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Irritable bowel syndrome: the evolution of multi-dimensional looking and multidisciplinary treatments.
World J Gastroenterol. 2014 Mar 14; 20(10):2499-514.WJ

Abstract

Irritable bowel syndrome (IBS) is common in the society. Among the putative pathogeneses, gut dysmotility results in pain and disturbed defecation. The latter is probably caused by the effect of abnormal gut water secretion. The interaction between abnormal gas accumulation, abdominal pain and bloating remains controversial. Visceral hypersensitivity and its modification along with the central transmission are the characteristics of IBS patients. The identification of biologic markers based on genetic polymorphisms is undetermined. Imbalanced gut microbiota may alter epithelial permeability to activate nociceptive sensory pathways which in turn lead to IBS. Certain food constituents may exacerbate bowel symptoms. The impact of adult and childhood abuses on IBS is underestimated. Using the concept of biopsychosocial dysfunction can integrate multidimensional pathogeneses. Antispasmodics plus stool consistency modifiers to treat the major symptoms and defecation are the first-line drug treatment. New drugs targeting receptors governing bowel motility, sensation and secretion can be considered, but clinicians must be aware of their potential serious side effects. Psychiatric drugs and modalities may be the final options for treating intractable subjects. Probiotics of multi-species preparations are safe and worth to be considered for the treatment. Antibiotics are promising but their long-term safety and effectiveness are unknown. Diet therapy including exclusion of certain food constituents is an economic measure. Using relatively safe complementary and alternative medicines (CAMs) may be optional to those patients who failed classical treatment. In conclusion, IBS is a heterogeneous disorder with multidimensional pathogeneses. Personalized medicines with multidisciplinary approaches using different classes of drugs, psychiatric measures, probiotics and antibiotics, dietary therapy, and finally CAMs, can be considered.

Authors+Show Affiliations

Full-Young Chang, Environmental Health and Safety Office and Division of Gastroenterology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei 11217, Taiwan.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24627587

Citation

Chang, Full-Young. "Irritable Bowel Syndrome: the Evolution of Multi-dimensional Looking and Multidisciplinary Treatments." World Journal of Gastroenterology, vol. 20, no. 10, 2014, pp. 2499-514.
Chang FY. Irritable bowel syndrome: the evolution of multi-dimensional looking and multidisciplinary treatments. World J Gastroenterol. 2014;20(10):2499-514.
Chang, F. Y. (2014). Irritable bowel syndrome: the evolution of multi-dimensional looking and multidisciplinary treatments. World Journal of Gastroenterology, 20(10), 2499-514. https://doi.org/10.3748/wjg.v20.i10.2499
Chang FY. Irritable Bowel Syndrome: the Evolution of Multi-dimensional Looking and Multidisciplinary Treatments. World J Gastroenterol. 2014 Mar 14;20(10):2499-514. PubMed PMID: 24627587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Irritable bowel syndrome: the evolution of multi-dimensional looking and multidisciplinary treatments. A1 - Chang,Full-Young, PY - 2013/09/12/received PY - 2013/10/16/revised PY - 2014/01/02/accepted PY - 2014/3/15/entrez PY - 2014/3/15/pubmed PY - 2015/4/7/medline KW - Antispasmodics KW - Biopsychosocial dysfunction KW - Comorbidity KW - Genetics KW - Irritable bowel syndrome KW - Microbiota KW - Probiotics KW - Visceral hyperalgesia SP - 2499 EP - 514 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 20 IS - 10 N2 - Irritable bowel syndrome (IBS) is common in the society. Among the putative pathogeneses, gut dysmotility results in pain and disturbed defecation. The latter is probably caused by the effect of abnormal gut water secretion. The interaction between abnormal gas accumulation, abdominal pain and bloating remains controversial. Visceral hypersensitivity and its modification along with the central transmission are the characteristics of IBS patients. The identification of biologic markers based on genetic polymorphisms is undetermined. Imbalanced gut microbiota may alter epithelial permeability to activate nociceptive sensory pathways which in turn lead to IBS. Certain food constituents may exacerbate bowel symptoms. The impact of adult and childhood abuses on IBS is underestimated. Using the concept of biopsychosocial dysfunction can integrate multidimensional pathogeneses. Antispasmodics plus stool consistency modifiers to treat the major symptoms and defecation are the first-line drug treatment. New drugs targeting receptors governing bowel motility, sensation and secretion can be considered, but clinicians must be aware of their potential serious side effects. Psychiatric drugs and modalities may be the final options for treating intractable subjects. Probiotics of multi-species preparations are safe and worth to be considered for the treatment. Antibiotics are promising but their long-term safety and effectiveness are unknown. Diet therapy including exclusion of certain food constituents is an economic measure. Using relatively safe complementary and alternative medicines (CAMs) may be optional to those patients who failed classical treatment. In conclusion, IBS is a heterogeneous disorder with multidimensional pathogeneses. Personalized medicines with multidisciplinary approaches using different classes of drugs, psychiatric measures, probiotics and antibiotics, dietary therapy, and finally CAMs, can be considered. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/24627587/Irritable_bowel_syndrome:_the_evolution_of_multi_dimensional_looking_and_multidisciplinary_treatments_ L2 - https://www.wjgnet.com/1007-9327/full/v20/i10/2499.htm DB - PRIME DP - Unbound Medicine ER -