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World J Gastroenterol. Jul 21, 2014; 20(27): 8867-8885
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.8867
Recent advances in pharmacological treatment of irritable bowel syndrome
Georgia Lazaraki, Grigoris Chatzimavroudis, Panagiotis Katsinelos
Georgia Lazaraki, Grigoris Chatzimavroudis, Panagiotis Katsinelos, Department of Endoscopy and Motility Unit, G. Gennimatas General Hospital, School of Medicine, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece
Author contributions: Lazaraki G mainly drafted and wrote the manuscript; Chatzimavroudis G is involved in writing and editing the manuscript; Katsinelos P is responsible for drafting and critical approval of the manuscript.
Correspondence to: Panagiotis Katsinelos, MD, PhD, Assistant Professor of Gastroenterology, Department of Endoscopy and Motility Unit, G. Gennimatas General Hospital, School of Medicine, Aristotle University of Thessaloniki, Ethnikis Aminis 41, 54635 Thessaloniki, Greece. gchatzimav@yahoo.gr
Telephone: +30-2310-963341 Fax: +30-2310-963341
Received: October 1, 2013
Revised: March 13, 2014
Accepted: June 20, 2014
Published online: July 21, 2014
Abstract

Irritable bowel syndrome (IBS) is a highly prevalent functional disorder that reduces patients’ quality of life. It is a chronic disorder characterized by abdominal pain or discomfort associated with disordered defecation in the absence of identifiable structural or biochemical abnormalities. IBS imposes a significant economic burden to the healthcare system. Alteration in neurohumoral mechanisms and psychological factors, bacterial overgrowth, genetic factors, gut motility, visceral hypersensitivity, and immune system factors are currently believed to influence the pathogenesis of IBS. It is possible that there is an interaction of one or more of these etiologic factors leading to heterogeneous symptoms of IBS. IBS treatment is predicated upon the patient’s most bothersome symptoms. Despite the wide range of medications and the high prevalence of the disease, to date no completely effective remedy is available. This article reviews the literature from January 2008 to July 2013 on the subject of IBS peripherally acting pharmacological treatment. Drugs are categorized according to their administration for IBS-C, IBS-D or abdominal pain predominant IBS.

Keywords: Irritable bowel syndrome, Irritable bowel syndrome constipation, Irritable bowel syndrome-diarrhea, Constipation, Diarrhea, Irritable bowel syndrome treatment, Irritable bowel syndrome-pain

Core tip: Irritable bowel syndrome (IBS) is a highly prevalent functional disorder that reduces patients’ quality of life and imposes a significant economic burden to the healthcare system. This article extensively reviews the literature from January 2008 to July 2013 on the subject of IBS peripherally acting pharmacological treatment. Pathophysiology background and mode of action in IBS of each substance are also discussed.