Integrative Perspectives on Irritable Bowel Syndrome (IBS): Pathophysiology and Therapeutic Approaches in Western and Unani Medicine

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by recurrent abdominal pain, bloating, and altered bowel habits, occurring in the absence of any identifiable structural abnormalities. Despite extensive research, the exact pathophysiology of IBS remains unclear, and current treatment approaches in modern medicine are primarily focused on symptomatic relief. IBS is among the most prevalent functional gastrointestinal disorders and is attributed to a complex interplay of gut-brain axis dysfunction, visceral hypersensitivity, dysbiosis of gut microbiota, and psychosocial stressors. In contrast, Unani medicine conceptualizes IBS within the framework of humoral imbalance, emphasizing disturbances in digestive temperament and dysfunctions of the liver and intestines. Symptoms resembling IBS are elaborated in Unani literature under various conditions affecting the sub-faculties of Quwa-e-Tabi‘iyah (natural faculties), including entities such as Ishaal-eDimāghī, Ishāl-e-Idwārī, Zarb-wa-Khulfa, Asbi Dast, and disorders involving Balgham and Safrā’. Other contributing factors described include altered Harkat-e-Dūdiyah (peristaltic movements), increased activity of Urūq-e-Jāzibah (absorptive vessels), and disturbances in Asbāb-e-Sitta Zarūriyya (six essential factors), as well as various forms of Qaulanj (colic). Unani scholars advocate for a holistic treatment approach involving dietary regulation (Ilāj bil Ghidhā), herbal formulations (Ilāj bil Dawa), and regimental therapies (Ilāj bil Tadbīr) such as cupping (Hijāmah) and massage to restore gastrointestinal balance and overall health Irritable Bowel Syndrome (IBS), Functional Gastrointestinal Disorder, Gut-Brain Axis, Visceral Hypersensitivity, Unani Medicine, Quwa-e-Tabi‘iyah, Humoral Imbalance, Herbal Medicine 1. Shahid A, Riyazuddin M, Bhat MDA. Irritable Bowel Syndrome - Reviewed Through the Lens of Unani System of Medicine. Res Rev J Unani Siddha Homeopathy. 2020;9(1):1-6. 2. Malone M, Allen S, Katz J, McCauley M, Watson H. Irritable Bowel Syndrome: A Review and Update. SL Gastroenterol. 2018;1(2):118. 3. Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016;150:1257-61. 4. Rome Foundation. Rome IV diagnostic criteria for functional gastrointestinal disorders [Internet]. 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