Published online Oct 28, 2015. doi: 10.3748/wjg.v21.i40.11353
Peer-review started: April 21, 2015
First decision: May 18, 2015
Revised: June 16, 2015
Accepted: August 25, 2015
Article in press: August 25, 2015
Published online: October 28, 2015
Processing time: 185 Days and 17.3 Hours
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder characterized by presence of abdominal pain or discomfort associated with altered bowel habits. It has three main subtypes - constipation predominant IBS (C-IBS), diarrhea predominant IBS (D-IBS) and IBS with mixed features of both diarrhea as well as constipation (M-IBS). Its pathophysiology and underlying mechanisms remain elusive. It is traditionally believed that IBS is a result of multiple factors including hypersensitivity of the bowel, altered bowel motility, inflammation and stress. Initial studies have shown familial aggregation of IBS suggesting shared genetic or environmental factors. Twin studies of IBS from different parts of world have shown higher concordance rates among monozygotic twins than dizygotic twins, and thus suggesting a genetic component to this disorder. Multiple studies have tried to link single-nucleotide polymorphisms (SNPs) to IBS but there is little evidence that these SNPs are functional. Various molecules have been studied and investigated by the researchers. Serotonin, a known neurotransmitter and a local hormone in the enteric nervous system, has been most extensively explored. At this time, the underlying gene pathways, genes and functional variants linked with IBS remain unknown and the promise of genetically-determined risk prediction and personalize medicine remain unfulfilled. However, molecular biological technologies continue to evolve rapidly and genetic investigations offer much promise in the intervention, treatment and prevention of IBS.
Core tip: Irritable bowel syndrome (IBS) is believed to result from interplay of several factors including hypersensitivity of the bowel, altered bowel motility, inflammation and stress. Familial aggregation of cases and twin studies underscore the genetic basis of IBS. Different researchers have studied several candidate genes but the evidence so far linking IBS to specific genes is inconsistent and weak. Genome wide association studies that can examine several common genetic variants are needed to design newer drugs and diagnostic methods.