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Latest Insights on the Pathogenesis of Irritable Bowel Syndrome
The pathogenesis of irritable bowel syndrome is multifactorial and complex. Our understanding of its pathophysiology has evolved, but remains incompletely understood. Symptoms result from a dysregulation of brain –gut interactions. Evidence has identified alterations in central and peripheral (gut) mechanisms in irritable bowel syndrome and the bidirectional communication between the brain and the gut. Pertinent mechanisms include disturbed gut motility, visceral hypersensitivity, altered mucosal and immun e function, altered gut microbiota, and altered central nervous system processing. This review addresses factors tha...
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Authors: Elizabeth J. Videlock, Lin Chang Source Type: research

Medical Therapies for Diarrhea-Predominant Irritable Bowel Syndrome
Diarrhea-predominant irritable bowel syndrome is a common functional gastrointestinal disorder that manifests with abdominal pain and diarrheal bowel patterns, without structural explanation. Diarrhea-predominant irritable bowel syndrome is a heterogeneous condition resulting from diverse pathophysiologic processes. Treatment strategies with varied mechanisms of action are beneficial in its management. The clinician must become familiar with a multi-dimensional approach to irritable bowel syndrome. The 3 approved medications are central to disease management. Effective treatment uses off-label medications and emerging ther...
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Authors: Gregory S. Sayuk Source Type: research

Focus on Pharmacotherapy for Irritable Bowel Syndrome with Constipation
This article highlights the pivotal evidence for these agents and most recent treatment guidance from the major North American gastroenterological societies. When pharmaceuticals are used, a patient-specific approach based on efficacy, safety, tolerability, access, and affordability is recommended. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Authors: Joy J. Liu, Darren M. Brenner Source Type: research

Irritable Bowel Syndrome
Ten years ago, I eagerly accepted the opportunity to compose and edit an issue of Gastroenterology Clinics of North America on Irritable Bowel Syndrome or IBS. A decade later, our world has changed in countless ways, affecting every aspect of our daily lives. From self-driving cars to CRISPR to COVID-19, what a difference a decade has made. Perhaps nowhere is this more apparent than in our understanding of IBS. The way we think about, diagnose, and treat IBS in 2021 is quite different than it was 10 years ago, no doubt related to the explosion of basic, translational, and clinical research addressing this vexing condition....
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Authors: William D. Chey Tags: Preface Source Type: research

Dedication
This issue of Gastroenterology Clinics of North America is dedicated to my parents, Fan and William Y. Chey, who helped me to understand my priorities and potential as a person, physician, investigator, and mentor. I also dedicate the issue to my wife and best friend, Janine, and 3 children, Sam, Russell, and Josie, whose collective unconditional love and support make me whole, keep me grounded, and motivate me to make the most of every day. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Authors: William D. Chey Source Type: research

Foreword
Ultrasound, MIR [MRI], CAT scan [CT], sonogram,Laparoscopy, inoscopy [colonoscopy], I be stressed,The prognosis, diagnosis, IBSAnd that ’s irritable bowel child—I.B.S. by Cam’ron from the Killa Season album (2006)Yes, irritable bowel syndrome (IBS) has been written about, sung about, and rapped about. It’s only one letter away from IBD, but in reality, actually a world away, although patients with IBS may have IBD and vice v ersa, and as such, clinicians may sometimes be treating the right problem at the wrong time or the wrong problem at the wrong time. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Authors: Alan L. Buchman Source Type: research

Irritable Bowel Syndrome
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Authors: William D. Chey Source Type: research

Copyright
Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Source Type: research

Contributors
ALAN L. BUCHMAN, MD, MSPH, FACP, FACN, FACG, AGAF (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Source Type: research

Gastroenterology Clinics of North America
Diseases of the Esophagus (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 23, 2021 Category: Gastroenterology Source Type: research

Complementary and Alternative Medicine Therapies for Irritable Bowel Syndrome
Complementary and alternative medicine (CAM) is a term used to define a broad range of therapies, most commonly grouped into natural products, mind-body medicine, and traditional systems of medicine. Patients with irritable bowel syndrome (IBS) commonly use CAM therapies, although there are many barriers that may keep patients and providers from talking about a patient ’s CAM use. Despite limited quantity and quality of evidence of CAM for IBS, providers can better counsel patients on CAM use by understanding pitfalls related to CAM use and by learning what is known about CAM. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 2, 2021 Category: Gastroenterology Authors: Jordan M. Shapiro, Jill K. Deutsch Source Type: research

Integrated Care for Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common symptom-based condition of heterogeneous pathogenesis and clinical phenotype. This heterogeneity and multidimensional nature creates significant diagnostic and treatment challenges. Recent evidence has documented the benefits of diet and behavioral interventions. These nonmedical strategies are causing a shift from the traditional care model to a multidisciplinary care model. Recent evidence suggests that collaborative, team-based integrated care leads to better clinical outcomes and reduced cost per cure compared with traditional care. Although it is growing increasingly clear th...
Source: Gastroenterology Clinics of North America - July 2, 2021 Category: Gastroenterology Authors: Sameer K. Berry, William D. Chey Source Type: research

Psychopharmacologic Therapies for Irritable Bowel Syndrome
Psychopharmacologic therapies are beneficial in reducing symptoms when treating irritable bowel syndrome (IBS) and other disorders of gut-brain interaction (DGBI). Noradrenaline, serotonin, and dopamine are neurotransmitters of key importance in psychopharmacology and pain-reduction mechanisms. The first-line (tricyclic antidepressants, serotonin noradrenaline reuptake inhibitors, selective serotonin reuptake inhibitors) and second-line (atypical antipsychotics, delta-ligand agents, low-dose naltrexone) neuromodulator treatment options are recommended when IBS-associated abdominal pain is of moderate or severe intensity an...
Source: Gastroenterology Clinics of North America - July 1, 2021 Category: Gastroenterology Authors: Hans T örnblom, Douglas A. Drossman Source Type: research

Emerging Role of the Gut Microbiome in Irritable Bowel Syndrome
This article describes the evidence from epidemiologic and clinical observational studies highlighting the link between IBS and gut microbiome by investigating postinfection IBS, small intestinal bacterial overgrowth, and microbial dysbiosis. It highlights the effects of gut microbiota on mechanisms implicated in the pathophysiology of IBS, including gut-brain axis, visceral hypersensitivity, motility, epithelial barrier, and immune activation. In addition, it summarizes the current evidence on microbiome-guided therapies in IBS, including probiotics, antibiotics, diet, and fecal microbiota transplant. (Source: Gastroenter...
Source: Gastroenterology Clinics of North America - June 25, 2021 Category: Gastroenterology Authors: Prashant Singh, Anthony Lembo Source Type: research