Irritable bowel syndrome; update on pathophysiology and management

Turkish Journal of Gastroenterology

Volumn 23, Issue 4, 2012, Pages 313-322

  Quigley, Eamonn M M ^a   Craig, Orla F ^a  

^a UNIVERSITY COLLEGE CORK   (Ireland)

Author keywords

Irritable bowel syndrome; Management; Pathophysiology; Post infectious IBS

Indexed keywords

ALOSETRON; ALVERINE; ANTIBIOTIC AGENT; ANTIDEPRESSANT AGENT; ANTIDIARRHEAL AGENT; AT 7505; CLARITHROMYCIN; GUANYLATE CYCLASE; ISPAGULA; LAXATIVE; LINACLOTIDE; LOPERAMIDE; LUBIPROSTONE; MEBEVERINE; METRONIDAZOLE; NEOMYCIN; PEPPERMINT OIL; PROBIOTIC AGENT; PRUCALOPRIDE; RAMOSETRON; RIFAXIMIN; SCOPOLAMINE; SEROTONIN 4 AGONIST; SEROTONIN UPTAKE INHIBITOR; SPASMOLYTIC AGENT; TEGASEROD; TRICYCLIC ANTIDEPRESSANT AGENT; UNCLASSIFIED DRUG; VELUSETRAG;

ABDOMINAL CRAMP; ABDOMINAL DISCOMFORT; ABDOMINAL PAIN; BLASTOCYSTIS HOMINIS; BLOATING; CARDIOTOXICITY; COLON FLORA; CONSTIPATION; DIARRHEA; DIENTAMOEBA; DIET THERAPY; DIETARY FIBER; DISEASE SEVERITY; DRUG EFFICACY; DRUG SAFETY; DRUG TOLERABILITY; GASTROENTERITIS; GASTROINTESTINAL DISEASE; GIARDIA; HEARTBURN; HEPATIC ENCEPHALOPATHY; HUMAN; IMMUNE RESPONSE; IMMUNOPATHOLOGY; INFLAMMATION; INTESTINE EPITHELIUM CELL; INTESTINE FLORA; INTESTINE MUCOSA; IRRITABLE COLON; ISCHEMIC COLITIS; NAUSEA; NONHUMAN; PALLIATIVE THERAPY; PATHOPHYSIOLOGY; POSTPRANDIAL STATE; PROTEIN LOCALIZATION; REVIEW; TRAVELLER DIARRHEA; UNSPECIFIED SIDE EFFECT; VIRAL GASTROENTERITIS; VOMITING; WHEAT BRAN;

ANTI-BACTERIAL AGENTS; ANTIDEPRESSIVE AGENTS; ANTIDIARRHEALS; CHLORIDE CHANNELS; COLITIS; COLON; DIETARY FIBER; HUMANS; INTESTINE, SMALL; IRRITABLE BOWEL SYNDROME; LAXATIVES; PREBIOTICS; PROBIOTICS; PSYCHOTHERAPY; SEROTONIN RECEPTOR AGONISTS;

EID: 84866514495     PISSN: 13004948     EISSN: None     Source Type: Journal    
DOI: 10.4318/tjg.2012.0551     Document Type: Review

References (134)

1. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006;130:1377-90.
2. Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993; 38:1569-80.
3. Drossman DA, Creed FH, Olden KW, et al. Psychosocial aspects of the functional gastrointestinal disorders. Gut 1999;45 Suppl 2:II25-30.
4. Koloski NA, Talley NJ, Boyce PM. The impact of functional gastrointestinal disorders on quality of life. Am J Gastroenterol 2000;95:67-71.
5. Akehurst RL, Brazier JE, Mathers N, et al. Health-related quality of life and cost impact of irritable bowel syndrome in a UK primary care setting. Pharmacoeconomics 2002; 20:455-62.
6. Maxion-Bergemann S, Thielecke F, Abel F, Bergemann R. Costs of irritable bowel syndrome in the UK and US. Pharmacoeconomics 2006;24:21-37.
7. Drossman DA, Dumitrascu DL. Rome III: New standard for functional gastrointestinal disorders. J Gastrointestin Liver Dis 2006;15:237-41.
8. Thompson WG, Irvine EJ, Pare P, et al. Functional gastrointestinal disorders in Canada: first population-based survey using Rome II criteria with suggestions for improving the questionnaire. Dig Dis Sci 2002;47:225-35.
9. Wang A, Liao X, Xiong L, et al. The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria. BMC Gastroenterol 2008;8:43.
10. Savarino E, Pohl D, Zentilin P, et al. Functional heartburn has more in common with functional dyspepsia than with non-erosive reflux disease. Gut 2009;58:1185-91.
11. Longstreth GF, Drossman DA. Severe irritable bowel and functional abdominal pain syndromes: managing the patient and health care costs. Clin Gastroenterol Hepatol 2005;3:397-400.
12. rd. The epidemiology of irritable bowel syndrome in North America: a systematic review. Am J Gastroenterol 2002;97:1910-5.
13. Quigley EM, Bytzer P, Jones R, Mearin F. Irritable bowel syndrome: the burden and unmet needs in Europe. Dig Liver Dis 2006;38:717-23.
14. Trimble KC, Farouk R, Pryde A, Douglas S, Heading RC. Heightened visceral sensation in functional gastrointestinal disease is not site-specific. Evidence for a generalized disorder of gut sensitivity. Dig Dis Sci 1995;40:1607-13.
15. Aziz Q, Thompson DG, Ng VW, et al. Cortical processing of human somatic and visceral sensation. J Neurosci 2000;20:2657-63.
16. McKee DP, Quigley EM. Intestinal motility in irritable bowel syndrome: is IBS a motility disorder? Part 2. Motility of the small bowel, esophagus, stomach, and gall-bladder. Dig Dis Sci 1993;38:1773-82.
17. Guarner F, Malagelada JR. Gut flora in health and disease. Lancet 2003; 361:512-9.
18. O'Hara AM, Shanahan F. Gut microbiota: mining for therapeutic potential. Clin Gastroenterol Hepatol 2007;5:274-284.
19. Spiller RC. Postinfectious irritable bowel syndrome. Gastroenterology 2003;124:1662-71.
20. McKendrick MW, Read MW. Irritable bowel syndrome - post-salmonella infection. J Infect 1994;29:1-3.
21. Neal KR, Hebdon J, Spiller R. Prevalence of gastrointestinal symptoms six months after bacterial gastroenteritis and risk factors for development of the irritable bowel syndrome. Br Med J 1997;314:779-82.
22. Garcia Rodriguez LA, Ruigomez A. Increased risk of irritable bowel syndrome after bacterial gastroenteritis: cohort study. Br Med J 1999;318:565-6.
23. Gwee KA, Graham JC, McKendrick MW et al. Psychometric scores and persistence of irritable bowel after infectious diarrhoea. Lancet 1996;347:150-3.
24. Gwee KA, Leong YL, Graham C, et al. The role of psychological and biological factors in post-infective gut dysfunction. Gut 1999;44:400-6.
25. Spiller RC, Jenkins D, Thornley JP, et al. Increased rectal mucosal enteroendocrine cells T lymphocytes and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut 2000;47:804-11.
26. Dunlop SP, Jenkins D, Neal KR, Spiller RC. Relative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS. Gastroenterology 2003;125:1651-9.
27. Mearin F, Perez-Oliveras M, Perello A et al. Dyspepsia and irritable bowel syndrome after a Salmonella gastroenteritis outbreak: one-year follow-up cohort study. Gastroenterology 2005;129:98-104.
28. Marshall JK, Thabane M, Garg AX, Clark WF, Salvadori M, Collins SM; Walkerton Health Study Investigators. Incidence and epidemiology of irritable bowel syndrome after a large waterborne outbreak of bacterial dysentery. Gastroenterology 2006;131:445-50.
29. Tornblom H, Holmvall P, Svenungsson B, Lindberg G. Gastrointestinal symptoms after infectious diarrhea: a five-year follow-up in a Swedish cohort of adults. Clin Gastroenterol Hepatol 2007;5:461-4.
30. Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis Gut. 2007;56:1066-71.
31. Ruigomez A, Garcia Rodriguez LA, Panes J. Risk of irritable bowel syndrome after an episode of bacterial gastroenteritis in general practice: influence of comorbidities. Clin Gastroenterol Hepatol 2007;5:465-9.
32. Thabane M, Kottachchi DT, Marshall JK. Systematic review and meta-analysis: the incidence and prognosis of postinfectious irritable bowel syndrome. Aliment Pharmacol Ther 2007;26535-44.
33. Neal KR, Barker L, Spiller RC. Prognosis in post-infective irritable bowel syndrome: a six year follow up study. Gut 2002;51:410-3.
34. McKeown ES, Parry SD, Stansfield R, et al. Postinfectious irritable bowel syndrome may occur after non-gastrointestinal and intestinal infection. Neurogastroenterol Motil 2006;18:839-43.
35. Stark D, van Hal S, Marriott D, et al. Irritable bowel syndrome: a review on the role of intestinal protozoa and the importance of their detection and diagnosis. Int J Parasitol, 2007;37:11-20.
36. Grazioli B, Matera G, Laratta C, et al. Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia: a prospective study. World J Gastroenterol 2006;12:1941-4.
37. Marshall JK, Thabane M, Borgaonkar MR, James C. Postinfectious irritable bowel syndrome after a food-borne outbreak of acute gastroenteritis attributed to a viral pathogen. Clin Gastroenterol Hepatol 2007;5:457-60.
38. Borgaonkar MR, Ford DC, Marshall JK, et al. The incidence of irritable bowel syndrome among community subjects with previous acute enteric infection. Dig Dis Sci 2006;51: 1026-32.
39. Chadwick V, Chen W, Shu D, et al. Activation of the mucosal immune system in irritable bowel syndrome. Gastroenterology 2002;122:1778-83.
40. Holmen N, Isaksson S, Simren M, et al. CD4+CD25+ regulatory T cells in irritable bowel syndrome patients. Neurogastroenterol Motil 2007;19:119-25.
41. Ohman L, Isaksson S, Lundgren A, et al. A controlled study of colonic immune activity and beta7+ blood T lymphocytes in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 2005;3:980-6.
42. Barbara G, Stanghellini V, De Giorgio R et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology 2004;126:693-702.
43. Barbara G, Wang B, Stanghellini V, et al. Mast cell-dependent excitation of visceral-nociceptive sensory neurons in irritable bowel syndrome. Gastroenterology. 2007;132:26-37.
44. Cenac N, Andrews CN, Holzhausen M, et al. Role for protease activity in visceral pain in irritable bowel syndrome. J Clin Invest 2007;117:636-47.
45. Guilarte M, Santos J, de Torres I, et al. Diarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum. Gut 2007;56:203-9.
46. Tornblom H, Lindberg G, Nyberg B, Veress B. Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome. Gastroenterology 2002;123:1972-9.
47. O'Mahony L, McCarthy J, Kelly P, et al. A Randomized, placebo-controlled, double-blind comparison of the probiotic bacteria lactobacillus and bifidobacterium in irritable bowel syndrome (IBS): symptom responses and relationship to cytokine profiles. Gastroenterology 2005;128:541-51.
48. Liebregts T, Adam B, Bredack C, et al. Immune activation in patients with irritable bowel syndrome. Gastroenterology 2007;132:913-20.
49. Dinan TG, Quigley EM, Ahmed SM, et al. Hypothalamic - pituitary - gut axis dysregulation in irritable bowel syndrome: plasma cytokines as a potential biomarker? Gastroenterology 2006;130:304-11.
50. Collins SM. A case for an immunological basis for irritable bowel syndrome. Gastroenterology 2002;122:2078-80.
51. Spiller RC. Role of nerves in enteric infection. Gut 2002;51: 759-62.
52. Gonsalkorale WM, Perrey C, Pravica V, et al. Interleukin 10 genotypes in irritable bowel syndrome: evidence for an inflammatory component? Gut 2003;52:91-3.
53. van der Veek PP, van den Berg M, de Kroon YE, et al. Role of tumor necrosis factor-alpha and interleukin-10 gene polymorphisms in irritable bowel syndrome. Am J Gastroenterol 2005;100:2510-6.
54. Schoepfer AM, Schaffer T, Seibold-Schmid B, et al. Antibodies to flagellin indicate reactivity to bacterial antigens in IBS patients. Neurogastroenterol Motil 2008;20:1110-8.
55. Ivison SM, Steiner TS. Anti-flagellin antibodies in irritable bowel syndrome: another attack on our commensals! Neurogastroenterol Motil 2008;20:1081-5.
56. Langhorst J, Junge A, Rueffer A, et al. Elevated human beta-defensin-2 levels indicate an activation of the innate immune system in patients with irritable bowel syndrome. The Am J Gastroenterol 2009;104:404-10.
57. Brint EK, MacSharry J, Fanning A, et al. Differential Expression of Toll-Like Receptors (TLRs) in patients with Irritable Bowel Syndrome. Am J Gastroenterol 2011;106: 329-36.
58. Kirsch R, Riddell RH. Histopathological alterations in irritable bowel syndrome. Mod Pathol 2006;19:1638-45.
59. Bradley HK, Wyatt GM, Bayliss CE, Hunter JO. Instability in the faecal flora of a patient suffering from food-related irritable bowel syndrome. J Med Microbiol 1987;23:29-32.
60. Si JM, Yu YC, Fan YJ, Chen SJ. Intestinal microecology and quality of life in irritable bowel syndrome patients. World J Gastroenterol 2004;10:1802-5.
61. Malinen E, Rinttila T, Kajander K, et al. Analysis of the fecal microbiota of irritable bowel syndrome patients and healthy controls with real-time PCR. Am J Gastroenterol 2005;100:373-82.
62. Matto J, Maunuksela L, Kajander K, et al. Composition and temporal stability of gastrointestinal microbiota in irritable bowel syndrome - a longitudinal study in IBS and control subjects. FEMS Immunol Med Microbiol 2005;43:213-22.
63. King TS, Elia M, Hunter JO. Abnormal colonic fermentation in irritable bowel syndrome. Lancet 1998;352:1187-9.
64. Dear KL, Elia M, Hunter JO. Do interventions which reduce colonic bacterial fermentation improve symptoms of irritable bowel syndrome? Dig Dis Sci 2005;50:758-66.
65. Maukonen J, Satokari R, Matto J, et al. Prevalence and temporal stability of selected clostridial groups in irritable bowel syndrome in relation to predominant faecal bacteria. J Med Microbiol 2006;55:625-33.
66. Kassinen A, Krogius-Kurikka L, Makivuokko H, et al. The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subjects. Gastroenterology 2007;133:24-33.
67. Codling C, O'Mahony L, Shanahan F, et al. A molecular analysis of fecal and mucosal bacterial communities in irritable bowel syndrome. Dig Dis Sci. 2010;55:392-7.
68. Pimentel M, Chow EJ, Lin HC. Eradication of small bowel bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol 2000;95:3503-6.
69. Pimentel M, Chow E, Lin H. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome: a double-blind, randomized, placebo-controlled study. Am J Gastroenterol 2003;98:412-9.
70. McCallum R, Schultz C, Sostarich S. Evaluating the role of small intestinal bacterial overgrowth (SIBO) in diarrhea predominant IBS (IBS-D) patients utilizing the glucose breath test. Gastroenterology 2005;128:T1118.
71. Nucera G, Gabrielli A, Lupascu A, et al. Abnormal breath tests to lactose, fructose and sorbitol in irritable bowel syndrome may be explained by small intestinal bacterial overgrowth. Aliment Pharmacol Ther 2005; 21: 1391-5.
72. Cuoco L, Salvagnini M. Small intestine bacterial overgrowth in irritable bowel syndrome: a retrospective study with rifaximin. Minerva Gastroenterol Dietol 2006;52:89-95.
73. Pimentel M, Soffer EE, Chow EJ, et al. Lower frequency of MMC is found in IBS subjects with abnormal lactulose breath test, suggesting bacterial overgrowth. Dig Dis Sci 2002;47:2639-43.
74. Majewski M, McCallum RW. Results of small intestinal bacterial overgrowth testing in irritable bowel syndrome patients: clinical profiles and effects of antibiotic trial. Adv Med Sci 2007;52:139-42.
75. Esposito I, de Leone A, Di Gregorio G, et al. Breath test for differential diagnosis between small intestinal bacterial overgrowth and irritable bowel disease: an observation on non-absorbable antibiotics. World J Gastroenterol 2007; 13:6016-21.
76. Weinstock LB, Fern SE, Duntley SP. Restless legs syndrome in patients with irritable bowel syndrome: response to small intestinal bacterial overgrowth therapy. Dig Dis Sci 2008;53:1252-6.
77. Weinstock LB, Klutke CG, Lin HC. Small intestinal bacterial overgrowth in patients with interstitial cystitis and gastrointestinal symptoms. Dig Dis Sci 2008;53:1246-51.
78. Cuoco L, Cammarota G, Jorizzo R, et al. Small intestinal bacterial overgrowth and symptoms of irritable bowel syndrome. Am J Gastroenterol 2001;96:2281-2.
79. Jones MP, Craig R, Olinger E. Small intestinal bacterial overgrowth is associated with irritable bowel syndrome: the cart lands squarely in front of the horse. Am J Gastroenterol 2001;96:3204-5.
80. Mishkin D, Mishkin S. Re: Pimentel et al. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol 2001;96: 2505-6.
81. Riordan SM, McIver CJ, Duncombe VM, et al. Small intestinal bacterial overgrowth and the irritable bowel syndrome. Am J Gastroenterol 2001;96:2506-8.
82. Hasler WL. Lactulose breath testing, bacterial overgrowth, and IBS: just a lot of hot air? Gastroenterology 2003;125:1898-900.
83. Quigley EM. A 51-year-old with irritable bowel syndrome: test or treat for bacterial overgrowth? Clin Gastroenterol Hepatol 2007;5:1140-3.
84. Vanner S. The small intestinal bacterial overgrowth. Irritable bowel syndrome hypothesis: implications for treatment. Gut 2008;57:1315-21.
85. Ford AC, Spiegel BM, Talley NJ, Moayyedi P. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. Clin Gastroenterol Hepatol 2009;7:1279-86.
86. Simrén M, Stotzer P-O. Use and abuse of hydrogen breath tests. Gut 2006;55:297-393.
87. Vanner S. The lactulose bresth test for diagnosing SIBO in IBS patients: another nail in the coffin. Am J Gastroenterol 2008;103:964-5.
88. Parisi G, Leandro G, Bottona E, et al. Small intestinal bacterial overgrowth and irritable bowel syndrome. Am J Gastroenterol 2003;98:2572.
89. 14C-d-Xylose and healthy controls. Am J Gastroenterol 2005;100:1566-70.
90. Posserud I, Stotzer PO, Bjornsson E, et al. Small intestinal bacterial overgrowth in patients with irritable bowel syndrome. Gut 2006;56:802-8.
91. Bratten JR, Spanier J, Jones MP. Lactulose breath testing does not discriminate patients with irritable bowel syndrome from healthy controls. Am J Gastroenterol 2008;103: 958-63.
92. Ford AC, Talley NJ, Spiegel BM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ 2008;337:a2313.
93. Hills JM, Aaronson PI. The mechanism of action of peppermint oil on gastrointestinal smooth muscle. An analysis using patch clamp electrophysiology and isolated tissue pharmacology in rabbit and guinea pig. Gastroenterology 1991;101:55-65.
94. 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; 20:295-8.
95. Snook J, Shepherd HA. Bran supplementation in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 1994;8:511-4.
96. Brandt LJ, Chey WD, Foxx-Orenstein AE, et al. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol 2009;104 Suppl 1:S1-35.
97. 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.
98. McQuay HJ, Tramer M, Nye BA, et al. systematic review of antidepressants in neuropathic pain. Pain 1996;68:217-27.
99. Ford AC, Talley NJ, Schoenfeld PS, et al. Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis. Gut 2009;58:367-78.
100. Gorard DA, Libby GW, Farthing MJ. Influence of antidepressants on whole gut and orocaecal transit times in health and irritable bowel syndrome. Aliment Pharmacol Ther 1994;8:159-66.
101. Chial HJ, Camilleri M, Burton D, et al. Selective effects of serotonergic psychoactive agents on gastrointestinal functions in health. Am J Physiol Gastrointest Liver Physiol 2003;284:G130-7.
102. Pae CU, Masand PS, Ajwani N, et al. Irritable bowel syndrome in psychiatric perspectives: a comprehensive review. Int J Clin Pract 2007;61:1708-18.
103. Pimentel M, Chow EJ, Lin HC. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study. Am J Gastroenterol 2003;98:412-9.
104. Nayak AK, Karnad DR, Abraham P, Mistry FP. Metronidazole relieves symptoms in irritable bowel syndrome: the confusion with so-called 'chronic amebiasis'. Indian J Gastroenterol 1997;16:137-9.
105. Pimentel M. Review of rifaximin as treatment for SIBO and IBS. Expert Opin Investig Drugs 2009;18:349-58.
106. Sharara AI, Aoun E, Abdul-Baki H, et al. A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence. Am J Gastroenterol 2006;101:326-33.
107. Pimentel M, Park S, Mirocha J, et al. The effect of a non-absorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial. Ann Intern Med 2006;145:557-63.
108. Lembo A, Zakko SF, Ferreira NL, et al. Rifaximin for the treatment of diarrhea-associated irritable bowel syndrome: short-term treatment leading to long term sustained response. Gastroenterology 2008; 134:A-545.
109. Ringel Y, Zakko SF, Ferreira NL, et al. Predictors of clinical response from a phase 2 multi-center efficacy trial using rifaximin, a gut-selective, nonabsorbed antibiotic for the treatment of diarrhea-associated irritable bowel syndrome. Gastroenterology 2008;134:A-550.
110. Pimentel M, Lembo A, Chey WD, et al., for the TARGET Study Group. Rifaximin therapy for patients with irritable bowel syndrome without constipation. New Engl J Med 2011;364:22-32.
111. Moayyedi P, Ford AC, Talley NJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut 2010;59:325-32.
112. Brenner DM, Moeller MJ, Chey WD, Schoenfeld PS. The Utility of Probiotics in the Treatment of Irritable Bowel Syndrome: A Systematic Review. Am J Gastroenterol 2009;104:1033-49.
113. Quigley EM. Prebiotics for irritable bowel syndrome. Expert Rev Gastroenterol Hepatol 2009;3:487-92.
114. Silk DB, Davis A, Vulevic J, et al. Clinical trial: the effects of a trans-galactooligosaccharide prebiotic on faecal microbiota and symptoms in irritable bowel syndrome. Aliment Pharmacol Ther 2009;29:508-18.
115. Ambizas EM, Ginzburg R. Lubiprostone: a chloride channel activator for treatment of chronic constipation. Ann Pharmacother 2007;41:957-64.
116. Johanson JF, Morton D, Geenen J, Ueno R. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of lubiprostone, a locally-acting type-2 chloride channel activator, in patients with chronic constipation. Am J Gastroenterol 2008;103:170-7.
117. Drossman DA, Chey WD, Johanson JF, et al. Clinical trial: lubiprostone in patients with constipation-associated irritable bowel syndrome - results of two randomized, placebo-controlled studies. Aliment Pharmacol Ther 2009;29: 329-41.
118. Andresen V, Camilleri M, Busciglio IA, et al. Effect of 5 days linaclotide on transit and bowel function in females with constipation- predominant irritable bowel syndrome. Gastroenterology 2007;133:761-8.
119. Johnston JM, Kurtz CB, Macdougall JE, et al. Linaclotide improves abdominal pain and bowel habits in a phase IIb study of patients with irritable bowel syndrome with constipation. Gastroenterology 2010;139:1877-1886.
120. Camilleri M. Review article: new receptor targets for medical therapy in irritable bowel syndrome. Aliment Pharmacol Ther 2010;31:35-46.
121. Kim DY, Camilleri M. Serotonin: a mediator of the braingut connection. Am J Gastroenterol 2000;95:2698-709.
122. Ford AC, Brandt LJ, Young C, et al. Efficacy of 5-HT3 antagonists and 5-HT4 agonists in irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol 2009;104:1831-43; quiz 44.
123. Camilleri M, Kerstens R, Rykx A, Vandeplassche L. A placebo- controlled trial of prucalopride for severe chronic constipation. N Engl J Med 2008;358:2344-54.
124. Quigley EM, Vandeplassche L, Kerstens R, Ausma J. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation - a 12-week, randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther 2009;29:315-28.
125. Tack J, van Outryve M, Beyens G, et al. Prucalopride (Resolor) in the treatment of severe chronic constipation in patients dissatisfied with laxatives. Gut 2009;58:357-65.
126. Matsueda K, Harasawa S, Hongo M, et al. A phase II trial of the novel serotonin type 3 receptor antagonist ramosetron in Japanese male and female patients with diarrhea- predominant irritable bowel syndrome. Digestion 2008; 77:225-35.
127. Matsueda K, Harasawa S, Hongo M, et al. A randomized, double-blind, placebo-controlled clinical trial of the effectiveness of the novel serotonin type 3 receptor antagonist ramosetron in both male and female Japanese patients with diarrhea-predominant irritable bowel syndrome. Scand J Gastroenterol 2008;43:1202-11.
128. Ragnarsson G, Bodemar G. Pain is temporally related to eating but not to defaecation in the irritable bowel syndrome (IBS). Patients' description of diarrhea, constipation and symptom variation during a prospective 6-week study. Eur J Gastroenterol Hepatol 1998;10:415-21.
129. Simren M, Mansson A, Langkilde AM, et al. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion 2001;63:108-15.
130. Dainese R, Galliani EA, De Lazzari F, et al. Discrepancies between reported food intolerance and sensitization test findings in irritable bowel syndrome patients. Am J Gastroenterol 1999;94:1892-7.
131. Zwetchkenbaum J, Burakoff R. The irritable bowel syndrome and food hypersensitivity. Ann Allergy 1988;61: 47-9.
132. Morcos A, Dinan T, Quigley EM. Irritable bowel syndrome: role of food in pathogenesis and management. J Dig Dis 2009;10:237-46.
133. Park MI, Camilleri M. Is there a role of food allergy in irritable bowel syndrome and functional dyspepsia? A systematic review. Neurogastroenterol Motil 2006;18:595-607.
134. Zijdenbos IL, de Wit NJ, van der Heijden GJ, et al. Psychological treatments for the management of irritable bowel syndrome. Cochrane Database Syst Rev 2009:CD006442.