From the Guidelines
Irritable bowel syndrome (IBS) is a complex condition with a multifactorial etiology, involving altered gut-brain interactions, visceral hypersensitivity, intestinal dysmotility, and psychological factors, as supported by recent studies 1. The primary risk factors for IBS include:
- Altered gut-brain interactions
- Visceral hypersensitivity
- Intestinal dysmotility
- Gut microbiome imbalances
- Psychological factors, such as anxiety and depression, which are highly prevalent in IBS patients 1 Genetic predisposition also plays a role, with family history increasing the risk of developing IBS by 2-3 times. Gastrointestinal infections can trigger post-infectious IBS in approximately 10-15% of cases, particularly following bacterial gastroenteritis. Dietary factors, such as FODMAPs, can trigger symptoms in susceptible individuals. Women are more likely to develop IBS than men, suggesting hormonal influences. Early life stressors, including trauma or adverse childhood experiences, increase vulnerability to IBS development later in life. Altered intestinal permeability and low-grade inflammation in the intestinal mucosa are also implicated in IBS pathophysiology, as noted in a recent review of the management of IBS 1. Understanding these risk factors is crucial in explaining why IBS presents differently among patients and why treatment approaches often need to be personalized to address the specific underlying mechanisms in each individual, with a focus on improving quality of life and reducing symptoms, as emphasized in a study on the efficacy of acupuncture in IBS management 1.
From the Research
Irritable Bowel Syndrome Risk Etiology
- The exact cause of irritable bowel syndrome (IBS) is not fully understood, but several risk factors have been identified, including acute enteric infection, psychological comorbidity, and genetic associations 2.
- IBS is more common in young adult women and people with a family history of inflammatory bowel disease or coeliac disease 2.
- The pathophysiology of IBS is complex and involves disordered communication between the gut and the brain, leading to motility disturbances, visceral hypersensitivity, and altered CNS processing 2.
- Other potential mechanisms that may contribute to the development of IBS include alterations in gastrointestinal microbiota and disturbances in mucosal and immune function 2.
Risk Factors
- Acute enteric infection is a well-established risk factor for IBS, and people with a history of gastrointestinal infection are more likely to develop IBS 2.
- Psychological comorbidity, such as anxiety and depression, is also a common feature of IBS, and people with IBS are more likely to have a history of adverse life events or psychosocial stressors 3.
- Genetic associations have been identified as a potential risk factor for IBS, although the exact relationship between genetics and IBS is not fully understood 2.
Diagnosis and Treatment
- IBS is typically diagnosed based on clinical history and symptoms, and diagnosis can be made using the Rome IV criteria, which define IBS as a functional bowel disorder characterized by recurrent abdominal pain associated with defecation or a change in bowel habits 4.
- Treatment for IBS typically involves a combination of dietary changes, soluble fiber, and antispasmodic drugs, as well as psychological therapies such as gut-directed psychotherapy 2, 5.
- A low FODMAP diet has been shown to be effective in improving symptoms of IBS, and is often recommended as a first-line treatment 4, 5.