Irritable bowel syndrome: shifts in point of view

Abstract

The main symptom of irritable bowel syndrome (IBS), a recurrent functional GI disorder, is abdominal pain associated with defecation, a change in the frequency of bowel movements and a change in the consistency of stool. Until recently, it was the only specific disease that was included in the international classification of the 10th revision. Another 53 functional disorders will be included in the classification of the 11th revision and receive the status of ICD diseases. There are four main variants of IBS: IBS with constipation, IBS with diarrhea, IBS with mixed bowel habit and IBS unclassified. The very concept of IBS was fast-changing. The latest Rome IV (2016) guidelines suggested a mechanism of intraepithelial contact disruption as one of the pathogenetic mechanisms, which activates a minor intramucosal inflammation. It could be relevant to the chronicity of the process and require the use of anti-inflammatory drugs and agents in the treatment that restore intraepithelial contacts, which increases the percentage of patients with a positive treatment effect. The report provides data on the pharmacotherapy of drugs that have a combination (concomitant) effect of action, for example, Meteospasmyl®, which is superior to drugs with antispastic action or action that restores impaired motility in terms of the final effect of the action. The author of this report invites to participate in the discussion about the feasibility of introducing a new IBS variant, which may have a chronic course, and the inclusion of anti-inflammatory drugs in the combination treatment (if drugs that affect motor disorders have insufficient effect).