Current opinion in gastroenterology
-
Irritable bowel syndrome refers to abdominal discomfort associated with altered bowel habits. Recent evidence suggests that the primary pathophysiologic mechanism is brain-gut dysregulation. Many central and peripheral factors are involved. This article will review important pathophysiologic mechanisms with a focus on new and emerging therapies. ⋯ A better understanding of pathophysiologic mechanisms has resulted in therapeutic advances. Prokinetic therapies may have a role in nondiarrhea predominant irritable bowel syndrome. Antidepressants are used to modulate pain and treat comorbid psychological distress. Newer agents target various receptor sites. Advances in psychological/behavioral treatments and alternative modalities hold promise for the future.