Review
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World J Gastroenterol. Jun 21, 2011; 17(23): 2791-2800
Published online Jun 21, 2011. doi: 10.3748/wjg.v17.i23.2791
Need for a comprehensive medical approach to the neuro-immuno-gastroenterology of irritable bowel syndrome
Pejman Katiraei, Gilberto Bultron
Pejman Katiraei, Gilberto Bultron, Department of Pediatrics, Loma Linda University, 11175 Campus Street, Coleman Pavilion A1121, Loma Linda, CA 92350, United States
Author contributions: Katiraei P is the primary author and major contributor to this paper; Bultron G is the secondary author and is a substantial contributor; both Katiraei P and Bultron G performed literature research, drafted the article, contributed to the intellectual content, and wrote the article.
Supported by A Generous Grant from the Riverside Community Health Foundation
Correspondence to: Pejman Katiraei, DO, Department of Pediatrics, Loma Linda University, 11175 Campus Street, Coleman Pavilion A1121, Loma Linda, CA 92350, United States. pkatiraei@llu.edu
Telephone: +1-909-5588142  Fax: +1-909-5584184
Received: December 23, 2010
Revised: March 8, 2011
Accepted: March 15, 2011
Published online: June 21, 2011
Abstract

Irritable bowel syndrome (IBS) is defined by the Rome III criteria as symptoms of recurrent abdominal pain or discomfort with the onset of a marked change in bowel habits with no evidence of an inflammatory, anatomic, metabolic, or neoplastic process. As such, many clinicians regard IBS as a central nervous system problem of altered pain perception. Here, we review the recent literature and discuss the evidence that supports an organic based model, which views IBS as a complex, heterogeneous, inter-dependent, and multi-variable inflammatory process along the neuronal-gut axis. We delineate the organic pathophysiology of IBS, demonstrate the role of inflammation in IBS, review the possible differences between adult and pediatric IBS, discuss the merits of a comprehensive treatment model as taught by the Institute of Functional Medicine, and describe the potential for future research for this syndrome.

Keywords: Irritable bowel syndrome; Abdominal pain; Inflammation; Probiotics; Stress