Need for a comprehensive medical approach to the neuroimmuno-gastroenterology of irritable bowel syndrome

Irritable bowel syndrome (IBS) is defined by the Rome Ⅲ criteria as symptoms of recurrent abdominal pain or discomfort with the onset of a marked change in bowel habits with no evidence of an inflammatory,anatomic,metabolic,or neoplastic process.As such,many clinicians regard IBS as a central nervous system problem of altered pain perception.Here,we review the recent literature and discuss the evidence that supports an organic based model,which views IBS as a complex,heterogeneous,inter-dependent,and multi-variable inflammatory process along the neuronal-gut axis.We delineate the organic pathophysiology of IBS,demonstrate the role of inflammation in IBS,review the possible differences between adult and pediatric IBS,discuss the merits of a comprehensive treatment model as taught by the Institute of Functional Medicine,and describe the potential for future research for this syndrome.