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Abdominal Pain in Irritable Bowel Syndrome (IBS)

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Chronic Abdominal Pain

Abstract

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. Although not life threatening IBS causes years of suffering and impaired quality of life. The pathogenesis of IBS is not completely understood but probably involves interplay between peripheral and central mechanisms. IBS patients demonstrate peripheral visceral hypersensitivity and motility disturbances as well as maladaptive central processing of visceral pain inputs. Stress and comorbid psychopathologies, such as anxiety, depression, and somatization, are frequently seen and are associated with a more severe clinical presentation. Since IBS lacks any diagnostic finding or biomarker the diagnosis is based on the presence of a typical cluster of symptoms and the absence of clinical warning signs also known as “red flags.”

Although IBS treatment is suboptimal and palliative in nature, still much can be done to help these patients. The corner stone of therapy must be a good doctor–patient relationship based on the biopsychosocial model. Treatment options include a wide range of dietary modifications, pharmacological agents, and behavioral interventions.

This chapter reviews the epidemiology pathophysiology and treatment of IBS. Special focus is given to the rationale, evidence, and practical use of psychotropic agents in IBS.

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Authors and Affiliations

  1. Department of Gastroenterology, Tel Aviv Medical Center, Waitzman 6, Tel Aviv, Israel, 64239

    Roy Dekel M.D.

  2. Center for Education and Practice of Biopsychosocial Care and Center for Functional GI and Motility Disorders, Drossman Gastroenterology and University of North Carolina at Chapel Hill, 55 Vilcom Center Drive Suite 110, Chapel Hill, NC, 27514, USA

    Douglas A. Drossman M.D.

  3. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Ami D. Sperber M.D., M.S.P.H.

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  1. Roy Dekel M.D.
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  2. Douglas A. Drossman M.D.
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  3. Ami D. Sperber M.D., M.S.P.H.
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Correspondence to Roy Dekel M.D. .

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Editors and Affiliations

  1. Medical Director, Carolinas Pain Institute and Clinical Research Center, Professor of Anesthesiology, Wake Forest University, School of Medicine, Winston-Salem, North Carolina, USA

    Leonardo Kapural

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Dekel, R., Drossman, D.A., Sperber, A.D. (2015). Abdominal Pain in Irritable Bowel Syndrome (IBS). In: Kapural, L. (eds) Chronic Abdominal Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1992-5_6

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  • DOI: https://doi.org/10.1007/978-1-4939-1992-5_6

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