While irritable bowel syndrome (IBS) is still considered a ‘disorder of gut function’ and is diagnosed on the basis of symptoms, evidence is growing to indicate the existence of biochemical, molecular, immune, and microbiological abnormalities in large subsets of patients. According to the current view, luminal factors (e.g. derived from food, microbiota, and bile acids) permeate into the mucosa through a leaky epithelial barrier. These substances elicit abnormal responses, partly related to the activation of the immune system, which evoke altered neuro-muscular responses and stimulation of pain pathways. This research is providing a new way of thinking about the pathophysiology of IBS and will potentially lead to the development of novel treatments for these common disorders.
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