Practical approach to irritable bowel syndrome-diarrhea beyond low-FODMAP diet

Irritable bowel syndrome (IBS) is a functional gastrointes-tinal disorder characterized by abdominal pain and altered defecation, usually accompanied by abdominal bloating or distension. The integrated model of bidirectional interaction between the central, autonomic, enteric nervous system, the microbiome, and the gut barrier allows a better under-standing of the pathophysiology of IBS, as well as consid-eration of potential therapeutic strategies. IBS with predom-inant diarrhea (IBS-D) represents a therapeutic challenge. Dietary changes or restrictions are most commonly used by patients in an attempt at symptom control. Therefore, a number of diets, especially low-FODMAP diet, have increas-ingly gained interest as a therapy for IBS-D or mixed IBS. However, this kind of diet, while effective, is not exempt of problems. It is therefore necessary that other therapeutic options be considered while bearing pathophysiological mechanisms and general symptom management in mind.

Automated summary

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and altered defecation. The bidirectional interaction between the central, autonomic, enteric nervous system, the microbiome, and the gut barrier helps understand the pathophysiology of IBS. Therapeutic options like low-FODMAP diet have gained interest, but other options should also be considered.