Management Options for Irritable Bowel Syndrome

Mayo Clin Proc. 2018 Dec;93(12):1858-1872. doi: 10.1016/j.mayocp.2018.04.032.


Irritable bowel syndrome (IBS) is associated with diverse pathophysiologic mechanisms. These mechanisms include increased abnormal colonic motility or transit, intestinal or colorectal sensation, increased colonic bile acid concentration, and superficial colonic mucosal inflammation, as well as epithelial barrier dysfunction, neurohormonal up-regulation, and activation of secretory processes in the epithelial layer. Novel approaches to treatment include lifestyle modification, changes in diet, probiotics, and pharmacotherapy directed to the motility, sensation, and intraluminal milieu of patients with IBS. Despite recent advances, there is a need for development of new treatments to relieve pain in IBS without deleterious central or other adverse effects.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Cognitive Behavioral Therapy
  • Constipation / drug therapy
  • Constipation / etiology
  • Diet Therapy / methods*
  • Exercise
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Intestines / drug effects
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / physiopathology
  • Irritable Bowel Syndrome / therapy*
  • Visceral Pain / drug therapy
  • Visceral Pain / etiology
  • Visceral Pain / physiopathology


  • Antidepressive Agents
  • Gastrointestinal Agents