Materiały źródłowe

• #1 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4051916/

  Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9%-23% of the population across the world. […] The pathophysiology of IBS is not clear. Many theories have been put forward, but the exact cause of IBS is still uncertain. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS. Altered gastrointestinal motility, visceral hypersensitivity, post infectious reactivity, brain-gut interactions, alteration in fecal micro flora, bacterial overgrowth, food sensitivity, carbohydrate malabsorption, and intestinal inflammation all have been implicated in the pathogenesis of IBS. […] The underlying causes of IBS remain to be adequately identified, but IBS-PI is a clear-cut entity.

• #2 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9%-23% of the population across the world. […] The pathophysiology of IBS is not clear. Many theories have been put forward, but the exact cause of IBS is still uncertain. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS. Altered gastrointestinal motility, visceral hypersensitivity, post infectious reactivity, brain-gut interactions, alteration in fecal micro flora, bacterial overgrowth, food sensitivity, carbohydrate malabsorption, and intestinal inflammation all have been implicated in the pathogenesis of IBS. […] The underlying causes of IBS remain to be adequately identified, but IBS-PI is a clear-cut entity.

• #3 Irritable Bowel Syndrome (IBS): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/180389-overview

  Irritable bowel syndrome (IBS) is a disorder of gut-brain interactions (DGBI). DGBIs are a group of gastrointestinal (GI) disorders that occur from alteration of the interconnected gut-brain pathways. This can result in many different symptoms, such as pain, bloating, cramping, nausea, feelings of satiety, and others. […] Traditional theories regarding the pathophysiology of irritable bowel syndrome (IBS) visualized IBS as a three-part complex of altered gastrointestinal (GI) motility, visceral hyperalgesia, and psychopathology. […] More recently, it is understood that IBS is a disorder of gut-brain interaction (DGBI) and, as such, theories inch closer to a unifying mechanism, though with multiple underlying etiologies. […] These may include altered GI motility, intestinal dysbiosis, visceral hypersensitivity, food triggers, mucosal inflammation and postinfectious reactivity, altered influence of gravity, and others.

• #4 Current insights in to the pathophysiology of Irritable Bowel Syndrome | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-2-3

  Irritable Bowel Syndrome (IBS) represents a functional disorder of gastrointestinal tract without the presence of an anatomic defect, in which abdominal pain is relieved with defecation and is associated with altered bowel habits. […] Recent studies indicate that the most important mechanisms include visceral sensitivity, abnormal gut motility and autonomous nervous system dysfunction. […] The etiology of IBS is most likely multifactorial. Several environmental factors, psychosocial stressors, gut flora alterations contribute to the pathophysiology of IBS, along with abnormal gastrointestinal motility and secretion and altered visceral perception. […] Today IBS is viewed upon as a disorder of dysregulation of the brain-gut axis, involving abnormal function in the enteric, autonomic and/or central nervous systems.

• #5 Irritable Bowel Syndrome (IBS): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/180389-overview

  The interconnectedness of the gut and brain are the key to understanding IBS. […] Altered motility is often seen in IBS. Yet, no single motility change encompasses all patients with IBS. […] Visceral hyperalgesia is common in IBS. […] Enhanced perception of normal motility and visceral pain characterizes IBS. […] Food has been shown to trigger DGBIs including IBS. […] The gut-brain axis includes the gut’s nervous system (the enteric nervous system [ENS], the central nervous system [CNS], the gut wall, and the hypothalamic-pituitary-adrenal axis [HPA] axis). […] Neuron sensitization and neuroimmune activation cause multiple up- and downstream effects, including triggering of pain receptors that lead to visceral hypersensitivity. […] The hypothalamic-pituitary axis appears involved in the pathogenesis of IBS.

• #6 Recent advances in the treatment of irritable bowel syndrome – Polish Archives of Internal Medicine

  https://www.mp.pl/paim/issue/article/16067

  Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder which presents with abdominal pain and altered bowel habits. […] Although the precise pathogenesis of IBS remains unclear, its multifactorial nature is evident and includes environmental and host factors. […] The pathogenesis of IBS is related to both host factors and environmental agents. Nevertheless, the precise mechanisms remain unclear. […] Irritable bowel syndrome is traditionally considered part of the so-called brain-gut disorders, along with other functional gastrointestinal diseases. […] Connections between the central nervous system and myenteric plexus constitute the brain-gut axis: through this pathway, emotions can influence intestinal motility, mucosal secretion, and barrier function and, vice versa, mental function can be influenced by gastrointestinal stimuli.

• #7 Current insights in to the pathophysiology of Irritable Bowel Syndrome | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-2-3

  The latest data indicate that the main mechanism inducing abdominal pain is the visceral hypersensitivity. […] It is known that visceral sensitivity is regulated in many levels. […] The presence of an injury in enteric mucosa leads to the release of chemical mediators like K+, ATP and bradykinin but also inflammatory mediators like prostaglandin E2 (PGE2). […] Some of the inflammatory mediators, which are released in enteric mucosa and submucosa seem to play a more specific role. […] It is known that bradykinin’s signaling influences visceral sensitivity in many ways. […] The enteric nervous system (ENS), which is located in submucosa (Meisner plexus) and between smooth muscle fibers (Auerbach plexus) regulates the neuromuscular function of gastrointestinal (GI) tract. […] New studies support that gut motility and defecation are regulated by psychical, somatic and immune stress.

• #8 Irritable Bowel Syndrome (IBS) – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs

  Irritable bowel syndrome (IBS) is characterized by recurrent abdominal discomfort or pain with at least two of the following characteristics: relation to defecation, association with a change in frequency of stool, or association with a change in consistency of stool. The cause is not known, and the pathophysiology is incompletely understood. […] Irritable bowel syndrome (IBS previously called functional gastrointestinal [GI] disorders) is a disorder of gut-brain interaction. No anatomic cause can be found on laboratory tests, imaging studies, and biopsies. […] A variety of physiologic factors seem to be involved in IBS symptoms. These factors include increased intestinal sensitivity (visceral hyperalgesia) and altered intestinal motility. […] Visceral hyperalgesia refers to hypersensitivity to normal amounts of intraluminal distention and heightened perception of pain in the presence of normal quantities of intestinal gas; it may result from remodeling of neural pathways in the gut-brain axis.

• #9 Irritable Bowel Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534810/

  The following pathophysiological mechanisms have been associated with IBS: Altered gastrointestinal motility includes aberrations in intestinal motility. The myoelectric activity of the gut consists of background slow waves and superimposed spike potentials. Intestinal dysmotility in IBS manifests as alterations in the slow-wave frequency and a late-peaking, blunted, postprandial response of spike potentials. […] Visceral hyperalgesia is the second key phenomenon characterizing IBS. This is characterized by visceral pain and a heightened perception of normal motility. A potential unifying mechanism is the sensitization of the afferent nociceptive pathways in the gut, which synapse in the dorsal column of the spinal cord. […] Psychopathology is the third aspect of the traditional 3-part complex of IBS. The exact relationship between psychiatric disturbances and IBS is not fully understood; however, patients with IBS have a higher incidence of major depression, panic disorder, anxiety disorders, and hypochondriasis. […] Additionally, environmental contributors to IBS include early life stressors, food intolerance, antibiotics, and enteric infections. Many patients often report that IBS symptoms are related to food intake; however, true food allergens have a limited role in IBS.

• #10 Irritable bowel syndrome | Nature Reviews Disease Primers

  https://www.nature.com/articles/nrdp201614

  Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with a high population prevalence. […] Although the underlying pathogenesis is far from understood, aetiological factors include increased epithelial hyperpermeability, dysbiosis, inflammation, visceral hypersensitivity, epigenetics and genetics, and altered braingut interactions. […] IBS considerably affects quality of life and imposes a profound burden on patients, physicians and the health-care system. […] This narrative review summarizes the current knowledge on brain networks in relation to genomic-, gastrointestinal-, immune- and gut microbiota-related parameters and develops a novel model to understand their importance in IBS. […] This meta-analysis summarizes data from 48 RCTs, which tested psychological interventions in patients with IBS, and reports that, overall, improvement in gastrointestinal symptoms was strongly associated with improvement in psychological distress.

• #11 Irritable Bowel Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534810/

  The following pathophysiological mechanisms have been associated with IBS: Altered gastrointestinal motility includes aberrations in intestinal motility. The myoelectric activity of the gut consists of background slow waves and superimposed spike potentials. Intestinal dysmotility in IBS manifests as alterations in the slow-wave frequency and a late-peaking, blunted, postprandial response of spike potentials. […] Visceral hyperalgesia is the second key phenomenon characterizing IBS. This is characterized by visceral pain and a heightened perception of normal motility. A potential unifying mechanism is the sensitization of the afferent nociceptive pathways in the gut, which synapse in the dorsal column of the spinal cord. […] Psychopathology is the third aspect of the traditional 3-part complex of IBS. The exact relationship between psychiatric disturbances and IBS is not fully understood; however, patients with IBS have a higher incidence of major depression, panic disorder, anxiety disorders, and hypochondriasis. […] Additionally, environmental contributors to IBS include early life stressors, food intolerance, antibiotics, and enteric infections. Many patients often report that IBS symptoms are related to food intake; however, true food allergens have a limited role in IBS.

• #12 Irritable Bowel Syndrome (IBS): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/180389-overview

  The interconnectedness of the gut and brain are the key to understanding IBS. […] Altered motility is often seen in IBS. Yet, no single motility change encompasses all patients with IBS. […] Visceral hyperalgesia is common in IBS. […] Enhanced perception of normal motility and visceral pain characterizes IBS. […] Food has been shown to trigger DGBIs including IBS. […] The gut-brain axis includes the gut’s nervous system (the enteric nervous system [ENS], the central nervous system [CNS], the gut wall, and the hypothalamic-pituitary-adrenal axis [HPA] axis). […] Neuron sensitization and neuroimmune activation cause multiple up- and downstream effects, including triggering of pain receptors that lead to visceral hypersensitivity. […] The hypothalamic-pituitary axis appears involved in the pathogenesis of IBS.

• #13 Irritable Bowel Syndrome (IBS) – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs

  Some patients (perhaps 1 in 7) have reported their IBS symptoms began after an episode of acute gastroenteritis (termed postinfectious IBS). However, many patients have no demonstrable physiologic abnormalities, and, even in those who do, the abnormalities may not correlate with symptoms. […] Constipation may be explained by slower colonic transit, and diarrhea may be explained by faster colonic transit. […] Postprandial abdominal discomfort may be attributed to an exaggerated gastro-colonic reflex (the colonic contractile response to a meal), the presence of colonic high amplitude-propagated contractions, visceral hyperalgesia, or a combination of these factors. […] Hormonal fluctuations affect bowel functions in women. […] Psychological distress is common among patients with IBS, especially in those who seek medical care.

• #14 Irritable Bowel Syndrome, Gut Microbiota and Probiotics

  https://www.jnmjournal.org/journal/view.html?uid=2&vmd=Full

  Recently, additional potential mechanisms of IBS have emerged including alteration of gut microbiota and low-grade inflammation/immune activation. These factors might lead to abnormal motility and visceral hypersensitivity and contribute to the symptoms. […] Gut microbiota is thought to play important roles in the pathogenesis of IBS. This is evident from the fact that IBS occurs more frequently after intestinal infection or antibiotics treatment. Studies have shown that the alterations of the intestinal microbiota are observed in IBS patients. […] Considering the relationship between alteration of gut microbiota and inflammation of gut, manipulation of gut microbiota by probiotics appears to be an ideal treatment modality for IBS. However, the beneficial effects and efficacy of altering gut microbiota by probiotics to improve the symptoms of IBS have not been consistent in clinical trials and therefore it remains uncertain as an effective treatment.

• #15 Molecular Mechanisms of Microbiota-Mediated Pathology in Irritable Bowel Syndrome

  https://www.mdpi.com/1422-0067/21/22/8664

  Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders, and accumulating evidence gained in both preclinical and clinical studies indicate the involvement of enteric microbiota in its pathogenesis. […] Based on these results, the term “brain–gut–microbiome axis” has been proposed and enteric microbiota have become a potential therapeutic target in IBS cases. However, details regarding the microbe-related pathophysiology of IBS remain elusive. This review summarizes the existing knowledge of molecular mechanisms in the pathogenesis of IBS as well as recent progress related to microbiome-derived neurotransmitters, compounds, metabolites, neuroendocrine factors, and enzymes. […] Dysbiosis is often observed in a variety of intestinal disorders including IBS.

• #16

  https://www.clinmedjournals.org/articles/jnmdc/journal-of-nutritional-medicine-and-diet-care-jnmdc-7-050.php?jid=jnmdc

  The pathogenesis of IBS is multifactorial and heterogeneous among patients with alterations in motility, visceral sensation, the microbiome, brain-gut interaction via the central and enteric nervous systems, mucosal immune function, bile acid metabolism and intestinal permeability. […] The microbiome of IBS patients has a different luminal bacterial composition with fewer Bifidobacteria, and Faecalibacterium prausnitzii sp and more Lactobacillaceae, Bacteroides, Enterobacteriaceae. […] These alterations in the microbiome have effects of increased visceral hypersensitivity with colonic distension in animal models. […] IBS patients have alterations in immune activation by increased toll-like receptor expression and production of pro-inflammatory cytokines. […] Degradation of tight junction proteins and increased intraepithelial permeability has been observed. […] This dysbiosis has effects on gut function and is an important player in the pathogenesis of IBS.

• #17 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  There is increasing evidence regarding the role of immune activation in the etiology of IBS, which has mainly been shown in studies investigating mechanisms of IBS-PI. […] The mechanisms that cause IBS-PI are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. […] Serotonin (5-HT), acting particularly through the 5-HT3 and 5-HT4 receptors, plays a significant role in the control of gastrointestinal motility, sensation, and secretion. […] Studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in IBS, it remains unclear whether SIBO causes IBS. […] Psychosocial factors appear to be important in IBS, although whether these factors directly alter gastrointestinal function remains uncertain. […] Studies have suggested that there is a genetic contribution to IBS, although the importance of this remains in dispute. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS.

• #18 Irritable Bowel Syndrome, Gut Microbiota and Probiotics

  https://www.jnmjournal.org/journal/view.html?uid=2&vmd=Full

  However, the prevalence of SIBO in IBS is not consistent between clinical studies varying from 4% to 84%. […] Studies using antibiotics to target the intestinal microbiota to treat IBS have been performed. […] Taken together, association of the alteration of gut microbiota, inflammation-immune reaction and IBS have been demonstrated from many experimental and clinical studies. Manipulation of the intestinal microbiota by probiotics looks like promising treatment modality. However, further studies are needed to identify how the microbiota and probiotics interact with the host from gut microbiota to systemic gut sensory-motor dysfunctions.

• #19 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  There is increasing evidence regarding the role of immune activation in the etiology of IBS, which has mainly been shown in studies investigating mechanisms of IBS-PI. […] The mechanisms that cause IBS-PI are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. […] Serotonin (5-HT), acting particularly through the 5-HT3 and 5-HT4 receptors, plays a significant role in the control of gastrointestinal motility, sensation, and secretion. […] Studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in IBS, it remains unclear whether SIBO causes IBS. […] Psychosocial factors appear to be important in IBS, although whether these factors directly alter gastrointestinal function remains uncertain. […] Studies have suggested that there is a genetic contribution to IBS, although the importance of this remains in dispute. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS.

• #20 Irritable bowel syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Irritable_bowel_syndrome

  Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by a group of symptoms that commonly include abdominal pain, abdominal bloating, and changes in the consistency of bowel movements. […] The cause of IBS is not known but multiple factors have been proposed to lead to the condition. Theories include combinations of „gut-brain axis” problems, alterations in gut motility, visceral hypersensitivity, infections including small intestinal bacterial overgrowth, neurotransmitters, genetic factors, and food sensitivity. […] Dysregulated brain-gut axis, abnormal serotonin/5-hydroxytryptamine (5-HT) metabolism, and high density of mucosal nerve fibers in the intestines have been implicated in the mechanisms of IBS. […] Chronic low-grade inflammation commonly occurs in IBS affected individuals with abnormalities found including increased enterochromaffin cells, intraepithelial lymphocytes, and mast cells resulting in chronic immune-mediated inflammation of the gut mucosa. […] It is believed that psychological stress can induce increased inflammation and thereby cause IBS to develop in predisposed individuals.

• #21

  https://www.clinmedjournals.org/articles/jnmdc/journal-of-nutritional-medicine-and-diet-care-jnmdc-7-050.php?jid=jnmdc

  The pathogenesis of IBS is multifactorial and heterogeneous among patients with alterations in motility, visceral sensation, the microbiome, brain-gut interaction via the central and enteric nervous systems, mucosal immune function, bile acid metabolism and intestinal permeability. […] The microbiome of IBS patients has a different luminal bacterial composition with fewer Bifidobacteria, and Faecalibacterium prausnitzii sp and more Lactobacillaceae, Bacteroides, Enterobacteriaceae. […] These alterations in the microbiome have effects of increased visceral hypersensitivity with colonic distension in animal models. […] IBS patients have alterations in immune activation by increased toll-like receptor expression and production of pro-inflammatory cytokines. […] Degradation of tight junction proteins and increased intraepithelial permeability has been observed. […] This dysbiosis has effects on gut function and is an important player in the pathogenesis of IBS.

• #22 Chemotactic Chemokines Are Important in the Pathogenesis of Irritable Bowel Syndrome | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093144

  Irritable bowel syndrome (IBS) is one of the most frequently diagnosed disorders, affecting about 20% of the general population in Western countries. This syndrome poses an enormous socio-economic burden, impairs the quality of life substantially, and increases healthcare costs. IBS can be classified as either idiopathic (ID-IBS) with unknown etiology or post-infectious (PI-IBS), which develops after a bout of acute diarrhea or gastroenteritis. Little is known about the immunopathogenesis of these two forms of IBS. […] We report for the first time that the concentrations of chemotactic chemokines MCP-1 (CCL2), MIP-1 (CCL4), and CXCL16 are significantly higher in the sera and stools of IBS patients compared to healthy volunteers. […] We demonstrate for the first time that the levels of monocytes chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 (MIP-1), CXCL16 are elevated in IBS patients. However, the levels of these chemokines were not significantly different between ID-IBS and PI-IBS, suggesting that these two forms of IBS exhibit similar phenotypes despite their different etiological origins.

• #23 Irritable Bowel Syndrome (IBS): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/180389-overview

  The majority of the body’s serotonin is produced in the gut. […] IBS often coexists with depression, anxiety, or other psychiatric disorders. […] A novel hypothesis published in 2022 suggested that „ineffective anatomical, physiological, and neuropsychological gravity management systems” may cause IBS.

• #24 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  There is increasing evidence regarding the role of immune activation in the etiology of IBS, which has mainly been shown in studies investigating mechanisms of IBS-PI. […] The mechanisms that cause IBS-PI are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. […] Serotonin (5-HT), acting particularly through the 5-HT3 and 5-HT4 receptors, plays a significant role in the control of gastrointestinal motility, sensation, and secretion. […] Studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in IBS, it remains unclear whether SIBO causes IBS. […] Psychosocial factors appear to be important in IBS, although whether these factors directly alter gastrointestinal function remains uncertain. […] Studies have suggested that there is a genetic contribution to IBS, although the importance of this remains in dispute. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS.

• #25 Recent advances in the treatment of irritable bowel syndrome – Polish Archives of Internal Medicine

  https://www.mp.pl/paim/issue/article/16067

  It has been reported that patients with IBS have abnormal serotonin and dopamine secretion and both the degree and proportion of these alterations may play a role in determining the clinical pattern of the disease. […] Some patients with IBS, particularly those in the IBS-D subgroup, show an increased intestinal membrane permeability and hypersensitivity to somatic and visceral stimuli, leading to altered perception of pain. […] Another factor involved in the pathogenesis of IBS is intestinal dismotility, which is related to dysregulation of the 5-hydroxytryptamine (HT) pathway. […] This mechanism represents a target for pharmacological treatment with 5-HT4 receptor agonists, which act as prokinetic agents, or 5-HT3 receptor antagonists, which slow intestinal transit. […] With regard to intestinal microbiota, their role in the pathogenesis of IBS is still not well defined, even though they are probably involved in barrier function alteration and mucosal inflammation.

• #26 Pathogenesis of Irritable bowel syndrome (IBS),a common syndrome seen by General Physicians In West Bengal | The BMJ

  https://www.bmj.com/rapid-response/2011/11/02/pathogenesis-irritable-bowel-syndrome-ibsa-common-syndrome-seen-general-ph

  Irritable bowel syndrome (IBS) is one of several functional disorders, in absence of any detectable organic causes and diagnostic criteria of ROME-2 of NICE guide line of the disease. […] Although patho-physiology of IBS remains yet unknown, alteration of GI motility, balance of absorption and secretion in the intestine is the underlying cause of irregularities of bowel habits and these abnormalities is mediated part by dys-regulation of gut mediated serotonin signaling system. […] Inflammatory cells including mast cells, activated T lymphocytes are increased above normal in the mucosa in a subset of patients with IBS, suggestive of low grade IBD particularly Crohns. […] These abnormal releases of 5HT have central role in manifestation of IBS. […] Therefore alteration in 5HT biosynthesis content, release, contributes to disordered GI function. The role of 5HT in pathophysiology of IBS remain yet unclear. […] Probably defects in 5HT signaling- are associated with IBS.

• #27 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  There is increasing evidence regarding the role of immune activation in the etiology of IBS, which has mainly been shown in studies investigating mechanisms of IBS-PI. […] The mechanisms that cause IBS-PI are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. […] Serotonin (5-HT), acting particularly through the 5-HT3 and 5-HT4 receptors, plays a significant role in the control of gastrointestinal motility, sensation, and secretion. […] Studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in IBS, it remains unclear whether SIBO causes IBS. […] Psychosocial factors appear to be important in IBS, although whether these factors directly alter gastrointestinal function remains uncertain. […] Studies have suggested that there is a genetic contribution to IBS, although the importance of this remains in dispute. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS.

• #28 Irritable Bowel Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534810/

  The following pathophysiological mechanisms have been associated with IBS: Altered gastrointestinal motility includes aberrations in intestinal motility. The myoelectric activity of the gut consists of background slow waves and superimposed spike potentials. Intestinal dysmotility in IBS manifests as alterations in the slow-wave frequency and a late-peaking, blunted, postprandial response of spike potentials. […] Visceral hyperalgesia is the second key phenomenon characterizing IBS. This is characterized by visceral pain and a heightened perception of normal motility. A potential unifying mechanism is the sensitization of the afferent nociceptive pathways in the gut, which synapse in the dorsal column of the spinal cord. […] Psychopathology is the third aspect of the traditional 3-part complex of IBS. The exact relationship between psychiatric disturbances and IBS is not fully understood; however, patients with IBS have a higher incidence of major depression, panic disorder, anxiety disorders, and hypochondriasis. […] Additionally, environmental contributors to IBS include early life stressors, food intolerance, antibiotics, and enteric infections. Many patients often report that IBS symptoms are related to food intake; however, true food allergens have a limited role in IBS.

• #29 Irritable Bowel Syndrome | Concise Medical Knowledge

  https://www.lecturio.com/concepts/irritable-bowel-syndrome/

  Post-infectious changes: T cells and enteroendocrine cells, serotonin levels, gastrointestinal motility and sensitivity. […] Psychosocial abnormalities: 50% of IBS patients have underlying depression, anxiety, or somatization disorders. […] Stress may influence abdominal pain and colonic motility in IBS symptoms. […] Other factors that are being investigated include altered fecal flora or small intestinal bacterial overgrowth, food allergies, malabsorption, and genetics. […] The mind-gut interaction contributing to the pathophysiology of IBS: stress, anxiety, and depression influence the CNS, autonomic nervous system (ANS), and enteric nervous system. This may affect the smooth muscles in the intestines, leading to the symptoms of IBS.

• #30 Irritable bowel syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Irritable_bowel_syndrome

  Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by a group of symptoms that commonly include abdominal pain, abdominal bloating, and changes in the consistency of bowel movements. […] The cause of IBS is not known but multiple factors have been proposed to lead to the condition. Theories include combinations of „gut-brain axis” problems, alterations in gut motility, visceral hypersensitivity, infections including small intestinal bacterial overgrowth, neurotransmitters, genetic factors, and food sensitivity. […] Dysregulated brain-gut axis, abnormal serotonin/5-hydroxytryptamine (5-HT) metabolism, and high density of mucosal nerve fibers in the intestines have been implicated in the mechanisms of IBS. […] Chronic low-grade inflammation commonly occurs in IBS affected individuals with abnormalities found including increased enterochromaffin cells, intraepithelial lymphocytes, and mast cells resulting in chronic immune-mediated inflammation of the gut mucosa. […] It is believed that psychological stress can induce increased inflammation and thereby cause IBS to develop in predisposed individuals.

• #31 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  There is increasing evidence regarding the role of immune activation in the etiology of IBS, which has mainly been shown in studies investigating mechanisms of IBS-PI. […] The mechanisms that cause IBS-PI are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. […] Serotonin (5-HT), acting particularly through the 5-HT3 and 5-HT4 receptors, plays a significant role in the control of gastrointestinal motility, sensation, and secretion. […] Studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in IBS, it remains unclear whether SIBO causes IBS. […] Psychosocial factors appear to be important in IBS, although whether these factors directly alter gastrointestinal function remains uncertain. […] Studies have suggested that there is a genetic contribution to IBS, although the importance of this remains in dispute. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS.

• #32 Pathogenesis of Irritable Bowel Syndrome: Is It Really in the Gene?

  https://www.jnmjournal.org/journal/view.html?uid=842&vmd=Full&

  Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder in the community and clinical practice. The pathogenesis of IBS is largely unknown. However, abnormal gut motility, dysbiosis, food intolerance such as lactose intolerance, visceral hypersensitivity, low-grade inflammation and abnormal brain-gut interaction have been incriminated in its pathogenesis. […] High degree of concordance among monozygotic twin and familial aggregation suggested a role of genetic factor in pathogenesis of IBS. […] How do the genetic factors influence occurrence of IBS? IBS is a multi-factorial polygenic disorder. Since gut motility, visceral sensation, degree of inflammation in response to microbes in the gut, food intolerance such as lactose intolerance and brain-gut interaction are all mediated by neuro-peptides, hormones and cytokines and various other proteins, which are transcribed from different genes, alteration in these genes may lead to alteration in these physiological processes.

• #33 Pathogenesis of Irritable Bowel Syndrome: Is It Really in the Gene?

  https://www.jnmjournal.org/journal/view.html?uid=842&vmd=Full&

  Several studies found association between polymorphisms in various genes such as serotonin transporter (SERT or SLC6A4), 2 adrenergic receptor, cytokine and G-protein genes and IBS. […] Genetic variations in 2 adrenergic receptor may influence visceral sensation in patients with IBS. […] Low-grade inflammation has been implicated in the pathophysiology of IBS. […] Cholecystokinin (CCK) is released by endocrine cells within the duodenal and jejunal mucosa in response to products of protein and fat digestion. […] Serotonin or 5-hydroxytryptamine (5-HT) is an important molecule for stimulating GI motility, secretion and enhancing visceral sensation. […] G-protein beta-3 subunit gene (GN3), C825T polymorphism alters intra-cellular signal transduction, which may lead to motor or sensory abnormalities of the GI tract.

• #34 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Mechanism-of-Irritable-Bowel-Syndrome-(IBS).aspx

  Family history tends to be positive in patients with Irritable Bowel Syndrome (IBS). This means there may be individuals suffering from the condition in the family. […] Genes implicated in the pathogenesis of IBS are genes for :- serotonin transporter (HTT-5), adrenergic receptor, interleukin-10 (IL-10), tumor necrosis factor (TNF-). […] Genetic factors, if present, play a minor role and better understanding of IBS and psychological influences are required before definite conclusions are drawn. […] Colonic dysmotility has been held as the major pathogenic mechanism behind IBS. In patients presenting with diarrhoea there is a greater number of high amplitude propagating contractions (HAPC) and decreased colonic transit time and the reverse features are present in patients with constipation.

• #35 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Mechanism-of-Irritable-Bowel-Syndrome-(IBS).aspx

  IBS patients have greater sense of discomfort after experimental gut stimulation which accounts for the heightened responsiveness. […] 6-17% of patients give a history of gastroenteritis preceding onset of IBS. This is accompanied by increase in gut inflammatory cells (T-lymphocytes) that might be responsible for the peripheral sensitization. […] Brain imaging and neurophysiological means has shown that certain areas of the brain in IBS patients involved in pain processing have an altered or exaggerated response to gut stimulation.

• #36 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9%-23% of the population across the world. […] The pathophysiology of IBS is not clear. Many theories have been put forward, but the exact cause of IBS is still uncertain. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS. Altered gastrointestinal motility, visceral hypersensitivity, post infectious reactivity, brain-gut interactions, alteration in fecal micro flora, bacterial overgrowth, food sensitivity, carbohydrate malabsorption, and intestinal inflammation all have been implicated in the pathogenesis of IBS. […] The underlying causes of IBS remain to be adequately identified, but IBS-PI is a clear-cut entity.

• #37 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  There is increasing evidence regarding the role of immune activation in the etiology of IBS, which has mainly been shown in studies investigating mechanisms of IBS-PI. […] The mechanisms that cause IBS-PI are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. […] Serotonin (5-HT), acting particularly through the 5-HT3 and 5-HT4 receptors, plays a significant role in the control of gastrointestinal motility, sensation, and secretion. […] Studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in IBS, it remains unclear whether SIBO causes IBS. […] Psychosocial factors appear to be important in IBS, although whether these factors directly alter gastrointestinal function remains uncertain. […] Studies have suggested that there is a genetic contribution to IBS, although the importance of this remains in dispute. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS.

• #38 The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome

  https://www.mdpi.com/2077-0383/13/17/5124

  The available evidence indicates that there are variations in gut microbiota between healthy individuals and those diagnosed with IBS. […] Food intolerances are estimated to affect around 5% of the general population. […] Immunohistological studies have shown the existence of inflammatory changes in the intestinal mucosa of patients with a DGBI, particularly those with post-infectious IBS and IBS-D. […] A significant proportion of patients with IBS, particularly those with IBS-D, exhibit altered intestinal permeability. […] Research on genetic polymorphisms indicates that an inherited predisposition to IBS may exist. […] The hypothesis that psychosocial factors can influence the sensory–motor function of the gastrointestinal tract appeared at the beginning of the 19th century, and much of the research evidence from that period is still valid.

• #39 Irritable Bowel Syndrome (IBS) – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/irritable-bowel-syndrome-ibs.asp

  An intestine that is too permeable allows macromolecules into the bloodstream, where they are more likely to trigger an immune response than smaller compounds. […] Probiotics may offer benefit in many ways, including healing the gut mucosal barrier, improving intestinal flora, altering ones immune response, decreasing inflammation, and/or altering fermentation in the intestinal tract.

• #40 Immune responses in the irritable bowel syndromes: time to consider the small intestine | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-022-02301-8

  Recent findings of subtle, sub-clinical gastrointestinal inflammatory changes in these patients indicate a role for the immune system in driving symptom onset and chronicity; however, the nature of immune activation and involvement remains unknown. […] The most consistently reported feature of IBS is increased mast cell numbers in both the SI and colon. […] Given the finding of increased mast cells in IBS, a prominent hypothesis for immune activation is the notion of antigens, likely of food and/or microbial origins, stimulating the induction of a Th type 2 response. […] The potential for Th17 responses in the microinflammatory profile of IBS has also been proposed, based on indirect evidence of increased peripheral TNF and IL-6 in patients. […] Increased SI and colonic barrier permeability have been associated with visceral hypersensitivity, independent of disease subtype, suggesting that a loss of barrier integrity may be the first step to priming of the immune system in IBS.

• #41

  https://www.clinmedjournals.org/articles/jnmdc/journal-of-nutritional-medicine-and-diet-care-jnmdc-7-050.php?jid=jnmdc

  The pathogenesis of IBS is multifactorial and heterogeneous among patients with alterations in motility, visceral sensation, the microbiome, brain-gut interaction via the central and enteric nervous systems, mucosal immune function, bile acid metabolism and intestinal permeability. […] The microbiome of IBS patients has a different luminal bacterial composition with fewer Bifidobacteria, and Faecalibacterium prausnitzii sp and more Lactobacillaceae, Bacteroides, Enterobacteriaceae. […] These alterations in the microbiome have effects of increased visceral hypersensitivity with colonic distension in animal models. […] IBS patients have alterations in immune activation by increased toll-like receptor expression and production of pro-inflammatory cytokines. […] Degradation of tight junction proteins and increased intraepithelial permeability has been observed. […] This dysbiosis has effects on gut function and is an important player in the pathogenesis of IBS.

• #42 Irritable Bowel Syndrome (IBS) At a Glance | British Journal of Medical Practitioners

  https://www.bjmp.org/content/irritable-bowel-syndrome-ibs-glance

  Twin studies have shown that IBS is twice as prevalent in monozygotic twins than in dizygotic twins. […] Culture positive gastroenteritis is a very strong risk factor for IBS. […] Pimentel and colleagues have shown that, when measured by the lactose hydrogen breath test (LHBT), small intestinal bacterial overgrowth (SIBO) has been detected in 78% to 84% of patients with IBS. […] Approximately 60% of IBS patients believe and different studies show that allergy to certain foods could trigger IBS symptoms. […] Normal gut physiology is predicated to be an interaction between the GI musculature and the autonomic nervous system (ANS), and central nervous system (CNS) by the neurotransmitter serotonin (5-hydroxytryptamine [5-HT]). Impairment in this interaction affects GI motility, secretion, and visceral sensitivity leading to the symptoms associated with IBS.

• #43 Irritable Bowel Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534810/

  The following pathophysiological mechanisms have been associated with IBS: Altered gastrointestinal motility includes aberrations in intestinal motility. The myoelectric activity of the gut consists of background slow waves and superimposed spike potentials. Intestinal dysmotility in IBS manifests as alterations in the slow-wave frequency and a late-peaking, blunted, postprandial response of spike potentials. […] Visceral hyperalgesia is the second key phenomenon characterizing IBS. This is characterized by visceral pain and a heightened perception of normal motility. A potential unifying mechanism is the sensitization of the afferent nociceptive pathways in the gut, which synapse in the dorsal column of the spinal cord. […] Psychopathology is the third aspect of the traditional 3-part complex of IBS. The exact relationship between psychiatric disturbances and IBS is not fully understood; however, patients with IBS have a higher incidence of major depression, panic disorder, anxiety disorders, and hypochondriasis. […] Additionally, environmental contributors to IBS include early life stressors, food intolerance, antibiotics, and enteric infections. Many patients often report that IBS symptoms are related to food intake; however, true food allergens have a limited role in IBS.

• #44 Pathogenesis of irritable bowel syndrome – Dr. Schär Institute

  https://www.drschaer.com/us/institute/a/pathogenesis-ibs

  Corticotrophin-releasing hormone (CRH) mediates the stress response and has been shown to increase gut motility. It has also been shown to promote inflammation by increasing intestinal permeability in IBS patients. […] Research has suggested that food allergy may be relevant in a subset of patients. […] There is increasing evidence that many IBS patients exhibit an intolerance to poorly absorbed carbohydrates such as fructose, lactose, polyols, fructans and galacto-oligosaccharides, known commonly as FODMAPs. These foods can cause fermentation in the gut resulting in gas, flatulence and bloating in sensitive individuals.

• #45 Diet in the pathophysiology and management of irritable bowel syndrome | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/83/9/663

  Diet plays an important role in the pathophysiology of irritable bowel syndrome (IBS) and is an effective tool in managing this disorder. This includes a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). […] These indigestible and poorly absorbed short-chain carbohydrates trigger IBS symptoms and are thought to exert their effects by increasing osmotic pressure in the lumen of the intestine and by providing a substrate for bacterial fermentation with consequent gas production. The gas causes abdominal distention, and the change in pressure in the lumen of the large intestine affects the release of serotonin, causing abdominal pain and discomfort. […] Recent studies have shown that the mechanisms by which FODMAPs exert their effects are more complicated than originally thought.

• #46 Diet in the pathophysiology and management of irritable bowel syndrome | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/83/9/663

  Diet plays an important role in the pathophysiology of irritable bowel syndrome (IBS) and is an effective tool in managing this disorder. This includes a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). […] These indigestible and poorly absorbed short-chain carbohydrates trigger IBS symptoms and are thought to exert their effects by increasing osmotic pressure in the lumen of the intestine and by providing a substrate for bacterial fermentation with consequent gas production. The gas causes abdominal distention, and the change in pressure in the lumen of the large intestine affects the release of serotonin, causing abdominal pain and discomfort. […] Recent studies have shown that the mechanisms by which FODMAPs exert their effects are more complicated than originally thought.

• #47

  https://link.springer.com/article/10.1007/s00535-023-01997-6

  Irritable bowel syndrome (IBS) is a complex multifactorial condition including alterations of the gut-brain axis, intestinal permeability, mucosal neuro-immune interactions, and microbiota imbalance. Recent advances proposed epigenetic factors as possible regulators of several mechanisms involved in IBS pathophysiology. […] More recently, epigenetic modifications such as chromatin remodelling, DNA methylation, and non-coding RNAs have been indicated among the players involved in IBS development. […] The term epigenetics refers to the whole biomolecular mechanism inducing chromosome-related, heritable changes of gene expression, regardless of DNA coding sequence. […] Perturbations of the complex homeostasis between host and intestinal microbial species in IBS have been largely studied in the last decade.

• #48 Epigenetic Mechanisms in Irritable Bowel Syndrome.

  https://escholarship.org/uc/item/2z69d2x7

  Irritable bowel syndrome (IBS) is a brain-gut axis disorder characterized by abdominal pain and altered bowel habits. IBS is a multifactorial, stress-sensitive disorder with evidence for familial clustering attributed to genetic or shared environmental factors. However, there are weak genetic associations reported with IBS and a lack of evidence to suggest that major genetic factor(s) contribute to IBS pathophysiology. […] Studies on animal models of stress, including early life stress, suggest a role for environmental factors, specifically, stress associated with dysregulation of corticotropin releasing factor and hypothalamus-pituitary-adrenal (HPA) axis pathways in the pathophysiology of IBS. Recent evidence suggests that epigenetic mechanisms, which constitute molecular changes not driven by a change in gene sequence, can mediate environmental effects on central and peripheral function.

• #49

  https://link.springer.com/article/10.1007/s00535-023-01997-6

  A recent study investigated the effects of SB on visceral sensitivity, highlighting the role of Interleukin-1 Receptor-Associated Kinase 1 (IRAK1). […] An altered miRNA profile has been related to intestinal barrier dysfunctions in IBS-D patients. […] The intestinal barrier is the first interface between the gastrointestinal tract and the environment. […] An increased number of mucosal immune cells, particularly mast cells, have been reported in IBS patients, and low-grade inflammation is considered as one of the most important underlying pathophysiological mechanisms of this syndrome. […] Increasing experimental evidence suggests the involvement of epigenetic regulation in IBS pathophysiology.

• #50 Irritable Bowel Syndrome (IBS): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/180389-overview

  The majority of the body’s serotonin is produced in the gut. […] IBS often coexists with depression, anxiety, or other psychiatric disorders. […] A novel hypothesis published in 2022 suggested that „ineffective anatomical, physiological, and neuropsychological gravity management systems” may cause IBS.

• #51 How Gravity May Cause Irritable Bowel Syndrome

  https://www.cedars-sinai.org/newsroom/how-gravity-may-cause-irritable-bowel-syndrome/

  Other theories suggest that abnormalities in motility, gut hypersensitivity, abnormal serotonin levels or a dysregulated autonomic nervous system cause IBS. […] As I thought about each theory, from those involving motility, to bacteria, to the neuropsychology of IBS, I realized they might all point back to gravity as a unifying factor. […] Gravity can compress the spine and decrease one’s flexibility. It can also cause organs to shift downward, moving from their proper position. […] If these systems fail, then IBS symptoms can occur along with musculoskeletal problems, Spiegel said. […] These factors might trigger motility problems or bacterial overgrowth in the gut. […] Dysregulated serotonin may be a form of gravity failure, Spiegel said. When serotonin biology is abnormal, people can develop IBS, anxiety, depression, fibromyalgia, and chronic fatigue. These may be forms of gravity intolerance. […] If proved correct, it is a major paradigm shift in the way we think about IBS and possibly treatment as well.

• #52 Scientists reveal mechanism that causes irritable bowel syndrome | ScienceDaily

  https://www.sciencedaily.com/releases/2021/01/210117132238.htm

  Researchers have identified the biological mechanism that explains why some people experience abdominal pain when they eat certain foods. The finding paves the way for more efficient treatment of irritable bowel syndrome and other food intolerances. […] Up to 20% of the world’s population suffers from the irritable bowel syndrome (IBS), which causes stomach pain or severe discomfort after eating. […] His team’s laboratory and clinical studies reveal a mechanism that connects certain foods with activation of the cells that release histamine (called mast cells), and subsequent pain and discomfort. […] Since people with IBS often report that their symptoms began after a gastrointestinal infection, such as food poisoning, the researchers started with the idea that an infection while a particular food is present in the gut might sensitise the immune system to that food.

• #53 Scientists May Have Finally Found a Key Mechanism Behind Irritable Bowel Syndrome : ScienceAlert

  https://www.sciencealert.com/researchers-have-sussed-out-a-driving-mechanism-behind-irritable-bowel-syndrome

  Scientists May Have Finally Found a Key Mechanism Behind Irritable Bowel Syndrome. […] The physiological mechanism behind our suffering has remained a mystery. […] Clinical studies have suggested gut infections from pathogens like Escherichia coli, and Salmonella can increase the likelihood of someone developing IBS and patients often describe their symptoms commencing after a case of food poisoning. […] Feeding them ovalbumin alone activated intestine immune cells, whereas these cells didn’t react in control mice that had been given ovalbumin but not the bacteria. […] But it appears that when the immune system activates in response to an infection, it also learns to see the food present at the time as a threat as well producing antibodies to recognise and remember these antigens. […] Histamines are known to make neurons extra sensitive explaining the abdominal pain even when the intestinal tissue is only stretched within normal limits during food digestion.

• #54 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4051916/

  Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9%-23% of the population across the world. […] The pathophysiology of IBS is not clear. Many theories have been put forward, but the exact cause of IBS is still uncertain. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS. Altered gastrointestinal motility, visceral hypersensitivity, post infectious reactivity, brain-gut interactions, alteration in fecal micro flora, bacterial overgrowth, food sensitivity, carbohydrate malabsorption, and intestinal inflammation all have been implicated in the pathogenesis of IBS. […] The underlying causes of IBS remain to be adequately identified, but IBS-PI is a clear-cut entity.

• #55 Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

  https://www.wjgnet.com/1007-9327/full/v20/i22/6759.htm

  There is increasing evidence regarding the role of immune activation in the etiology of IBS, which has mainly been shown in studies investigating mechanisms of IBS-PI. […] The mechanisms that cause IBS-PI are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. […] Serotonin (5-HT), acting particularly through the 5-HT3 and 5-HT4 receptors, plays a significant role in the control of gastrointestinal motility, sensation, and secretion. […] Studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in IBS, it remains unclear whether SIBO causes IBS. […] Psychosocial factors appear to be important in IBS, although whether these factors directly alter gastrointestinal function remains uncertain. […] Studies have suggested that there is a genetic contribution to IBS, although the importance of this remains in dispute. […] Understanding the pathogenesis of IBS is important because today’s newer pharmacotherapy agents are beginning to target the known pathophysiologic mechanisms of IBS.

• #56

  https://link.springer.com/article/10.1007/s12325-016-0336-3

  Any therapeutic approach to IBS should contemplate the aspects outlined in Table 1, including epidemiological data applicable to an individual patient, the specific symptomatology and severity of illness, the associated manifestations, and comorbidities that may be present, and the personality traits and psychosomatic aspects, which cannot be ignored. […] These various features may provide useful hints about the pathogenetic mechanisms operating in a given patient, helping us direct the various potential therapeutic measures in the most efficient way. […] There is mounting evidence of altered gut mucosal immune activity including the presence of mucosal immune cell infiltrates, modified mucosal lymphocyte phenotypes, mast cell proliferation in proximity to nerve endings, and increased apical junction complex permeability.

• #57

  https://link.springer.com/article/10.1007/s12325-016-0336-3

  Furthermore, elevated levels of circulating proinflammatory cytokines have been reported. […] In certain models there is evidence that probiotics may diminish proinflammatory cytokine activity providing some mechanistic support for the therapeutic use of probiotics in IBS. […] Post-infectious IBS is a special form where mucosal inflammation and abnormal gut-host microbial interactions probably play a particularly significant role. […] In post-infectious IBS, mucosal immune activation and immune cell proliferation may enhance peripheral sensory signaling and contribute to visceral hypersensitivity which is considered a pivotal symptom mechanism in IBS. […] Microbiota alterations may also contribute to the pathogenesis of IBS, but evidence so far is spotty and sometimes contradictory.

• #58 Scientists reveal mechanism that causes irritable bowel syndrome | ScienceDaily

  https://www.sciencedaily.com/releases/2021/01/210117132238.htm

  „But knowing the mechanism that leads to mast cell activation is crucial, and will lead to novel therapies for these patients,” he goes on. „Mast cells release many more compounds and mediators than just histamine, so if you can block the activation of these cells, I believe you will have a much more efficient therapy.”

• #59 Scientists reveal mechanism that causes irritable bowel syndrome | UZ Leuven

  https://www.uzleuven.be/en/annual-reports/annual-report-2021/news/scientists-reveal-mechanism-causes-irritable-bowel-syndrome

  Professor Boeckxstaens speculates that this points to a spectrum of food-related immune diseases. „At one end of the spectrum, the immune response to a food antigen is very local, as in IBS. At the other end of the spectrum is food allergy, comprising a generalised condition of severe mast cell activation, with an impact on breathing, blood pressure, and so on.” […] When food antigens associated with IBS (gluten, wheat, soy and cow milk) were injected into the intestine wall of 12 IBS patients, they produced localised immune reactions similar to that seen in the mice. […] „This is further proof that the mechanism we have unravelled has clinical relevance,” Professor Boeckxstaens says. […] „But knowing the mechanism that leads to mast cell activation is crucial, and will lead to novel therapies for these patients,” he goes on. „Mast cells release many more compounds and mediators than just histamine, so if you can block the activation of these cells, I believe you will have a much more efficient therapy.”

Zobacz więcej