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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 7, 2008; 14(17): 2639-2649
Published online May 7, 2008. doi: 10.3748/wjg.14.2639
Updates on treatment of irritable bowel syndrome
Christopher W Hammerle, Christina M Surawicz
Christopher W Hammerle, Department of Medicine, University of Colorado Health Sciences Center, Denver 80011, United States
Christina M Surawicz, Harborview Medical Center, University of Washington, BOX 359773 HMC, 325, 9th Avenue, Seattle, WA 98104, United States
Author contribution: Hammerle CW and Surawicz CM contributed equally to this work; Hammerle CW and Surawicz CM wrote the paper.
Correspondence to: Christina M Surawicz, MD, Professor of Medicine, Harborview Medical Center, University of Washington, BOX 359773 HMC, 325, 9th Avenue, Seattle, WA 98104, United States.
Telephone: +1-206-3414634
Fax: +1-206-7318698
Received: December 19, 2007
Revised: January 17, 2008
Published online: May 7, 2008

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits. It is estimated to affect 10%-15% of the Western population, and has a large impact on quality of life and (in)direct healthcare costs. IBS is a multifactorial disorder involving dysregulation within the brain-gut axis, and it is frequently associated with gastrointestinal motor and sensory dysfunction, enteric and central nervous system irregularities, neuroimmune dysregulation, and post-infectious inflammation. As with other functional medical disorders, the treatment for IBS can be challenging. Conventional therapy for those with moderate to severe symptoms is largely unsatisfactory, and the development of new and effective drugs is made difficult by the complex pathogenesis, variety of symptoms, and lack of objective clinical findings that are the hallmark of this disorder. Fortunately, research advances over the past several decades have provided insight into potential mechanisms responsible for the pathogenesis of IBS, and have led to the development of several promising pharmaceutical agents. In recent years there has been much publicity over several of these new IBS medications (alosetron and tegaserod) because of their reported association with ischemic colitis and cardiovascular disease. While these agents remain available for use under restricted prescribing programs, this highlights the need for continued development of safe and effective medication for IBS. This article provides a physiologically-based overview of recently developed and frequently employed pharmaceutical agents used to treat IBS, and discusses some non-pharmaceutical options that may be beneficial in this disorder.

Keywords: Irritable bowel syndrome, Treatment, Pharmacotherapy, Challenges, Opportunities