Irritable bowel syndrome: expert guidance on diagnosis and management of challenging cases

Authors

  • Sujit Chaudhuri Manipal Hospital, Broadway, Salt Lake, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20242976

Keywords:

IBS, IBD, Rome criteria, Biomarkers for IBS, Antispasmodics in IBS, New therapies for IBS

Abstract

Irritable bowel syndrome (IBS) is a common functional gastrointestinal condition that affects a large proportion of the world's population. The diagnostic complications caused by the lack of unambiguous biomarkers, symptom overlap with other gastrointestinal illnesses, and heterogeneity within IBS subtypes are discussed. The article delves into the diverse pathophysiology of IBS and associated conditions such as small intestinal bacterial overgrowth (SIBO), mental disorders, and inflammatory bowel disease (IBD), highlighting the importance of the gut-brain axis and microbiome dysbiosis. Pain management options for IBS are discussed, including biofeedback therapy, dietary changes, antispasmodic medicines, and new therapies. Experts from India provided their recommendations on the need for a multidisciplinary approach towards management of IBS, with a view to achieving improvement in quality of life for individuals grappling with this complex disorder.

References

Pittayanon R, Lau JT, Yuan Y, Leontiadis GI, Tse F, Surette M, et al. Gut microbiota in patients with irritable bowel syndrome-A systematic review. Gastroenterology 2019;157(1):97-108.

Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol 2014;20(22):6759-73.

Nagaonkar SN, Singh VS, Kangule DT, Sadhanala S. A study of prevalence and determinants of irritable bowel syndrome in an urban slum community in Mumbai. J Datta Meghe Inst Med Sci Univ 2018;13:87-90.

Occhipinti K, Smith JW. Irritable bowel syndrome: a review and update. Clin Colon Rectal Surg 2012;25(1):46-52.

Black CJ, Craig O, Gracie DJ, Ford AC. Comparison of the Rome IV criteria with the Rome III criteria for the diagnosis of irritable bowel syndrome in secondary care. Gut. 2021;70(6):1110-6.

Ghoshal UC, Abraham P, Bhatia SJ, Misra SP, Choudhuri G, Biswas KD, et al. Comparison of Manning, Rome I, II, and III, and Asian diagnostic criteria: report of the Multicentric Indian Irritable Bowel Syndrome (MIIBS) study. Indian J Gastroenterol. 2013;32(6):369-75.

Delvaux M. Role of visceral sensitivity in the pathophysiology of irritable bowel syndrome. Gut. 2002;51(1):i67-71.

Marynowski M, Likońska A, Zatorski H, Fichna J. Role of environmental pollution in irritable bowel syndrome. World J Gastroenterol. 2015;21(40):11371-8.

Menees S, Chey W. The gut microbiome and irritable bowel syndrome. F1000Res. 2018;7:F1000.

Clemente JC, Ursell LK, Parfrey LW, Knight R. The impact of the gut microbiota on human health: an integrative view. Cell. 2012;148(6):1258-70.

Takakura W, Pimentel M. Small intestinal bacterial overgrowth and irritable bowel syndrome - An update. Front Psychiatry. 2020;11:664.

Ghoshal UC, Kumar S, Mehrotra M, Lakshmi C, Misra A. Frequency of small intestinal bacterial overgrowth in patients with irritable bowel syndrome and chronic non-specific diarrhea. J Neurogastroenterol Motil. 2010;16(1):40-6.

Fadgyas-Stanculete M, Buga AM, Popa-Wagner A, Dumitrascu DL. The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations. J Mol Psychiatry. 2014;2(1):4.

Mayer EA, Craske MG, Naliboff BD. Depression, anxiety and the gastrointestinal system. J Clin Psychiatr. 2001;62(8):28-36.

Ng QX, Soh AYS, Loke W, Venkatanarayanan N, Lim DY, Yeo WS. Systematic review with meta-analysis: The association between post-traumatic stress disorder and irritable bowel syndrome. J Gastroenterol Hepatol. 2019;34(1):68-73.

Quigley EM. Overlapping irritable bowel syndrome and inflammatory bowel disease: less to this than meets the eye? Therap Adv Gastroenterol. 2016;9(2):199-212.

Deiteren A, De Wit A, Van der Linden L, De Man JG, Pelckmans PA, De Winter BY. Irritable bowel syndrome and visceral hypersensitivity: Risk factors and pathophysiological mechanisms. Acta Gastroenterol Belg. 2016;79(1):29-38.

Lacy BE, Pimentel M, Brenner DM, Chey WD, Keefer LA, Long MD, et al. ACG clinical guideline: Management of irritable bowel syndrome. Am J Gastroenterol. 2021;116(1):17-44.

Camilleri M. Management options for irritable bowel syndrome. Mayo Clin Proc. 2018;93(12):1858-72.

Annaházi A, Róka R, Rosztóczy A, Wittmann T. Role of antispasmodics in the treatment of irritable bowel syndrome. World J Gastroenterol. 2014;20(20):6031-43.

Daniluk J, Malecka-Wojciesko E, Skrzydlo-Radomanska B, Rydzewska G. The efficacy of mebeverine in the treatment of irritable bowel syndrome-A systematic review. J Clin Med. 2022;11(4):1044.

Bor S, Lehert P, Chalbaud A, Tack J. Efficacy of pinaverium bromide in the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Therap Adv Gastroenterol 2021;14:17562848211033740.

Kingsley M, Moshiree B. Irritable bowel syndrome in Rao S, Lee Y and Ghoshal U, editors. Clinical and Basic Neurogastroenterology and Motility. UK: Academic press. 2020;421-34.

Kurin M, Cooper G. Irritable bowel syndrome with diarrhea: Treatment is a work in progress. Cleve Clin J Med. 2020;87(8):501-11.

Weaver KR, Melkus GD, Henderson WA. Irritable bowel syndrome. Am J Nurs. 2017;117(6):48-55.

Bharucha AE, Wouters MM, Tack J. Existing and emerging therapies for managing constipation and diarrhea. Curr Opin Pharmacol. 2017;37:158-66.

Khanna R, MacDonald JK, Levesque BG. Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. J Clin Gastroenterol. 2014;48(6):505-12.

Jadallah KA, Kullab SM, Sanders DS. Constipation-predominant irritable bowel syndrome: a review of current and emerging drug therapies. World J Gastroenterol. 2014;20(27):8898-909.

Nam Y, Min YS, Sohn UD. Recent advances in pharmacological research on the management of irritable bowel syndrome. Arch Pharm Res. 2018;41(40):955-66.

Corsetti M, Pannemans J, Whorwell P. Targeting mu opioid receptors to modulate gastrointestinal function: what have we learnt so far from the studies in functional bowel disorders? F1000Res. 2019;8:F1000.

Sharma A, Herekar AA, Bhagatwala J, Rao SS. Profile of plecanatide in the treatment of chronic idiopathic constipation: design, development, and place in therapy. Clin Exp Gastroenterol. 2019;12:31-6.

Downloads

Published

2024-09-30

How to Cite

Chaudhuri, S. (2024). Irritable bowel syndrome: expert guidance on diagnosis and management of challenging cases. International Journal of Research in Medical Sciences, 12(10), 3989–3996. https://doi.org/10.18203/2320-6012.ijrms20242976

Issue

Section

Review Articles