Irritable Bowel Syndrome: A Review of Treatment Options

Irritable Bowel Syndrome: A Review of Treatment Options

Abstract and Introduction

Abstract

Irritable bowel syndrome (IBS) is a complex gastrointestinal condition whose pathophysiology is not well understood. Nonpharmacologic treatment options are the mainstay of therapy, and interventions should focus on dietary alterations and physical activity initially and throughout treatment. Drug therapy is rather limited but is focused on the predominant symptoms of IBS—constipation or diarrhea—as well as on improving abdominal pain. Pharmacists have a vital role in patient education and in drug-therapy management for IBS, and they can help ensure that treatment is safe and efficacious.

Introduction

Irritable bowel syndrome (IBS) encompasses a group of gastrointestinal (GI) conditions that are characterized by pain and abnormal bowel habits that have no identifiable root cause. The pathophysiology of IBS is not completely understood, but a wide variety of factors are believed to be involved. Data are conflicting and have not revealed a specific abnormality that can elucidate why IBS occurs or point to a particular mode of therapy. Many currently used treatments for IBS have addressed GI motility, visceral and dietary sensitivities, inflammation, and alterations in GI flora. One of the more recent etiologies studied is the role of serotonin in the peristaltic reflex of the gut, where an abnormality could lead to increased or decreased motility.^[1] A 2014 study estimated that 5% to 15% of people worldwide experience IBS symptomatology, making this a disorder that will be encountered often in practice.^[2]