IRRITABLE BOWEL SYNDROME: A COMPREHENSIVE REVIEW OF CURRENT KNOWLEDGE

Maksymilian Szklarski; Jędrzej Sztajura; Karol Józef Szkarłat; Szymon Targosz; Michał  Stachel; Ewa Maraszewska; Weronika Szymacha; Aleksandra Płecka; Karol Zimnicki; Alicja Stępień

doi:10.31435/ijitss.2(50).2026.5315

Authors

Maksymilian Szklarski Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0001-6977-0666
Jędrzej Sztajura Students’ Scientific Club, Department of Neurosurgery, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0009-8975-731X
Karol Józef Szkarłat Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0004-2889-8382
Szymon Targosz Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0005-2251-5229
Michał Stachel Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0008-3264-4747
Ewa Maraszewska Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0003-0992-7144
Weronika Szymacha Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland https://orcid.org/0009-0000-1592-5602
Aleksandra Płecka Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0007-0075-5234
Karol Zimnicki Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0001-9687-2641
Alicja Stępień Voivodship Dental Clinic, Consulting Dental Prosthetics Department, Cracow, Poland https://orcid.org/0009-0003-2717-6030

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5315

Keywords:

Irritable Bowel Syndrome; Gut-Brain Interaction; Rome IV Criteria

Abstract

Introduction and purpose: Irritable bowel syndrome (IBS) is a chronic intestinal disorder and a prevalent disorder of gut-brain interaction (DGBI) that significantly impairs daily functioning and quality of life. While the exact pathophysiology is not fully understood, a multifactorial etiology involving biological, genetic, and psychological influences is postulated. This review aims to condense findings from various studies into a single, accessible overview, emphasizing practical strategies for diagnosis and treatment.

Materials and methods: This review analyzed 34 articles published between 1973 and 2026, identified through an extensive PubMed search. The timeframe bridges historical clinical accounts with contemporary research. The study focused on synthesizing data related to diagnostic protocols and current treatment strategies.

Description of the state of knowledge: Diagnosis currently utilizes the 2016 Rome IV criteria, which prioritize recurrent abdominal pain associated with changes in bowel frequency or stool consistency. IBS is categorized into four subtypes based on the Bristol Stool Form Scale: IBS-C, IBS-D, IBS-M, and IBS-U. Pathophysiological factors include genetic mutations, and psychological distress, which affects up to 80% of patients. Management involves lifestyle changes like increased physical activity, dietary modifications such as the Low FODMAP diet, and psychological therapies including specialised CBT and hypnotherapy. Pharmacotherapy is tailored to the clinical subtype, utilizing antispasmodics, laxatives, and antidepressants.

Conclusions: IBS management remains challenging due to high individual variability and frequent relapses. Sustained remission requires a multidisciplinary strategy addressing both somatic manifestations and the significant psychological burden of the disorder.

References

Ford, A. C., Sperber, A. D., Corsetti, M., & Camilleri, M. (2020). Irritable bowel syndrome. The Lancet, 396(10263), 1675–1688. https://doi.org/10.1016/S0140-6736(20)31548-8

Sebastián Domingo, J. J. (2022). Irritable bowel syndrome. Medicina Clínica, 158(2), 76–81. https://doi.org/10.1016/j.medcli.2021.04.029

Huang, K. Y., Wang, F. Y., Lv, M., Ma, X. X., Tang, X. D., & Lv, L. (2023). Irritable bowel syndrome: Epidemiology, overlap disorders, pathophysiology and treatment. World Journal of Gastroenterology, 29(26), 4120–4135. https://doi.org/10.3748/wjg.v29.i26.4120

Woods, A. T., Ford, A. C., & Black, C. J. (2026). All in my head or all in my gut? An update on irritable bowel syndrome. Current Opinion in Gastroenterology, 42(1), 52–58. https://doi.org/10.1097/MOG.0000000000001141

Ng, Q. X., Soh, A. Y. S., Loke, W., Lim, D. Y., & Yeo, W. S. (2018). The role of inflammation in irritable bowel syndrome (IBS). Journal of Inflammation Research, 11, 345–349. https://doi.org/10.2147/JIR.S174982

Saito, Y. A., Petersen, G. M., Larson, J. J., Atkinson, E. J., Fridley, B. L., de Andrade, M., Locke, G. R., III, Zimmerman, J. M., Almazar-Elder, A. E., & Talley, N. J. (2010). Familial aggregation of irritable bowel syndrome: A family case-control study. American Journal of Gastroenterology, 105(4), 833–841. https://doi.org/10.1038/ajg.2010.116

Lembo, A., Zaman, M., Jones, M., & Talley, N. J. (2007). Influence of genetics on irritable bowel syndrome, gastro-oesophageal reflux and dyspepsia: A twin study. Alimentary Pharmacology & Therapeutics, 25(11), 1343–1350. https://doi.org/10.1111/j.1365-2036.2007.03326.x

Locke, G. R., III, Ackerman, M. J., Zinsmeister, A. R., Thapa, P., & Farrugia, G. (2006). Gastrointestinal symptoms in families of patients with an SCN5A-encoded cardiac channelopathy: Evidence of an intestinal channelopathy. American Journal of Gastroenterology, 101(6), 1299–1304. https://doi.org/10.1111/j.1572-0241.2006.00507.x

Saito, Y. A., Strege, P. R., Tester, D. J., Locke, G. R., III, Talley, N. J., Bernard, C. E., Rae, J. L., Makielski, J. C., Ackerman, M. J., & Farrugia, G. (2009). Sodium channel mutation in irritable bowel syndrome: Evidence for an ion channelopathy. American Journal of Physiology-Gastrointestinal and Liver Physiology, 296(2), G211–G218. https://doi.org/10.1152/ajpgi.90571.2008

Ritchie, J. (1973). Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut, 14(2), 125–132. https://doi.org/10.1136/gut.14.2.125

Holtmann, G. J., Ford, A. C., & Talley, N. J. (2016). Pathophysiology of irritable bowel syndrome. The Lancet Gastroenterology & Hepatology, 1(2), 133–146. https://doi.org/10.1016/S2468-1253(16)30023-1

Black, C. J., & Ford, A. C. (2020). Global burden of irritable bowel syndrome: Trends, predictions and risk factors. Nature Reviews Gastroenterology & Hepatology, 17(8), 473–486. https://doi.org/10.1038/s41575-020-0286-8

Qin, H. Y., Cheng, C. W., Tang, X. D., & Bian, Z. X. (2014). Impact of psychological stress on irritable bowel syndrome. World Journal of Gastroenterology, 20(39), 14126–14131. https://doi.org/10.3748/wjg.v20.i39.14126

Yu, R. L., & Weber, H. C. (2025). Irritable bowel syndrome, the gut microbiome, and diet. Current Opinion in Endocrinology, Diabetes and Obesity, 32(3), 102–107. https://doi.org/10.1097/MED.0000000000000905

Jalanka-Tuovinen, J., Salojärvi, J., Salonen, A., Immonen, O., Garsed, K., Kelly, F. M., Zaitoun, A., Palva, A., Spiller, R. C., & de Vos, W. M. (2014). Faecal microbiota composition and host-microbe cross-talk following gastroenteritis and in postinfectious irritable bowel syndrome. Gut, 63(11), 1737–1745. https://doi.org/10.1136/gutjnl-2013-305994

Surdea-Blaga, T., Băban, A., & Dumitrascu, D. L. (2012). Psychosocial determinants of irritable bowel syndrome. World Journal of Gastroenterology, 18(7), 616–626. https://doi.org/10.3748/wjg.v18.i7.616

Bradford, K., Shih, W., Videlock, E. J., Presson, A. P., Naliboff, B. D., Mayer, E. A., & Chang, L. (2012). Association between early adverse life events and irritable bowel syndrome. Clinical Gastroenterology and Hepatology, 10(4), 385–390.e3. https://doi.org/10.1016/j.cgh.2011.12.018

Lovell, R. M., & Ford, A. C. (2012). Effect of gender on prevalence of irritable bowel syndrome in the community: Systematic review and meta-analysis. American Journal of Gastroenterology, 107(7), 991–1000. https://doi.org/10.1038/ajg.2012.131

Gwee, K. A. (2005). Irritable bowel syndrome in developing countries—A disorder of civilization or colonization? Neurogastroenterology & Motility, 17(3), 317–324. https://doi.org/10.1111/j.1365-2982.2005.00627.x

Sood, R., Law, G. R., & Ford, A. C. (2014). Diagnosis of IBS: Symptoms, symptom-based criteria, biomarkers or “psychomarkers”? Nature Reviews Gastroenterology & Hepatology, 11(11), 683–691. https://doi.org/10.1038/nrgastro.2014.127

Saha, L. (2014). Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine. World Journal of Gastroenterology, 20(22), 6759–6773. https://doi.org/10.3748/wjg.v20.i22.6759

Black, C. J., Craig, O., Gracie, D. J., & Ford, A. C. (2021). Comparison of the Rome IV criteria with the Rome III criteria for the diagnosis of irritable bowel syndrome in secondary care. Gut, 70(6), 1110–1116. https://doi.org/10.1136/gutjnl-2020-322519

Nathani, R. R., Sodhani, S., & Goosenberg, E. (2025). Irritable bowel syndrome. In StatPearls. StatPearls Publishing.

Schmulson, M. J., & Drossman, D. A. (2017). What is new in Rome IV. Journal of Neurogastroenterology and Motility, 23(2), 151–163. https://doi.org/10.5056/jnm16214

Asghar, Z., Thoufeeq, M., Kurien, M., Ball, A. J., Rej, A., Tai, F. W. D., Afify, S., & Aziz, I. (2022). Diagnostic yield of colonoscopy in patients with symptoms compatible with Rome IV functional bowel disorders. Clinical Gastroenterology and Hepatology, 20(2), 334–341.e3. https://doi.org/10.1016/j.cgh.2020.08.062

Johannesson, E., Ringström, G., Abrahamsson, H., & Sadik, R. (2015). Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects. World Journal of Gastroenterology, 21(2), 600–608. https://doi.org/10.3748/wjg.v21.i2.600

Taneja, I., Deepak, K. K., Poojary, G., Acharya, I. N., Pandey, R. M., & Sharma, M. P. (2004). Yogic versus conventional treatment in diarrhea-predominant irritable bowel syndrome: A randomized control study. Applied Psychophysiology and Biofeedback, 29(1), 19–33. https://doi.org/10.1023/b:apbi.0000017861.60439.95

Harvie, R. M., Chisholm, A. W., Bisanz, J. E., Burton, J. P., Herbison, P., Schultz, K., & Schultz, M. (2017). Long-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPs. World Journal of Gastroenterology, 23(25), 4632–4643. https://doi.org/10.3748/wjg.v23.i25.4632

Vasant, D. H., Paine, P. A., Black, C. J., Houghton, L. A., Everitt, H. A., Corsetti, M., Agrawal, A., Aziz, I., Farmer, A. D., Eugenicos, M. P., Moss-Morris, R., Yiannakou, Y., & Ford, A. C. (2021). British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut, 70(7), 1214–1240. https://doi.org/10.1136/gutjnl-2021-324598

Gupta, D., Ghoshal, U. C., Misra, A., Misra, A., Choudhuri, G., & Singh, K. (2007). Lactose intolerance in patients with irritable bowel syndrome from northern India: A case-control study. Journal of Gastroenterology and Hepatology, 22(12), 2261–2265. https://doi.org/10.1111/j.1440-1746.2007.04986.x

Ford, A. C., Lacy, B. E., Harris, L. A., Quigley, E. M. M., & Moayyedi, P. (2019). Effect of antidepressants and psychological therapies in irritable bowel syndrome: An updated systematic review and meta-analysis. American Journal of Gastroenterology, 114(1), 21–39. https://doi.org/10.1038/s41395-018-0222-5

Black, C. J., Thakur, E. R., Houghton, L. A., Quigley, E. M. M., Moayyedi, P., & Ford, A. C. (2020). Efficacy of psychological therapies for irritable bowel syndrome: Systematic review and network meta-analysis. Gut, 69(8), 1441–1451. https://doi.org/10.1136/gutjnl-2020-321191

Amato, A., Liotta, R., & Mulè, F. (2014). Effects of menthol on circular smooth muscle of human colon: Analysis of the mechanism of action. European Journal of Pharmacology, 740, 295–301. https://doi.org/10.1016/j.ejphar.2014.07.018

Chapman, R. W., Stanghellini, V., Geraint, M., & Halphen, M. (2013). Randomized clinical trial: Macrogol/PEG 3350 plus electrolytes for treatment of patients with constipation associated with irritable bowel syndrome. American Journal of Gastroenterology, 108(9), 1508–1515. https://doi.org/10.1038/ajg.2013.197