Irritable bowel syndrome classification and subtypes

Introduction The diagnosis of irritable bowel syndrome (IBS) is established based on symptoms, which include abdominal pain associated with a change in stool form or frequency, with the Bristol Stool Scale being very useful for characterizing stool types1 (Table 1). Symptoms usually vary in intensity and frequency, and may worsen in stressful situations. Changes in […]

Diagnosis of irritable bowel syndrome

Introduction Irritable bowel syndrome (IBS) is a disorder of gut–brain interaction (DGBI) whose pathophysiology is related to any combination of alterations in motility, visceral sensitivity, epithelial barrier, mucosal immune function, intestinal dysbiosis, or processing at the level of the central nervous system1. Due to its multifactorial nature, diagnosis is based on symptom criteria. In the […]

Irritable bowel syndrome and small intestinal bacterial overgrowth

Small intestinal bacterial overgrowth: cause or consequence of irritable bowel syndrome? The correlation between the etiopathogenesis of small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS) has not yet been satisfactorily clarified. Some authors support the hypothesis that SIBO is the primary event or cause, while others indicate that it is a consequence of […]

Irritable bowel syndrome and diet: evidence based nutritional strategies

Introduction to the role of diet in irritable bowel syndrome Since 70%-89% of patients with irritable bowel syndrome (IBS) report exacerbation of symptoms with certain specific foods, it is common for them to self-eliminate these foods from their diet, negatively impacting their nutritional status1. Therefore, diet is a fundamental pillar in the management of IBS. […]

Management of irritable bowel syndrome with diarrhea

Definition Irritable bowel syndrome (IBS) is a disorder of gut–brain interaction characterized by abdominal pain associated with changes in bowel habits, and it can be categorized into 4 subtypes depending on the predominant bowel pattern: IBS with diarrhea predominance (IBS-D), constipation predominance (IBS-C), mixed (IBS-M), or unclassified (IBS-U)1. IBS-D is defined, according to the Rome […]

Treatment of irritable bowel syndrome with predominance of constipation

Introduction Irritable bowel syndrome with constipation predominance (IBS-C) is one of the most common forms of IBS and the most frequently diagnosed disorder of the brain-gut interaction in clinical practice1. It is characterized by the presence of abdominal pain or discomfort accompanied by alterations in bowel habits, especially constipation, and other symptoms such as bloating, […]

Non-pharmacologic neuromodulation in irritable bowel syndrome

Definition and physiological foundations Irritable bowel syndrome (IBS) is a disorder of the gut-brain interaction (DGBI). The gut-brain axis is the complex bidirectional connection between the intestine and the central nervous system (CNS), which includes the brain, spinal cord, autonomic nervous system (sympathetic, parasympathetic, and enteric), neuroendocrine system, and neurohumoral system1. Afferent pathways transmit visceral […]