New Insights into the Pathogenesis and Pathophysiology of Irritable Bowel Syndrome

The irritable bowel syndrome is a chronic abdominal symptom complex for which there is no underlying structural abnormality. Abdominal symptoms occurring in IBS are thought to arise as a result of motility disturbances, although the exact relationships between symptoms and altered motor patterns remain to be determined.1 The disorder may involve any part of the gastrointestinal tract, giving rise to a variety of symptom-complexes and thus the clinical heterogeneity of the syndrome. The disorder is extremely common and accounts for a very large proportion of referrals to gastroenterologists.2,3 Therapy in IBS is a controversial issue and has recently been reviewed.1 Uncertainty regarding therapy in IBS reflects a number of issues, many of which stem over controversy regarding the pathogenesis of the syndrome.