A Global Perspective on Irritable Bowel Syndrome

Abstract

Irritable bowel syndrome (IBS) is common in western Europe and North America, and many aspects of its epidemiology, risk factors, and natural history have been described in these regions. Recent data suggest, however, that IBS is also common in the rest of the world and there has been some evidence to suggest some differences in demographics and presenting features between IBS in the west and as it is experienced elsewhere. The World Gastroenterology Organization, therefore, established a Task Force comprising experts on the topic from all parts of the world to examine IBS from a global perspective. IBS does, indeed, seem to be common worldwide though with some significant variations in prevalence rates between regions and countries and there may well be some potentially interesting variations in presenting symptoms and sex distribution. The global map of IBS is far from complete; community-based prevalence data is not available from many areas. Furthermore, while some general trends are evident in terms of IBS impact and demographics, international comparisons are hampered by differences in diagnostic criteria, study location and methodology; several important unanswered questions have been identified that should form the basis for future collaborative research and have the potential to shed light on this challenging disorder.

Do gut microbial communities differ in pediatric IBS and health?

“…Proposed causes of IBS include altered motor function, abnormal gas handling, acute bacterial gastroenteritis, food intolerance, increased intestinal permeability and gut motility, altered intestinal immune function, as well as bacterial overgrowth of small intestine (SIBO). 4,5 While none of the potential causes has yet emerged as the established determinant of IBS development, many of the symptoms of IBS are consistent with SIBO,6 and the prevalence of SIBO was found to be higher in many previous investigations of IBS patients. [7][8][9] While the SIBO model of IBS development implicates intestinal microbiota as a major cause of this syndrome, the available studies of gut microbiota in IBS do not show a strong consensus as to which microbiota members might be responsible for the condition and whether specific ©2013 Landes Bioscience.…”

Modern Management of Irritable Bowel Syndrome: More Than Motility

“…Available guidelines advocate making a symptom-based definition, with a cost-effective screening to rule out organic disease, and additional examinations such as colonoscopy in those with risk or alarm features [6,7,8]. After making a positive diagnosis, which needs to be clearly communicated to the patient, dietary and life-style review and counseling are recommended [6,7,8].…”

“…After making a positive diagnosis, which needs to be clearly communicated to the patient, dietary and life-style review and counseling are recommended [6,7,8]. Although evidence is largely lacking that these directly improve IBS symptoms, recommendations often include fiber-rich diets (where appropriate), regular mealtimes, intake of sufficient fluids, and sufficient physical activity [8].…”

“…1) [1,6]. Guidelines for management have been published by a number of bodies [6,7,8]. The pathophysiology underlying IBS is heterogeneous and involves an interplay between altered intestinal motility, visceral hypersensitivity, dietary factors, the intestinal microbiota, impaired mucosal barrier function, low-grade inflammatory changes in the gastrointestinal wall and altered brain-gut axis interactions [9,10,11].…”

The microbiota link to irritable bowel syndrome

“…1,2 This makes IBS the most widespread gastrointestinal disorder and, as individuals suffering from IBS have a reduced quality of life and report more co-morbidities than the general population, it has a significant negative burden on society 1 . IBS is commonly subtyped according to predominant bowel habit into diarrhea-predominant, constipation-predominant or mixed/alternating phenotypes (IBS-D, IBS-C or IBS-M).…”