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New insights into the pathogenesis and pathophysiology of irritable bowel syndrome.

Review article
Authors Lena Öhman
Magnus Simrén
Published in Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
Volume 39
Issue 3
Pages 201-15
ISSN 1590-8658
Publication year 2007
Published at Institute of Biomedicine, Department of Microbiology and Immunology
Institute of Medicine, Department of Internal Medicine
Pages 201-15
Language en
Keywords Animals, Autonomic Nervous System, physiopathology, Disease Models, Animal, Gases, Genetic Predisposition to Disease, Humans, Hypothalamo-Hypophyseal System, physiopathology, Intestines, microbiology, Irritable Bowel Syndrome, etiology, pathology, physiopathology, psychology, Pituitary-Adrenal System, physiopathology, Serotonin, physiology
Subject categories Gastroenterology and Hepatology


The pathogenesis and pathophysiology of irritable bowel syndrome is complex and still incompletely known. Potential pathogenetic factors include genes, infectious events, psychological symptoms and other loosely defined environmental factors. Both alterations at the central and peripheral level are thought to contribute to the symptoms of irritable bowel syndrome, including psychosocial factors, abnormal gastrointestinal motility and secretion, and visceral hypersensitivity. Today irritable bowel syndrome is viewed upon as a disorder of dysregulation of the so-called brain-gut axis, involving abnormal function in the enteric, autonomic and/or central nervous systems, with peripheral abnormalities probably dominating in some patients and disturbed central processing of signals from the periphery in others. Lines of evidence also suggest that inflammation within the gastrointestinal tract may be of great importance in at least subgroups of irritable bowel syndrome patients. To conclude, a complex picture of the pathogenesis and pathophysiology of irritable bowel syndrome is emerging, with interactions between several different alterations resulting in the divergent symptom pattern in these patients.

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