-Proste-rozpoznanie-jakie-leczenie-,44088.html (accessed: 2024.08.08)
Ford AC, Moayyedi P, Chey WD, et al; ACG Task Force on Management of Irritable Bowel Syndrome. American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome. Am J Gastroenterol. 2018; 113(Suppl 2): 1-18. https://doi.org/10.1038/s41395-018-0084-x.
National Institute for Health and Care Excellence. Irritable bowel syndrome in adults: diagnosis and management. NICE. https://www.nice.org.uk/guidance/cg61 (accessed: 2024.08.05)
Wnęk D. Dieta o małej zawartości FODMAP (dieta zalecana w zespole jelita drażliwego). Medycyna Praktyczna. https://www.mp.pl/pacjent/dieta/diety/diety_w_chorobach/111607 (accessed: 2024.08.10).
Black CJ, Staudacher HM, Ford AC. Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis. Gut. 2022; 71(6): 1117-1126. https://doi.org/10.1136/gutjnl-2021-325214.
Radziszewska M, Smarkusz-Zarzecka J, Ostrowska L. Nutrition, Physical Activity and Supplementation in Irritable Bowel Syndrome. Nutrients. 2023; 15(16): 3662. https://doi.org/10.3390/nu15163662.
Shahabi L, Naliboff BD, Shapiro D. Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study. Psychol Health Med. 2016; 21(2): 176-88. https://doi.org/10.1080/13548506.2015.1051557.
Gao X, Tian S, Huang N, et al. Associations of daily sedentary behavior, physical activity, and sleep with irritable bowel syndrome: A prospective analysis of 362,193 participants. J Sport Health Sci. 2024; 13(1): 72-80. https://doi.org/10.1016/j.jshs.2023.02.002.
Ribichini E, Scalese G, Cesarini A, et al. Exercise-Induced Gastrointestinal Symptoms in Endurance Sports: A Review of Pathophysiology, Symptoms, and Nutritional Management. Dietetics. 2023; 2(3): 289-307. https://doi.org/10.3390/dietetics2030021
Kinsinger SW. Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights. Psychol Res Behav Manag. 2017; 10: 231-237. https://doi.org/10.2147/PRBM.S120817.
Shafiei F, Dehghani M, Lavasani FF, et al. Intensive short-term dynamic psychotherapy for irritable bowel syndrome: a randomized controlled trial examining improvements in emotion regulation, defense mechanisms, quality of life, and IBS symptoms. Front Psychol. 2024; 15: 1293150. https://doi.org/10.3389/fpsyg.2024.1293150.
Nobaek S, Johansson ML, Molin G, et al. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol. 2000; 95(5): 1231-8. https://doi.org/10.1111/j.1572-0241.2000.02015.x.
Sun YY, Li M, Li YY, et al. The effect of Clostridium butyricum on symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. Sci Rep. 2018; 8(1): 2964. https://doi.org/10.1038/s41598-018-21241-z.
Satish Kumar L, Pugalenthi LS, Ahmad M, et al. Probiotics in Irritable Bowel Syndrome: A Review of Their Therapeutic Role. Cureus. 2022; 14(4): e24240. https://doi.org/10.7759/cureus.24240.
Ford AC, Harris LA, Lacy BE, et al. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Aliment Pharmacol Ther. 2018; 48(10): 1044-1060. https://doi.org/10.1111/apt.15001.
Wilson B, Whelan K. Prebiotic inulin-type fructans and galacto-oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders. J Gastroenterol Hepatol. 2017; 32 Suppl 1: 64-68. https://doi.org/10.1111/jgh.13700.
Wilson B, Rossi M, Dimidi E, et al. Prebiotics in irritable bowel syndrome and other functional bowel disorders in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2019; 109(4): 1098-1111. https://doi.org/10.1093/ajcn/nqy376.
Mari A, Abu Baker F, Mahamid M, et al. The Evolving Role of Gut Microbiota in the Management of Irritable Bowel Syndrome: An Overview of the Current Knowledge. J Clin Med. 2020; 9(3): 685. https://doi.org/10.3390/jcm9030685.
Black CJ, Burr NE, Camilleri M, et al. Efficacy of pharmacological therapies in patients with IBS with diarrhoea or mixed stool pattern: systematic review and network meta-analysis. Gut. 2020; 69(1): 74-82. https://doi.org/10.1136/gutjnl-2018-318160.
Lembo AJ, Lacy BE, Zuckerman MJ, et al. Eluxadoline for Irritable Bowel Syndrome with Diarrhea. N Engl J Med. 2016; 374(3): 242-53. https://doi.org/10.1056/NEJMoa1505180.
Wong BS, Camilleri M, Carlson Pet al. Increased bile acid biosynthesis is associated with irritable bowel syndrome with diarrhea. Clin Gastroenterol Hepatol. 2012; 10(9): 1009-15. https://doi.org/10.1016/j.cgh.2012.05.006.
Merecz K, Hirsa M, Biniszewska O, et al. An overview of 5-HT3 receptor antagonists as a treatment option for irritable bowel syndrome with diarrhea. Expert Opin Pharmacother. 2023; 24(10): 1189-1198. https://doi.org/10.1080/14656566.2023.2214314.
Vasant DH, Paine PA, Black CJ, et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut. 2021; 70(7): 1214-1240. https://doi.org/10.1136/gutjnl-2021-324598.
Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: management of Irritable Bowel Syndrome. Am J Gastroenterol. 2021; 116(1): 17-44. https://doi.org/10.14309/ajg.0000000000001036.
Black CJ, Burr NE, Quigley EMM, et al. Efficacy of Secretagogues in Patients With Irritable Bowel Syndrome With Constipation: Systematic Review and Network Meta-analysis. Gastroenterology. 2018; 155(6): 1753-1763. https://doi.org/10.1053/j.gastro.2018.08.021.
Costa VA, Ovalle Hernández AF. Rol de los antiespasmódicos en el manejo del síndrome de intestino irritable. Revista Colombiana de Gastroenterología. 2019; 34(3): 269-276. https://doi.org/10.22516/25007440.309.
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Copyright (c) 2024 Dominika Opala, Izabela Staszczyk, Dominika Szczotka, Dobromiła Osuch, Aleksandra Drabik, Antonina Szemplińska, Klaudia Błachnio, Agnieszka Anderska
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