Approach to Irritable Bowel Syndrome

  • Kyung Bong Koh


Irritable bowel syndrome (IBS) is characterized by diarrhea or constipation, abdominal pain, and abdominal bloating. Biological and psychological factors are currently believed to influence the pathogenesis of IBS. Biological factors include alteration in gut microbiome, gut motility, visceral sensation, intestinal permeability, gut immune function, and brain-gut interactions. Some IBS patients are difficult to cope with abdominal symptoms due to their emotional distress. For constipation, high fiber diet or bulking agents can be helpful, whereas for diarrhea, anticholinergic agents are effective. In IBS cases comorbid with anxiety or depressive disorders, tricyclic antidepressants are recommended. However, antianxiety agents and antipsychotics should be avoided because the former may lead to drug dependence and the latter may develop tardive dyskinesia. Explanation, reassurance, and supportive psychotherapy can also be helpful for some IBS patients. In addition, hypnosis and cognitive behavioral therapy (CBT) have beneficial effects in improving gastrointestinal symptoms of patients with IBS.


Irritable bowel syndrome Biological factors Psychological factors Anxiety disorders Depressive disorders Tricyclic antidepressants Supportive psychotherapy Hypnosis Cognitive behavioral therapy 


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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Kyung Bong Koh
    • 1
  1. 1.Department of PsychiatryYonsei University College of MedicineSeoulKorea

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