Future Direction of Research and Treatment Possibility for Irritable Bowel Syndrome

There are many unsolved problems in the field of irritable bowel syndrome (IBS). Actually considerable patients with IBS do not respond to the standard treatments. This fact implies that we do not fully understand the pathogenesis and pathophysiology of IBS. Besides, treatment for IBS has not been completed systematically. Therefore, it is necessary to investigate unsolved aspects of pathogenesis and pathophysiology of IBS and develop new treatments for IBS in the very near future. The first point is whether Rome IV IBS patients are more homogenous in pathophysiology than Rome III IBS patients. The second point is whether there is more clinical merit to diagnose IBS with Rome IV criteria than that to do with Rome III criteria. The most important things are to increase studies measuring pathophysiology of IBS including difference among IBS subtypes. Future direction of pathogenesis will be a combination of following factors: gut microbiota, stress, and susceptible genes. Future direction of treatment will be 5-HT3 antagonist, 5-HT4 agonist, intestinal secretagogues, ileal bile acid transporter inhibitor, sodium-glucose cotransporter 1 inhibitors, and many other novel agents and treatments. Research interest in IBS is largely expanding in the world. Further research including pathophysiology, pathogenesis, and treatment will improve the quality of life of IBS patients.