Mechanism-Oriented Therapy of Irritable Bowel Syndrome

Juan R Malagelada, Carolina Malagelada

Research output: Contribution to journalReview articleResearchpeer-review

3 Citations (Scopus)


Irritable bowel syndrome (IBS) is a common and well-accepted diagnosis but often imprecisely applied to patients in usual clinical practice. Diagnosis is entirely based on symptom criteria that tend to include broad strata of abdominal complainers. Established criteria for diagnosis are strictly followed in controlled clinical trials for new therapeutic agents, but physicians are more lax in the clinic. Predictably, in light of the above ambiguities, many pathogenetic mechanisms and pathophysiological disturbances appear to be involved in IBS, but so far no mechanism-based subgroupings to guide specific therapy have been soundly established. Thus, diverse therapeutic approaches coexist and are discretionally prescribed by attending clinicians on the basis of major manifestations (i.e., diarrhea-predominance or constipation-predominance), more or less apparent psychological disturbances, and patient preferences (pharmacological versus dietary or microbiological approaches). In this review, we have attempted to update scientific knowledge about the more relevant disease mechanisms involved and relate this more fundamental basis to the various treatment options available today.

Original languageEnglish
Pages (from-to)877-93
Number of pages17
JournalAdvances in Therapy
Issue number6
Publication statusPublished - Jun 2016


  • Disease Management
  • Humans
  • Irritable Bowel Syndrome/diagnosis
  • Symptom Assessment/methods


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