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Lookup NU author(s): Emeritus Professor Amritpal Hungin, Emeritus Professor Greg RubinORCiD, Dr Andrew Russell
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© 2015 John Wiley & Sons Ltd.Background: Although irritable bowel syndrome (IBS) is a symptom-based diagnosis, clinicians' management of and communication about the disorder is often hampered by an unclear conceptual understanding of the nature of the problem. We aimed to elucidate an integrated explanatory model (EM) for IBS from the existing literature for pragmatic use in the clinical setting. Methods: Systematic and exploratory literature searches were performed in PubMed to identify publications on IBS and EMs. Key Results: The searches did not identify a single, integrated EM for IBS. However, three main hypotheses were elucidated that could provide components with which to develop an IBS EM: (i) altered peripheral regulation of gut function (including sensory and secretory mechanisms); (ii) altered brain-gut signaling (including visceral hypersensitivity); and (iii) psychological distress. Genetic polymorphisms and epigenetic changes may, to some degree, underlie the etiology and pathophysiology of IBS and could increase the susceptibility to developing the disorder. The three model components also fit into one integrated explanation for abdominal symptoms and changes in stool habit. Additionally, IBS may share a common pathophysiological mechanism with other associated functional syndromes. Conclusions & Inferences: It was possible to elucidate an integrated, three-component EM as a basis for clinicians to conceptualize the nature of IBS, with the potential to contribute to better diagnosis and management, and dialog with sufferers.
Author(s): Hungin APS, Becher A, Cayley B, Heidelbaugh JJ, Muris JWM, Rubin G, Seifert B, Russell A, De Wit NJ
Publication type: Review
Publication status: Published
Journal: Neurogastroenterology and Motility
Year: 2015
Volume: 27
Issue: 6
Pages: 750-763
Print publication date: 01/06/2015
Online publication date: 20/02/2015
Acceptance date: 13/01/2015
ISSN (print): 1350-1925
ISSN (electronic): 1365-2982
Publisher: Blackwell Publishing Ltd
URL: https://doi.org/10.1111/nmo.12524
DOI: 10.1111/nmo.12524
PubMed id: 25703486
