Skip to main content
SpringerLink
Log in

New Insights into the Pathogenesis and Pathophysiology of Irritable Bowel Syndrome

  • Chapter
Modern Concepts in Gastroenterology

Part of the book series: Topics in Gastroenterology ((TGEN))

  • 60 Accesses

Abstract

The irritable bowel syndrome is a chronic abdominal symptom complex for which there is no underlying structural abnormality. Abdominal symptoms occurring in IBS are thought to arise as a result of motility disturbances, although the exact relationships between symptoms and altered motor patterns remain to be determined.1 The disorder may involve any part of the gastrointestinal tract, giving rise to a variety of symptom-complexes and thus the clinical heterogeneity of the syndrome. The disorder is extremely common and accounts for a very large proportion of referrals to gastroenterologists.2,3 Therapy in IBS is a controversial issue and has recently been reviewed.1 Uncertainty regarding therapy in IBS reflects a number of issues, many of which stem over controversy regarding the pathogenesis of the syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Collins SM. Pharmacotherapy in the irritable bowel syndrome. Can Med Assoc J 1988; 138: 309–314.

    CAS  Google Scholar 

  2. Harvey RF, Salik SY, Read AE. Organic and functional disorders in 2000 gastroenterology outpatients. Lancet 1983; 1: 632–633.

    Article  PubMed  CAS  Google Scholar 

  3. Switz DM. What the gastroenterologist does all day. Gastroenterology 1976; 70: 1048–1050.

    PubMed  CAS  Google Scholar 

  4. Editorial. An irritable mind or an irritable bowel? Lancet 1984: 1249–1250.

    Google Scholar 

  5. Hislop IG. Psychological significance of the irritable bowel syndrome. Gut 1971; 12: 452–457.

    Article  PubMed  CAS  Google Scholar 

  6. Palmer RL, Stonehill E, Crisp AH, et al. Psychological characteristics of patients with the irritable bowel syndrome. Postgrad Med J 1974; 50: 416–419.

    Article  PubMed  CAS  Google Scholar 

  7. Young SJ, Alpers DH, Norland CC, Woodruff RA. Psychiatric illness and the irritable bowel syndrome. Gastroenterology 1976; 70: 162–166.

    PubMed  CAS  Google Scholar 

  8. Svedlund J, Sjodin I, Ottosson J-O, Dotevall G. Controlled trial of psychotherapy in the irritable bowel syndrome. Lancet 1983; 2: 589–592.

    Article  PubMed  CAS  Google Scholar 

  9. Whorwell PJ, Prior A, Faragher EB. Controlled trial of hypnotherapy in the treatment of severe refractory irritable bowel syndrome. Lancet 1984; 1: 1232–1234.

    Article  Google Scholar 

  10. Thompson WG, Heaton KW. Functional bowel disorders in apparently healthy people. Gastroenterology 1980; 79: 283–288.

    PubMed  CAS  Google Scholar 

  11. Drossman DA, Sandler RS, McKee DC, Lovitz AJ. Bowel patterns among subjects not seeking health care. Gastroenterology 1982; 83: 529–534.

    PubMed  CAS  Google Scholar 

  12. Ritchie J. Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut 1973; 14: 125–132.

    Article  PubMed  CAS  Google Scholar 

  13. Whitehead WE, Engel BT, Schuster MM. Irritable bowel syndrome: physiological and psychological differences between diarrhea-predominant and constipation pre-dominant patients. Dig Dis Sci 1980; 25: 404–413.

    Article  PubMed  CAS  Google Scholar 

  14. Cook IJ, van Eeden A, Collins SM. Patients with irritable bowel syndrome have greater pain tolerance than normal subjects. Gastroenterology 1987; 93: 727–733.

    PubMed  CAS  Google Scholar 

  15. Snape WJ, Carlson GM, Cohen S. Colonic myoelectrical activity in the irritable bowel syndrome. Gastroenterology 1976; 70: 326–330.

    PubMed  Google Scholar 

  16. Taylor I, Darby C, Hammond P. Comparison of rectosigmoid myoelectrical activity in irritable colon syndrome during relapses and remissions. Gut 1978; 19: 923–929.

    Article  PubMed  CAS  Google Scholar 

  17. Latimer P, Sarna S, Campbell D, et al. Colonic motor and myoelectrical activity: a comparative study of normal subjects, psychoneurotic patients and patients with irritable bowel syndrome. Gastroenterology 1981; 80: 893–901.

    PubMed  CAS  Google Scholar 

  18. Bueno L, Fioramonti J, Ruckebusch Y, et al. Evaluation of colonic myoelectrical activity in health and functional disorders. Gut 1980; 21: 480–485.

    Article  PubMed  CAS  Google Scholar 

  19. Thompson DG, Laidlaw JM, Wingate DL. Abnormal small bowel motility demonstrated in a patient with irritable colon. Lancet 1979; 2: 1321–1322.

    Article  PubMed  CAS  Google Scholar 

  20. Cook IJ, Reddy SN, Collins SM, Daniel EE. The influence of recording techniques on measurement of canine colonic motility. Dig Dis Sci 1988; 33 (8);999–1106.

    Article  PubMed  CAS  Google Scholar 

  21. Huizinga JD, Daniel EE. Control of human colonic motor function. Dig Dis Sci 1986; 31 (8):865–877.

    Article  PubMed  CAS  Google Scholar 

  22. Connell AM. The motility of the pelvic colon II. Paradoxical motility in diarrhoea and constipation. Gut 1962; 3: 342–3348.

    Article  PubMed  CAS  Google Scholar 

  23. Waller S, Misiewicz J J, Kiley N. Effect of eating on motility of the pelvic colon in constipation and in diarrhoea. Gut 1972; 13: 805–811.

    Article  PubMed  CAS  Google Scholar 

  24. Sullivan MA, Cohen S, Snape WJ. Colonic myoelectrical activity in irritable bowel syndrome. Effect of eating and anticholinergics. N Engl J Med 1978; 298: 878–883.

    Article  PubMed  CAS  Google Scholar 

  25. Taylor I, Basu P, Hammond P, et al. Effect of bile acid perfusion on colonic motor function in patients with irritable colon syndrome. Gut 1980; 21: 843–847.

    Article  PubMed  CAS  Google Scholar 

  26. Harvey RF, Read AE. Effect of cholecystokinin on colonic motility and symptoms in patients with irritable bowel syndrome. Lancet 1973; 1: 1–3.

    Article  PubMed  CAS  Google Scholar 

  27. Collins SM, Gardner JD. Cholecystokinin-induced contraction of dispersed smooth muscle cells. Am J Physiol 1982; 243: G497–G504.

    PubMed  CAS  Google Scholar 

  28. Oddsson E, Rask-Madsen J, Drag E. A secretory epithelium of the small intestine with increased sensitivity to bile acids in irritable bowel syndrome associated with diarrhea. Scand J Gastroenterol 1978; 13: 409–416.

    Article  CAS  Google Scholar 

  29. Whorwell PJ, McCallum M, Creed FH, Roberts CT. Non-colonic features of irritable bowel syndrome. Gut 1986; 27: 37–40.

    Article  PubMed  CAS  Google Scholar 

  30. Fielding JF, Regan R. Excessive cold pressor response in the irritable colon syndrome. Irish J Med Sci 1984; 153: 348–350.

    Article  PubMed  CAS  Google Scholar 

  31. Whorwell PJ, Lupton EW, Erduran D, Wilson K. Bladder smooth muscle dysfunction in patients with irritable bowel syndrome. Gut 1986; 27: 1014–1017.

    Article  PubMed  CAS  Google Scholar 

  32. Watier A, Devroede G, Duranceau A, et al. Constipation with colonic inertia. A manifestation of systemic disease? Dig Dis Sci 1983; 28: 1025–1033.

    Article  PubMed  CAS  Google Scholar 

  33. Hargreave FE, Ryan G, Thomson NC, et al. Bronchial responsiveness to histamine or meth-acholine in asthma: measurement and clinical significance. J Allergy Clin Immunol 1981; 68: 347–355.

    Article  PubMed  CAS  Google Scholar 

  34. O’Byrne PM, Thomson NC, Latimer KM, et al. The effect of inhaled hexamethonium bromide and atropine sulphate on airway responsiveness to histamine. J Allergy Clin Immunol 1985; 76: 97–103.

    Article  PubMed  Google Scholar 

  35. White A, Upton A, Collins SM. Is irritable bowel syndrome the asthma of the gut? Gastroenterology 1988; 94 (5):A494.

    Google Scholar 

  36. Smart HL, Atkinson M. Abnormal vagal function in irritable bowel syndrome. Lancet 1987; 7: 475–478.

    Article  Google Scholar 

  37. Hargreave FE, Dolovich J, O’Byrne PM, et al. The origin of airway hyperresponsiveness. J Allerg Clin Immunol 1986; 78 (5):825–832.

    Article  CAS  Google Scholar 

  38. Hiatt RB, Katz L. Mast cells in inflammatory conditions of the gastrointestinal tract. Am J Gastroenterol 1962; 37: 541–545.

    PubMed  CAS  Google Scholar 

  39. Jones VA, McLaughlan P, Shorthouse M, et al. Food intolerance: a major factor in the pathogenesis of irritable bowel syndrome. Lancet 1982; 2: 1115–1117.

    Article  PubMed  CAS  Google Scholar 

  40. Burkitt DP, Trowell HC, eds. Refined Carbohydrate Foods and Disease: Some Implications of Dietary Fibre. London: Academic Press, 1975.

    Google Scholar 

  41. Burkitt DP, Walker ARP, Painter NS. Effect of dietary fibre on stools and transit times and its role in the causation of disease. Lancet 1972; 2: 1408–1411.

    Article  PubMed  CAS  Google Scholar 

  42. Watson WC, Corke M, Pomare EW, Sullivan SN. A double-blind study on the effect of dietary fibre on stool frequency and appearance, abdominal symptoms and serum lipid levels in patients with the irritable bowel syndrome. Gastroenterology 1977; 72: 1146.

    Google Scholar 

  43. Soltoft J, Gudmand-Hoyer E, Krag B, et al. A double blind trial of the effect of wheat bran on symptoms of irritable bowel syndrome. Lancet 1976; 1: 270–272.

    Article  PubMed  CAS  Google Scholar 

  44. Longstreth GF, Fox DD, Youkeles L, et al. Psyllium therapy in the irritable bowel syndrome. A double-blind trial. Ann Intern Med 1981; 95: 53–56.

    PubMed  CAS  Google Scholar 

  45. Cann PA, Read NW, Holds worth CD. What is the benefit of coarse wheat bran in patients with irritable bowel syndrome? Gut 1984; 25: 168–173.

    Article  PubMed  CAS  Google Scholar 

  46. Arffmann S, Andersen JR, Hegnhoj J, et al. The effect of coarse wheat bran in the irritable bowel syndrome. A double-blind cross-over study. Scand J Gastroenterol 1985; 20: 295–298.

    Article  PubMed  CAS  Google Scholar 

  47. Lucey MR, Clark ML, Loundes J, Dawson AM. Is bran efficacious in irritable bowel syndrome? A double blind placebo controlled cross-over study. Gut 1987; 28: 221–225.

    Article  PubMed  CAS  Google Scholar 

  48. Cook I J, Irvine EJ, Campbell D, et al. Effect of dietary fiber on symptoms and colonic motility in patients with IBS: a cross-over study. Gastroenterology 1988; 94 (5):A479.

    Google Scholar 

  49. Brodribb AJM, Condon RE, Cowles V, DeCosse JJ. Effect of dietary fiber on intraluminal pressure and myoelectrical activity of left colon in monkeys. Gastroenterology 1979; 77: 70–74.

    PubMed  CAS  Google Scholar 

  50. McLeish JA, Johnson AG. Low residue diet affects motility of the duodenum as well as the colon. In: Gastrointestinal Motility in Health and Disease. (Duthie HL, ed). Baltimore: University Park Press, 1978, pp. 185–194.

    Google Scholar 

  51. Fioramonti J, Bueno L. Motor activity in the large intestine of the pig related to dietary fibre and retention time. Br J Nutr 1980; 43: 155–162.

    Article  PubMed  CAS  Google Scholar 

  52. Burrows CF, Merritt AM. Influence of alpha-cellulose on myoelectrical activity of proximal canine colon. Am J Physiol 1983; 245: G301–G306.

    PubMed  CAS  Google Scholar 

  53. Chaudhary NA, Truelove SC. The irritable bowel syndrome. Am J Med 1962; 123: 307–322.

    Google Scholar 

  54. Collins SM, Vermillion DL, Randall B, Blennerhassett P. Repeated stress alters properties of intestinal smooth muscle. Dig Dis Sci 1989: 33 (3):482.

    Google Scholar 

  55. Chaudhary NA, Truelove SC. Human colonic motility: a comparative study of normal subjects, patients with ulcerative colitis and patients with the irritable colon syndrome. II. The effect of prostigmin. Gastroenterology 1961; 40: 18–26.

    PubMed  CAS  Google Scholar 

  56. Fox-Robichaud AE, Collins SM. Altered calcium handling properties of jejunal smooth muscle from the rat infected with the enteric parasite N. brasiliensis. Gastroenterology 1986; 91: 1462–1469.

    PubMed  CAS  Google Scholar 

  57. Vermillion DL, Collins SM. Increased responsiveness of jejunal longitudinal muscle in Tri-chinella-infected rats. Am J Physiol 1988; 254: G124–G129.

    PubMed  CAS  Google Scholar 

  58. Collins SM, Blennerhassett P, Vermillion DL, Blennerhassett M. Trichinella spiralis infection in the rat alters acetylcholine release from the myenteric plexus. Gastroenterology 1988; 94; (5):A75.

    Google Scholar 

  59. Swain M, Collins SM. Intestinal inflammation alters sympathetic nerve function in the rat myenteric plexus. Gastroenterology 1989; 96: A498.

    Google Scholar 

  60. Vermillion DL, Collins SM. Mast cells contract human intestinal muscle via the release of PAF and leukotriene D4 in patients with or without Crohn’s disease. Gastroenterology 1989; 96: A95.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Intestinal Diseases Research Unit, Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada, L8N 3Z5

    Stephen M. Collins

Authors
  1. Stephen M. Collins
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. The University of Alberta, Edmonton, Alberta, Canada

    Alan B. R. Thomson M.D., Ph.D.

  2. University of Calgary, Calgary, Alberta, Canada

    Eldon Shaffer M. D.

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer Science+Business Media New York

About this chapter

Cite this chapter

Collins, S.M. (1992). New Insights into the Pathogenesis and Pathophysiology of Irritable Bowel Syndrome. In: Thomson, A.B.R., Shaffer, E. (eds) Modern Concepts in Gastroenterology. Topics in Gastroenterology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3314-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-3314-6_9

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-6459-7

  • Online ISBN: 978-1-4615-3314-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation