Abstract
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.
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References
Singh P, Staller K, Barshop K, et al. Patients with irritable bowel syndrome-diarrhea have lower disease-specific quality of life than irritable bowel syndrome-constipation. World J Gastroenterol. 2015;21:8103–9.
Holtmann GJ, Ford AC, Talley NJ. Pathophysiology of irritable bowel syndrome. Lancet Gastroenterol Hepatol. 2016;1:133–46.
Garrick TR. Gastrointestinal disorders. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry, vol. 2. 6th ed. Baltimore: Williams & Wilkins; 1995.
Longstreth GF, Wilson A, Knight K, et al. Irritable bowel syndrome, health care use, and costs: a U.S. managed care perspective. Am J Gastroenterol. 2003;98:600–7.
Sammons MT, Karoly P. Psychosocial variables in irritable bowel syndrome: a review and proposal. Clin Psychol Rev. 1987;7:187–204.
Lazaraki G, Chatzimavroudis G, Katsinelos P. Recent advances in pharmacological treatment of irritable bowel syndrome. World J Gastroenterol. 2014;20:8867–85.
Lee V, Guthrie E, Robinson A, et al. Functional bowel disorders in primary care: factors associated with health-related quality of life and doctor consultation. J Psychosom Res. 2008;64:129–38.
Deiteren A, de Wit A, van der Linden L, et al. Irritable bowel syndrome and visceral hypersensitivity: risk factors and pathophysiological mechanisms. Acta Gastroenterol Belg. 2016;79:29–38.
Holtmann G, Shah A, Morrison M. Pathophysiology of functional gastrointestinal disorders: a holistic overview. Dig Dis. 2017;35(Suppl 1):5–13.
Thompson WG. The irritable bowel: one disease, or several, or none? In: Read NW, editor. Irritable bowel syndrome. New York: Grune & Stratton; 1985.
Manning AP, Thompson WG, Heaton KW. Towards positive diagnosis of the irritable bowel. Br Med J. 1978;2:653–4.
Thompson DG, Laidlow JM, Wingate DL. Abnormal small-bowel motility demonstrated by radiotelemetry in a patient with irritable colon. Lancet. 1979;2:1321–3.
Waston WC, Sullivan SN, Corke M. Globus and headache: common symptoms of the irritable bowel syndrome. Can Med Assoc J. 1978;118:387–8.
Kellner R. Psychosomatic syndromes and somatic symptoms. Washington, DC: Am Psychiatric Press; 1991. p. 111–44.
Crowell MD, Harris L, Jones MP, et al. New insights into the pathophysiology of irritable bowel syndrome: implications for future treatments. Curr Gastroenterol Rep. 2005;7:272–9.
Hasler WL. Traditional thoughts on the pathophysiology of irritable bowel syndrome. Gastroenterol Clin N Am. 2011;40:21–43.
Pimentel M, Chang C. Inflammation and microflora. Gastroenterol Clin N Am. 2011;40:69–85.
Chaudhary NA, Truelove SC. Human colonic motility: a comparative study of normal subjects, patients with ulcerative colitis and patients with irritable colon syndrome. Gastroenterology. 1961;40:1–36.
Ritchie J. Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut. 1973;14:125–32.
Elsenbruch S. Abdominal pain in irritable bowel syndrome: a review of putative psychological, neural and neuro-immune mechanisms. Brain Behav Immun. 2011;25:386–94.
Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA. 2015;313:949–58.
Cook IJ, van Eeden A, Collins SM. Patients with irritable bowel syndrome have greater pain tolerance than normal subjects. Gastroenterology. 1987;93:727–33.
Almy TP. Experimental studies on the irritable colon. Am J Med. 1951;10:60–7.
Hislop IG. Psychological significance of the irritable colon syndrome. Gut. 1971;12:452–7.
Welgan P, Meshkinpour H, Beeler M. Effect of anger on colon motor and myoelectric activity in irritable bowel syndrome. Gastroenterology. 1988;94:1150–6.
Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011;62:591–9.
Qin HY, Cheng CW, Tang XD, et al. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20:14126–31.
Esler MD, Goulston KJ. Levels of anxiety in colonic disorders. N Engl J Med. 1973;288:16–20.
Drossman DA, McKee DC, Sandler RS. Psychosocial factors in the irritable bowel syndrome: a multivariate study of patients and non-patients with irritable bowel syndrome. Gastroenterology. 1988;95:701–8.
Smith RC, Greenbaum DS, Vancouver JB. Psychosocial factors are associated with health care seeking rather than diagnosis in irritable bowel syndrome. Gastroenterology. 1990;98:293–301.
Whitehead WE, Bosmajian L, Zonderman AB. Symptoms of psychologic distress associated with irritable bowel syndrome. Gastroenterology. 1988;95:709–14.
Lowman BC, Drossman DA, Cramer EM. Recollection of childhood events in adults with irritable bowel syndrome. J Clin Gastroenterol. 1987;9:324–30.
Hill OW, Blendis L. Physical and psychological evaluation of non-organic abdominal pain. Gut. 1967;8:221–9.
Whitehead WE, Schuster MM. Gastrointestinal disorders: behavioral and physiological basis for treatment. New York: Academic; 1985.
Latimer PR. Irritable bowel syndrome: a behavioral model. Behav Res Ther. 1981;19:475–83.
Latimer PR, Campbell D. Behavioral medicine and the functional bowel disorders. Int J Ment Health. 1980;9:111–28.
Walker EA, Roy-Byrne PP, Katon WJ. Irritable bowel syndrome and psychiatric illness. Am J Psychiatry. 1990;147:365–72.
Whitehead WE, Engel BT, Schuster MM. Irritable bowel syndrome: physiological and psychological differences between diarrhea-predominant and constipation-predominant patients. Dig Dis Sci. 1980;25:404–13.
Liss JL, Alpers D, Woodruff RA. The irritable colon syndrome and psychiatric illness. Dis Nerv Syst. 1973;34:151–7.
Young SJ, Alpers DH, Norland CC, Woodruff RA. Psychiatric illness and the irritable bowel syndrome. Gastroenterology. 1976;70:162–6.
Surdea-Blaga T, Baban A, Nedelcu L, et al. Psychological interventions for irritable bowel syndrome. J Gastrointestin Liver Dis. 2016;25:359–66.
Fava GA, Pavan L. Large bowel disorders: illness configuration and life events. Psychother Psychosom. 1976/1977;27:93–99.
Ford MJ, Miller PM, Eastwood J. Life events, psychiatric illness, and the irritable bowel syndrome. Gut. 1987;28:160–5.
Toner BB, Garfinkel PE, Jeejeebhoy KN. Self-schema in irritable bowel syndrome and depression. Psychosom Med. 1990;52:149–55.
West KL. MMPI correlates of ulcerative colitis. J Clin Psychol. 1970;26:214–9.
Schwarz SP, Blanchard EB, Berreman CF, et al. Psychological aspects of irritable bowel syndrome: comparisons with inflammatory bowel disease and nonpatient controls. Behav Res Ther. 1993;31:297–304.
Greenbaum DS, Mayle JE, Vanegeren LE. Effects of desipramine on irritable bowel syndrome compared with atropine and placebo. Dig Dis Sci. 1987;32:257–66.
Clouse RE. Antidepressants for functional gastrointestinal syndromes. Dig Dis Sci. 1994;39:2352–63.
Wise TN. Gastroenterology. In: Stoudemire A, Fogel BS, editors. Principles of medical psychiatry. New York: Grune & Stratton; 1987.
Simrén M. Hypnosis for irritable bowel syndrome: the quest for the mechanism of action. Int J Clin Exp Hypn. 2006;54:65–84.
Whorwell PJ, Prior A, Colgan SM. Hypnotherapy in severe irritable bowel syndrome: further experience. Gut. 1987;28:423–5.
Latimer PR. Irritable bowel syndromes. In: Dorfman W, Cristofar L, editors. Psychosomatic illness review. New York: Macmillan Publishing Co; 1985.
Tang QL, Lin GY, Zhang MQ. Cognitive-behavioral therapy for the management of irritable bowel syndrome. World J Gastroenterol. 2013;19:8605–10.
Lackner JM1, Jaccard J, Krasner SS, et al. How does cognitive behavior therapy for irritable bowel syndrome work? A mediational analysis of a randomized clinical trial. Gastroenterology. 2007;133:433–44.
Li L, Xiong L, Zhang S, et al. Cognitive-behavioral therapy for irritable bowel syndrome: a meta-analysis. J Psychosom Res. 2014;77:1–12.
Kanfer FH, Saslow G. Behavioral analysis. Arch Gen Psychiatry. 1965;12:529–38.
Waller SL, Misiewicz JJ. Prognosis in the irritable-bowel syndrome. Lancet. 1969;1:753–6.
Lancaster-Smith MJ, Prout BJ, Pinto T, et al. Influence of drug treatment on the irritable bowel syndrome and its interaction with psychoneurotic morbidity. Acta Psychiatr Scand. 1982;66:33–41.
Chaudhary NA, Truelove SC. The irritable colon syndrome. Q J Med. 1962;31:307–22.
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Koh, K.B. (2018). Approach to Irritable Bowel Syndrome. In: Stress and Somatic Symptoms. Springer, Cham. https://doi.org/10.1007/978-3-030-02783-4_23
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DOI: https://doi.org/10.1007/978-3-030-02783-4_23
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