Date of Award

Spring 2024

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Elizabeth Masten

Abstract

Irritable Bowel Syndrome is a common gastrointestinal condition that is characterized by abdominal pain and discomfort and altered bowel habits. Irritable Bowel Syndrome is thought out to be a multifactorial disorder that involves GI dysmotility, symptomology, altered gut microbial environment and alteration of the CNS with mental health manifestations including depression and anxiety. Many theories of the pathophysiology of IBS have been put forward, however the exact etiology remains unclear to this day. IBS is diagnosed based on the Rome IV Criteria that represent one of the four subtypes; 1) IBS with constipation (IBS-C), 2) IBS with diarrhea (IBS-D) 3) mixed IBS (IBS-M) or 4) IBS with unclassified. Over the years, prevalence of IBS has increased in gastroenterology clinics leading to a significant economic burden in healthcare. Patients diagnosed with IBS are more prone to live a poor quality of life that limits work productivity and social activities along with developing symptoms of anxiety and depression, representing an increased utilization of the healthcare system resources. The diversity and individuality of a patient with IBS along with the absence of known pathophysiology to gear medical management towards makes treatment for IBS difficult. In this paper, we will explore the different theories of pathogenesis of Irritable Bowel Syndrome while also looking at current and emerging treatment options targeting those theories.

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Evaluating the Pathogenesis and Treatment Algorithms for Patients with Irritable Bowel Syndrome

Irritable Bowel Syndrome is a common gastrointestinal condition that is characterized by abdominal pain and discomfort and altered bowel habits. Irritable Bowel Syndrome is thought out to be a multifactorial disorder that involves GI dysmotility, symptomology, altered gut microbial environment and alteration of the CNS with mental health manifestations including depression and anxiety. Many theories of the pathophysiology of IBS have been put forward, however the exact etiology remains unclear to this day. IBS is diagnosed based on the Rome IV Criteria that represent one of the four subtypes; 1) IBS with constipation (IBS-C), 2) IBS with diarrhea (IBS-D) 3) mixed IBS (IBS-M) or 4) IBS with unclassified. Over the years, prevalence of IBS has increased in gastroenterology clinics leading to a significant economic burden in healthcare. Patients diagnosed with IBS are more prone to live a poor quality of life that limits work productivity and social activities along with developing symptoms of anxiety and depression, representing an increased utilization of the healthcare system resources. The diversity and individuality of a patient with IBS along with the absence of known pathophysiology to gear medical management towards makes treatment for IBS difficult. In this paper, we will explore the different theories of pathogenesis of Irritable Bowel Syndrome while also looking at current and emerging treatment options targeting those theories.