Keywords
How to Cite
Abstract
Introduction: Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterized by chronic symptoms, including recurrent abdominal pain, changes in bowel habits, abdominal distension and discomfort associated with defecation. Objective: To evaluate the pathogenesis and management of irritable bowel syndrome. Methodology: This is a bibliographic review that included original articles and systematic reviews in English and Portuguese, which addressed the pathogenic components and treatment of IBS, published between 2013 and 2024, selected from the PubMed, Scopus and SciELO databases. After careful selection, 24 articles were chosen to compose this bibliographic review. Results: There are multiple relevant aspects in understanding the framework. The genetic characteristics are notable, given the polymorphisms associated with interleukins, adrenergic receptors, serotonin and cholecystokinin receptors. In addition, the brain-gut axis plays a significant role in the pathophysiology of IBS, with emotional stressors triggering gastrointestinal dysmotility and an exacerbated motor response. Management includes interventions such as a low-FODMAP diet, antispasmodics, antidepressants and agents that modulate intestinal transit, allowing treatment to be personalized based on the symptoms and individual characteristics of each patient. Considerations: The pathogenesis of the condition is complex, involving genetic, neurohormonal aspects, infections, and eating habits. Management includes pharmacological and non-pharmacological interventions, differences in care in individuality and particularity are observed depending on the patient's clinical manifestations.
References
Ballou, S. & Keefer, L. The impact of irritable bowel syndrome on daily functioning: Characterizing and understanding daily consequences of IBS. Neurogastroenterol Motil. 2017;29. doi:10.1111/nmo.12982.
Bellini M, Gambaccini D, Stasi C, Urbano MT, Marchi S, Usai-Satta P. Irritable bowel syndrome: A disease still searching for pathogenesis, diagnosis and therapy. World J Gastroenterol. 2014;20(27):8807-20.
Canavan C, West J, Card T. Review article: the economic impact of the irritable bowel syndrome. Aliment Pharmacol Ther. 2014;40:1023–1034. doi: 10.1111/apt.12938.
Choung RS, Unalp-Arida A, Ruhl CE, Brantner TL, Everhart JE, Murray JA. Less hidden celiac disease but increased gluten avoidance without a diagnosis in the United States: findings from the National Health and Nutrition Examination Surveys from 2009 to 2014. Mayo Clin Proc. 2017;92(1):30–38. doi: 10.1016/j.mayocp.2016.10.012.
Colucci R, Gambaccini D, Ghisu N, Rossi G, Costa F, Tuccori M, De Bortoli N, Fornai M, Antonioli L, Ricchiuti A, Mumolo MG, Marchi S, Blandizzi C, Bellini M. Influence of the serotonintransporter 5HTTLPR polymorphism on symptomseverity in irritable bowel syndrome. PLoS One. 2013;8(2):e54831.
Dothel G, Chang L, Shih W, et al. µ-opioid receptor, β-endorphin, and cannabinoid receptor-2 are increased in the colonic mucosa of irritable bowel syndrome patients. Neurogastroenterol Motil. 2019; 31: e13688.
Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology. 2016;150:1262-79.
Elli L, Branchi F, Tomba C, Villalta D, Norsa L, Ferretti F, Roncoroni L, Bardella MT. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol: WJG. 2015;21(23):7110-9.
Enck P, Aziz Q, Barbara G, Farmer AD, Fukudo S, Mayer EA, Niesler B, Quigley EMMM, Rajilić-
Stojanović M, Schemann M, et al. Irritable bowel syndrome. Nat Rev Prim. 2016; 2 :16014. doi: 10.1038/nrdp.2016.14.
Ford AC, Lacy BE, Talley NJ. Irritable Bowel Syndrome. N Engl J Med. 2017;376:2566–2578. doi: 10.1056/NEJMra1607547.
Hanevik K, Wensaas KA, Rortveit G, Eide GE, Mørch K, Langeland N. Irritable bowel syndrome and chronic fatigue 6 years after giardia infection: a controlled prospective cohort study. Clin Infect Dis. 2014;59(10):1394-400.
Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: management of irritable bowel syndrome. Am J Gastroenterol. 2021;116(1):17–44. doi: 10.14309/ajg.0000000000001036.
Lehrer JK. Irritable Bowel Syndrome. Medscape. Available at http:// emedicine.medscape.com/article/180389. 2017. Updated: Apr 04, 2017.
Mahurkar-Joshi S, Rankin CR, Videlock EJ, et al. The Colonic Mucosal MicroRNAs, MicroRNA-219a-5p, and MicroRNA-338-3p Are Downregulated in Irritable Bowel Syndrome and Are Associated With Barrier Function and MAPK Signaling. Gastroenterology. 2021; 160: 2409–2422.e19.
Mari A., Abu Baker, F., Mahamid, M., Sbeit, W. & Khoury, T. The Evolving Role of Gut Microbiota in the Management of Irritable Bowel Syndrome: An Overview of the Current Knowledge. J Clin Med. 2020;9. doi:10.3390/jcm9030685.
Rangan V, Ballou S, Shin A, Camilleri M, Beth Israel Deaconess Medical Center GI Motility Working Group, Lembo A. Use of treatments for irritable bowel syndrome and patient satisfaction based on the IBS in America survey. Gastroenterology. 2020;158(3):786–88.
Salix Pharmaceuticals. Xifaxan (rifaximin) tablets, for oral use [package insert]. Bridgewater, NJ: Salix Pharmaceuticals; 2020.
Salvo-Romero E, Martínez C, Lobo B, et al. Overexpression of corticotropin-releasing factor in intestinal mucosal eosinophils is associated with clinical severity in Diarrhea-Predominant Irritable Bowel Syndrome. Sci Rep. 2020; 10: 20706.
Shorey S, Demutska A, Chan V, Siah KTH. Adults living with irritable bowel syndrome (IBS): A qualitative systematic review. J Psychosom Res. 2021;140:110289. doi: 10.1016/j.jpsychores.2020.110289.
Simren M, Palsson OS, Whitehead WE. Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice. Curr Gastroenterol Rep. 2017 Apr;19(4):15. doi: 10.1007/s11894-017-0554-0. PMID: 28374308; PMCID: PMC5378729.
Sperber AD, Dumitrascu D, Fukudo S, Gerson C, Ghoshal UC, Gwee KA, Hungin APS, Kang J-Y, Minhu C, Schmulson M, et al. The global prevalence of IBS in adults remains uncertain due to study heterogeneity: a Rome Foundation Working Team literature review. Intestine. 2017; 66 :1075–1082. doi: 10.1136/gutjnl-2015-311240.
Tsushima H, Zhang Y, Muratsubaki T, et al. Oxytocin antagonist induced visceral pain and corticotropin-releasing hormone neuronal activation in the central nucleus of the amygdala during colorectal distention in mice. Neurosci Res. 2021; 168: 41–53.
Vasant DH, Paine PA, Black CJ, et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut. 2021;70(7):1214–1240. doi: 10.1136/gutjnl-2021-324598.
Wright-McNaughton M, Ten Bokkel HS, Frampton CMA, et al. Measuring diet intake and gastrointestinal symptoms in irritable bowel syndrome: validation of the food and symptom times diary. Clin Transl Gastroenterol. 2019;10(12):e00103. doi: 10.14309/ctg.0000000000000103.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 Mauro Alexandre Caixeta, Paulo Vytor Cardoso Nobre, Victor da Costa Sacksida Valladão, Lucas Henrique da Silva, Celiany Rocha Appelt, Caroline Lavinas Lúcio da Silva, Airllys Manuele de Souza Araujo, Jean Marcos da Silva, Marcelo Cantarelli Correia da Silva Filho, Rita Karoline Nascimento Chaves , Karina Araújo de Melo Tenorio de Souza, Rodrigo Batista de Lima