IRRITABLE BOWEL SYNDROME - PATHOGENESIS, EPIDEMIOLOGY, TREATMENT

Irritable bowel syndrome (IBS) is a common disorder of gut–brain interaction characterized by recurrent abdominal pain and altered bowel habits, including diarrhea, constipation, or mixed patterns. Despite its significant impact on quality of life and healthcare systems, IBS remains underdiagnosed. Diagnosis is based on the Rome IV criteria, which emphasize symptom patterns rather than structural abnormalities. The pathogenesis of IBS is multifactorial and not fully understood, involving low-grade intestinal inflammation, immune activation, alterations in the gut microbiota, and dysregulation of the gut–brain axis, as well as psychological factors such as stress, anxiety, and depression. Epidemiological data show substantial global variation in IBS prevalence, influenced by geographic, methodological, and diagnostic differences. Recent meta-analyses estimate a global prevalence of approximately 14%, with higher rates observed in women and individuals experiencing psychological distress. Post-infectious IBS is also increasingly recognized, with a significantly elevated risk following acute gastroenteritis. Management of IBS requires a multidisciplinary and individualized approach. First-line strategies include patient education, dietary modifications, and stress management. Pharmacological treatments are selected based on the predominant symptom subtype, with options including antibiotics such as rifaximin for IBS-D and laxatives or secretagogues for IBS-C. Increasing attention has been given to microbiota-targeted therapies, including probiotics and fecal microbiota transplantation. Dietary interventions, particularly the low FODMAP diet, have shown effectiveness in reducing global IBS symptoms, although long-term adherence requires careful supervision. Overall, advances in research and treatment strategies offer promising prospects for improving symptom control, patient outcomes, and disease awareness.