Pathophysiology of irritable bowel syndrome and comparing the efficacy of the current treatments for the disease
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Abstract
Irritable Bowel Syndrome (IBS) is the most prevalent functional gastrointestinal (GI) disease in the western world today. There are multiple subtypes of IBS and the symptoms of the disease vary drastically. The main types of IBS are IBS with constipation (IBS-C), IBS with diarrhea (IBS-D) and mixed IBS (IBS-M). Because of the commonality of this disease, there are a wide array of treatments that have been used and are currently being used to treat patients suffering with IBS symptoms. These treatments vary in their efficacy, with some being much more effective than others for the specific subtypes of the disease. However, as technological advances increase and the root cause and pathophysiology of IBS is discovered, more efficacious treatments are also being discovered. The most common treatments used today include but are not limited to probiotic supplements, limited diets such as the FODMAP diet, antibiotics and antidepressants, and psychological interventions such as Cognitive Behavioral Therapy (CBT) and hypnosis. New promising treatments include Fecal Microbiota Transplants (FMT) and individualized medicine.
The pathophysiology of IBS has not yet been completely elucidated but the literature is clear on the fact that there are microbiome changes in patients with IBS. Many of the treatments that have high rates of success address the microbiome changes. The future of IBS treatments may depend on the gut microbiota and establishing a new gut environment through a variety of methods. Moreover, many of the current treatments treat this aspect of IBS as well. IBS is not a disease exclusive to the gut and is thought to influence and be influenced by outside stress and neurotransmitters such as serotonin. The research on IBS treatments indicates that there is no one treatment that is the most effective but rather that individuals need to work with health professionals to find a unique treatment that will work for their particular symptoms.