Consensus report

Clinical perspectives, mechanisms, diagnosis and management of irritable bowel syndrome

Michael Camilleri, R. C. Heading, W. G. Thompson

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

This consensus document reviews the current status of the epidemiology, social impact, patient quality of life, pathophysiology, diagnosis and treatment of irritable bowel syndrome. Current evidence suggests that two major mechanisms may interact in irritable bowel syndrome: altered gastrointestinal motility and increased sensitivity of the intestine. However, other factors, such as psychosocial factors, intake of food and prior infection, may contribute to its development. Management of patients is based on a positive diagnosis of the symptom complex, careful history and physical examination to exclude 'red flags' as risk factors for organic disease, and, if indicated, investigations to exclude other disorders. Therapeutic choices include dietary fibre for constipation, opioid agents for diarrhoea and low-dose antidepressants or infrequent use of antispasmodics for pain, although the evidence basis for efficacy is limited or in some cases absent. Psychotherapy and hypnotherapy are the subject of ongoing study. Treatment should be tailored to patient needs and fears. Novel therapies are emerging, and drugs acting on serotonin receptors have proven efficacy and a scientific rationale and, if approved, should be useful in the overall management of patients with irritable bowel syndrome. Patient and physician education, early identification of psychosocial issues and better therapies are important strategies to reduce the suffering and societal cost of irritable bowel syndrome.

Original languageEnglish (US)
Pages (from-to)1407-1430
Number of pages24
JournalAlimentary Pharmacology and Therapeutics
Volume16
Issue number8
DOIs
StatePublished - Aug 2002

Fingerprint

Irritable Bowel Syndrome
Consensus
Parasympatholytics
Gastrointestinal Motility
Hypnosis
Serotonin Receptors
Dietary Fiber
Patient Education
Constipation
Therapeutics
Social Change
Psychological Stress
Psychotherapy
Opioid Analgesics
Antidepressive Agents
Physical Examination
Fear
Intestines
Diarrhea
Epidemiology

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Consensus report : Clinical perspectives, mechanisms, diagnosis and management of irritable bowel syndrome. / Camilleri, Michael; Heading, R. C.; Thompson, W. G.

In: Alimentary Pharmacology and Therapeutics, Vol. 16, No. 8, 08.2002, p. 1407-1430.

Research output: Contribution to journalArticle

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