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Strategy to Manage Irritable Bowel Syndrome in Korea

과민성장증후군 치료전략: 언제, 어떤 약을 사용할 것인가?

  • Kim, Jeong Hwan (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Sung, In-Kyung (Department of Internal Medicine, Konkuk University School of Medicine)
  • 김정환 (건국대학교 의학전문대학원 소화기내과) ;
  • 성인경 (건국대학교 의학전문대학원 소화기내과)
  • Published : 2014.06.01

Abstract

Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders. It is a multi-factorial disorder due to abnormal gastrointestinal motility, low-grade inflammation, visceral hypersensitivity, and communication between the gut-brain axis. IBS is traditionally treated with dietary and lifestyle modifications, fiber supplementation, and psychological and pharmacological therapies. Diet therapy including the low FODMAP diet and excluding certain food constituents is often used. Antispasmodics plus stool consistency modifiers to treat the major symptoms and defecation are first-line drug treatments. 5-Hydroxytryptamine (5-HT) receptors in the gastrointestinal tract, particularly $5-HT_3$ and $5-HT_4$ receptors are involved not only in modulating gut motility but in visceral sensory pathways. Drugs that act on both receptor classes appear to reduce visceral sensitivity and have inhibitory effects on motor activity in the distal intestine. $5-HT_4$ agonists may improve constipation-predominant IBS by normalizing bowel habits and thereby reduce abdominal pain. IBS continues to be a therapeutic challenge because of its diverse symptomatology and lack of a single pathophysiological target for drug intervention.

Keywords

References

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