Pathophysiology of irritable bowel syndrome.
Level 5 - mechanism / opinion, no new human data
Narrative review of pathophysiological mechanisms without systematic search methodology or original human data.
PubMed 42462748 · doi:10.1016/S2468-1253(26)00148-2
What was done
This narrative review summarizes thirty years of literature on the peripheral, central, and integrated pathophysiological mechanisms underlying irritable bowel syndrome (IBS) and examines the availability of validated diagnostic tools.
What was found
The abstract reports no quantitative results. It identifies multiple peripheral factors (gut infections, microbiome changes, visceral hypersensitivity, increased intestinal permeability, low-grade mucosal inflammation, altered immune function, abnormal motility, and dysregulated serotonin, bile acid, and carbohydrate metabolism) and central factors (psychological health, altered central pain processing). Although a few mechanisms (such as bile acid metabolism, colonic transit, and psychological comorbidities) can be measured with validated tests or questionnaires, most mechanisms currently lack reliable clinical tests to guide targeted treatment.
Why it matters
The review consolidates the current understanding of IBS as a disorder of gut-brain interaction, highlighting the gap between identified biological mechanisms and actionable clinical biomarkers.
Limits
As a narrative review, it presents no primary data, systematic search criteria, or quantitative synthesis. Specific diagnostic test performance metrics and effect sizes are not reported in the abstract.
Cited by
- contradicts Scientists do not know what causes irritable bowel syndrome (IBS), and IBS is caused by stress.