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Background/Objective <p>Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder characterized by abdominal pain, bloating, and altered bowel habits in the absence of detectable structural or biochemical abnormalities. Despite its high global burden, the pathophysiology of IBS remains largely unknown. Current evidence suggests that IBS arises from multifactorial interactions involving genetic predisposition, visceral hypersensitivity, gut microbiota dysbiosis, immune dysregulation, and disturbances in the gut–brain axis. Psychosocial factors such as stress, anxiety, and depression further contribute to symptom severity. This review aims to summarize the current understanding of IBS pathogenesis and discuss emerging integrative management strategies.</p> Methods <p>A narrative review of recent literature was conducted, focusing on advances in IBS pathophysiology, diagnostic criteria, and therapeutic approaches. Studies related to microbiome alterations, immune and serotonergic signalling, and novel pharmacological and non-pharmacological treatments were examined. Diagnostic classification based on the Rome IV Criteria for Functional Gastrointestinal Disorders was also considered.</p> Results <p>IBS is classified into four clinical subtypes according to predominant bowel patterns: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M), and unclassified IBS (IBS-U). Increasing evidence highlights the roles of microbiome imbalance, immune activation, altered serotonergic pathways, and genetic susceptibility in disease progression. Recent therapeutic developments include targeted pharmacological agents such as Eluxadoline, Lubiprostone, and Rifaximin, alongside adjunctive treatments including selective serotonin reuptake inhibitors and probiotics. Dietary modification (e.g., low-FODMAP diet, increased soluble fiber), physiotherapy, and psychological interventions such as cognitive behavioral therapy and gut-directed hypnotherapy also demonstrate significant clinical benefit.</p> Conclusions <p>IBS management requires a comprehensive, multidisciplinary approach integrating pharmacological, dietary, and psychological interventions. Future research focusing on personalized and microbiome-targeted therapies may further improve outcomes and quality of life in IBS patients.</p> Graphical Abstract <p></p>

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Irritable Bowel Syndrome: Clinical Manifestations, Pathological Insights, Diagnostic Methods and Effective Management Strategies

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • Mudassir Alam,
  • Kashif Abbas,
  • Muskan Khan,
  • Rakshit Singh Saini,
  • Mohd Faraz

摘要

Background/Objective

Irritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder characterized by abdominal pain, bloating, and altered bowel habits in the absence of detectable structural or biochemical abnormalities. Despite its high global burden, the pathophysiology of IBS remains largely unknown. Current evidence suggests that IBS arises from multifactorial interactions involving genetic predisposition, visceral hypersensitivity, gut microbiota dysbiosis, immune dysregulation, and disturbances in the gut–brain axis. Psychosocial factors such as stress, anxiety, and depression further contribute to symptom severity. This review aims to summarize the current understanding of IBS pathogenesis and discuss emerging integrative management strategies.

Methods

A narrative review of recent literature was conducted, focusing on advances in IBS pathophysiology, diagnostic criteria, and therapeutic approaches. Studies related to microbiome alterations, immune and serotonergic signalling, and novel pharmacological and non-pharmacological treatments were examined. Diagnostic classification based on the Rome IV Criteria for Functional Gastrointestinal Disorders was also considered.

Results

IBS is classified into four clinical subtypes according to predominant bowel patterns: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M), and unclassified IBS (IBS-U). Increasing evidence highlights the roles of microbiome imbalance, immune activation, altered serotonergic pathways, and genetic susceptibility in disease progression. Recent therapeutic developments include targeted pharmacological agents such as Eluxadoline, Lubiprostone, and Rifaximin, alongside adjunctive treatments including selective serotonin reuptake inhibitors and probiotics. Dietary modification (e.g., low-FODMAP diet, increased soluble fiber), physiotherapy, and psychological interventions such as cognitive behavioral therapy and gut-directed hypnotherapy also demonstrate significant clinical benefit.

Conclusions

IBS management requires a comprehensive, multidisciplinary approach integrating pharmacological, dietary, and psychological interventions. Future research focusing on personalized and microbiome-targeted therapies may further improve outcomes and quality of life in IBS patients.

Graphical Abstract