Intestino irritable: una enfermedad orgánica en 2026
DOI:
https://doi.org/10.47892/rgp.2026.462.2262Palabras clave:
Síndrome del Intestino Irritable, Eje Cerebro-Intestino, Microbioma Gastrointestinal, Motilidad Gastrointestinal, Función de la Barrera IntestinalResumen
El síndrome del intestino irritable (SII) es un desorden de la interacción del eje intestino-cerebro caracterizado por dolor abdominal y alteración en la forma y/o frecuencia de las deposiciones. El concepto previo de este síndrome como un “trastorno funcional” ha sido a menudo interpretado erróneamente como “lo contrario a orgánico” o “netamente psicológico”, estigmatizándolo e incluso deslegitimándolo. La evidencia soporta que, por el contrario, este síndrome tiene una base orgánica subyacente mediada por la compleja interacción de múltiples alteraciones fisiopatológicas medibles y cuantificables. Entre estas alteraciones destacan la predisposición genética, alteraciones de la microbiota intestinal, hipersensibilidad visceral, anormalidades en el procesamiento central del dolor, anormalidades en la motilidad gastrointestinal, alteraciones en la función de barrera intestinal e influencias ambientales. En conjunto, todos estos elementos se integran a través del modelo del eje intestino-cerebro, en el cual forman múltiples bucles de retroalimentación positiva que inician, exacerban y perpetúan las manifestaciones del SII. En esta revisión discutimos a profundidad las alteraciones fisiopatológicas subyacentes al SII para recordar y concientizar al personal de salud sobre la naturaleza orgánica de este síndrome. Además, resumimos a la luz de estas alteraciones los abordajes terapéuticos modernos y sus limitaciones.
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Aggeletopoulou I, Papantoniou K, Pastras P, Triantos C. Unraveling the Pathophysiology of Irritable Bowel Syndrome: Mechanisms and Insights. Int J Mol Sci. 2025;26(21):10598. doi: 10.3390/ijms262110598.
Corsetti M, Shin A, Lacy BE, Cash BD, Simrén M, Schmulson MJ, et al. Bowel Disorders. Gastroenterology. 2026;170(6):1261- 1282. doi: 10.1053/j.gastro.2026.02.003.
Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel Disorders. Gastroenterology. 2016;150(6):1393-1407. e5. doi: 10.1053/j.gastro.2016.02.031.
Ballena-Caicedo J, Valladolid-Sandoval LAM, ZuzunagaMontoya FE, Vera-Ponce VJ. Global Prevalence of Irritable Bowel Syndrome: An Updated Systematic Review and MetaAnalysis. Gastroenterology Res. 2025;18(6):308-21. doi: 10.14740/gr2095.
Pontet Y, Olano C. [Irritable bowel syndrome prevalence in Latin America]. Rev Gastroenterol Peru. 2021;41(3):144-9.
Black CJ, Ford AC. An evidence-based update on the diagnosis and management of irritable bowel syndrome. Expert Review of Gastroenterology & Hepatology. 2025;19(3):227-42. doi: 10.1080/17474124.2025.2455586.
Arnaout AY, Nerabani Y, Douba Z, Kassem LH, Arnaout K, Shabouk MB, et al. The prevalence and risk factors of irritable bowel syndrome (PRIBS study) among adults in lowand middle-income countries: A multicenter cross-sectional study. Health Sci Rep. 2023;6(10):e1592. doi: 10.1002/ hsr2.1592.
Berumen A, Lennon R, Breen-Lyles M, Griffith J, Patel R, Boxrud D, et al. Characteristics and Risk Factors of Post-Infection Irritable Bowel Syndrome After Campylobacter Enteritis. Clin Gastroenterol Hepatol. 2021;19(9):1855-1863.e1. doi: 10.1016/j.cgh.2020.07.033.
Waehrens R, Ohlsson H, Sundquist J, Sundquist K, Zöller B. Risk of irritable bowel syndrome in first-degree, seconddegree and third-degree relatives of affected individuals: a nationwide family study in Sweden. Gut. 2015;64(2):215-21. doi: 10.1136/gutjnl-2013-305705.
Goodoory VC, Ng CE, Black CJ, Ford AC. Direct healthcare costs of Rome IV or Rome III-defined irritable bowel syndrome in the United Kingdom. Aliment Pharmacol Ther. 2022;56(1):110- 120. doi: 10.1111/apt.16939.
Goodoory VC, Ng CE, Black CJ, Ford AC. Impact of Rome IV irritable bowel syndrome on work and activities of daily living. Aliment Pharmacol Ther. 2022;56(5):844-56. doi: 10.1111/ apt.17132.
Remes-Troche JM, Coss-Adame E, Schmulson M, GarcíaZermeño KR, Amieva-Balmori M, Carmona-Sánchez R, et al. Pharmacologic treatment of irritable bowel syndrome. Position statement of the Asociación Mexicana de Gastroenterología, 2024. Rev Gastroenterol Mex. 2025;90(1):77-110. doi: 10.1016/j.rgmxen.2024.10.009.
Choi Y, Youn YH, Kang SJ, Shin JE, Cho YS, Jung YS, et al. 2025 Seoul Consensus on Clinical Practice Guidelines for Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2025;31(2):133- 69. doi: 10.5056/jnm25007.
Neumann I, Santesso N, Akl EA, Rind DM, Vandvik PO, Alonso-Coello P, et al. A guide for health professionals to interpret and use recommendations in guidelines developed with the GRADE approach. Journal of Clinical Epidemiology. 2016;72:45-55. doi: 10.1016/j.jclinepi.2015.11.017.
Hearn M, Whorwell PJ, Vasant DH. Stigma and irritable bowel syndrome: a taboo subject? Lancet Gastroenterol Hepatol. 2020;5(6):607-15. doi: 10.1016/S2468-1253(19)30348-6.
Sun S, Chen J, Li H, Lou Y, Chen L, Lv B. Patients’ perspectives on irritable bowel syndrome: a qualitative analysis based on social media in China. Qual Life Res. 2023;1-11. doi: 10.1007/ s11136-023-03417-x.
Sahoo S, Padhy SK. Cross-cultural and psychological issues in irritable bowel syndrome. J Gastroenterol Hepatol. 2017;32(10):1679-1685. doi: 10.1111/jgh.13773.
Drossman DA, Thompson WG, Talley NJ, Funch-Jensen P, Janssens J. Identification of subgroups of functional gastrointestinal disorders. Gastroenterol Int. 1990;3:159-172.
Drossman DA, Richter JE, Talley NJ, Thompson WG, Corazziari E, Whitehead WE, editors. The functional gastrointestinal disorders: diagnosis, pathophysiology and treatment: a multinational consensus. Boston: Little, Brown; 1994.
Ferreira AI, Garrido M, Castro-Poças F. Irritable Bowel Syndrome: News from an Old Disorder. GE Port J Gastroenterol. 2020;27(4):255-68. doi: 10.1159/000503757.
Holtmann GJ, Ford AC, Talley NJ. Pathophysiology of irritable bowel syndrome. Lancet Gastroenterol Hepatol. 2016;1(2):133- 46. doi: 10.1016/S2468-1253(16)30023-1.
Alam M, Abbas K, Khan M, Saini RS, Faraz M. Irritable Bowel Syndrome: Clinical Manifestations, Pathological Insights, Diagnostic Methods and Effective Management Strategies. SN Compr Clin Med. 2026;8(1):78. doi: 10.1007/s42399-026- 02317-8.
Henström M, D’Amato M. Genetics of irritable bowel syndrome. Mol Cell Pediatr. 2016;3:7. doi: 10.1186/s40348-016-0038-6.
Saito YA. The Role of Genetics in IBS. Gastroenterol Clin North Am. 2011;40(1):45-67. doi: 10.1016/j.gtc.2010.12.011.
Kaplina A, Kononova S, Zaikova E, Pervunina T, Petrova N, Sitkin S. Necrotizing Enterocolitis: The Role of Hypoxia, Gut Microbiome, and Microbial Metabolites. Int J Mol Sci. 2023;24(3):2471. doi: 10.3390/ijms24032471.
Ivashkin V, Poluektov Y, Kogan E, Shifrin O, Sheptulin A, Kovaleva A, et al. Disruption of the pro-inflammatory, anti-inflammatory cytokines and tight junction proteins expression, associated with changes of the composition of the gut microbiota in patients with irritable bowel syndrome. PLoS One. 2021;16(6):e0252930. doi: 10.1371/journal. pone.0252930.
Hanning N, Edwinson AL, Ceuleers H, Peters SA, De Man JG, Hassett LC, et al. Intestinal barrier dysfunction in irritable bowel syndrome: a systematic review. Ther Adv Gastroenterol. 2021;14:1756284821993586. doi: 10.1177/1756284821993586.
Chopyk DM, Kumar P, Raeman R, Liu Y, Smith T, Anania FA. Dysregulation of junctional adhesion molecule-A contributes to ethanol-induced barrier disruption in intestinal epithelial cell monolayers. Physiol Rep. 2017;5(23):e13541. doi: 10.14814/phy2.13541.
Strege PR, Mazzone A, Bernard CE, Neshatian L, Gibbons SJ, Saito YA, et al. Irritable bowel syndrome patients have SCN5A channelopathies that lead to decreased NaV1.5 current and mechanosensitivity. Am J Physiol Gastrointest Liver Physiol. 2018;314(4):G494-503. doi: 10.1152/ajpgi.00016.2017.
Gao J, Xiong T, Grabauskas G, Owyang C. Mucosal Serotonin Reuptake Transporter Expression in Irritable Bowel Syndrome Is Modulated by Gut Microbiota Via Mast Cell-Prostaglandin E2. Gastroenterology. 2022;162(7):1962-1974.e6. doi: 10.1053/j. gastro.2022.02.016.
Grozić A, Coker K, Dussik CM, Sabir MS, Sabir Z, Bradley A, et al. Identification of putative transcriptomic biomarkers in irritable bowel syndrome (IBS): Differential gene expression and regulation of TPH1 and SERT by vitamin D. PLOS ONE. 2022;17(10):e0275683. doi: 10.1371/journal.pone.0275683.
Aggeletopoulou I, Triantos C. Microbiome Shifts and Their Impact on Gut Physiology in Irritable Bowel Syndrome. International Journal of Molecular Sciences. 2024;25(22). doi: 10.3390/ijms252212395.
Eijsbouts C, Zheng T, Kennedy NA, Bonfiglio F, Anderson CA, Moutsianas L, et al. Genome-wide analysis of 53,400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders. Nat Genet. 2021;53(11):1543-52. doi: 10.1038/s41588-021-00950-8.
Zamfir-Taranu A, Löscher BS, Franke A, Bonfiglio F, Ohlsson B, D’Amato M. Sucrase-isomaltase hypomorphic variant Val15Phe affects the response to a sucrose challenge test in patients with IBS. Gut. 2025;75(3):e336393. doi: 10.1136/ gutjnl-2025-336393.
Bonfiglio F, Zheng T, Garcia-Etxebarria K, Hadizadeh F, Bujanda L, Bresso F, et al. Female-Specific Association Between Variants on Chromosome 9 and Self-Reported Diagnosis of Irritable Bowel Syndrome. Gastroenterology. 2018;155(1):168-79. doi: 10.1053/j.gastro.2018.03.064.
Camilleri M, Zhernakova A, Bozzarelli I, D’Amato M. Genetics of irritable bowel syndrome: shifting gear via biobank-scale studies. Nat Rev Gastroenterol Hepatol. 2022;19(11):689-702. doi: 10.1038/s41575-022-00662-2.
Rosenberg E. Diversity of bacteria within the human gut and its contribution to the functional unity of holobionts. NPJ Biofilms Microbiomes. 2024;10(1):134. doi: 10.1038/s41522- 024-00580-y.
Rajilić-Stojanović M, de Vos WM. The first 1000 cultured species of the human gastrointestinal microbiota. FEMS Microbiol Rev. 2014;38(5):996-1047. doi: 10.1111/1574-6976.12075.
Chong PP, Chin VK, Looi CY, Wong WF, Madhavan P, Yong VC. The Microbiome and Irritable Bowel Syndrome - A Review on the Pathophysiology, Current Research and Future Therapy. Front Microbiol. 2019;10:1136. doi: 10.3389/fmicb.2019.01136.
Shaikh SD, Sun N, Canakis A, Park WY, Weber HC. Irritable Bowel Syndrome and the Gut Microbiome: A Comprehensive Review. J Clin Med. 2023;12(7):2558. doi: 10.3390/jcm12072558.
Tang W, Wang J, Wang W, Xue J, Wang Y, Jiang F, et al. Reviewing the Peripheral and Central Mechanisms of Visceral Hypersensitivity in Intestinal Disorders. Int J Med Sci. 2026;23(3):1121-1143. doi: 10.7150/ijms.126361.
Gomaa EZ. Human gut microbiota/microbiome in health and diseases: a review. Antonie van Leeuwenhoek. 2020;113(12):2019-40. doi: 10.1007/s10482-020-01474-7.
Canakis A, Haroon M, Weber HC. Irritable bowel syndrome and gut microbiota. Curr Opin Endocrinol Diabetes Obes. 2020;27(1):28-35. doi: 10.1097/MED.0000000000000523.
Jeffery IB, Das A, O’Herlihy E, Coughlan S, Cisek K, Moore M, et al. Differences in Fecal Microbiomes and Metabolomes of People With vs Without Irritable Bowel Syndrome and Bile Acid Malabsorption. Gastroenterology. 2020;158(4):1016- 1028.e8. doi: 10.1053/j.gastro.2019.11.301.
Duan R, Zhu S, Wang B, Duan L. Alterations of Gut Microbiota in Patients With Irritable Bowel Syndrome Based on 16S rRNA-Targeted Sequencing: A Systematic Review. Clin Transl Gastroenterol. 2019;10(2):e00012. doi: 10.14309/ ctg.0000000000000012.
Wang L, Alammar N, Singh R, Nanavati J, Song Y, Chaudhary R, et al. Gut Microbial Dysbiosis in the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies. J Acad Nutr Diet. 2020;120(4):565-86. doi: 10.1016/j. jand.2019.05.015.
Liu HN, Wu H, Chen YZ, Chen YJ, Shen XZ, Liu TT. Altered molecular signature of intestinal microbiota in irritable bowel syndrome patients compared with healthy controls: A systematic review and meta-analysis. Dig Liver Dis. 2017;49(4):331-7. doi: 10.1016/j.dld.2017.01.142.
Jacobs JP, Lagishetty V, Hauer MC, Labus JS, Dong TS, Toma R, et al. Multi-omics profiles of the intestinal microbiome in irritable bowel syndrome and its bowel habit subtypes. Microbiome. 2023;11:5. doi: 10.1186/s40168-022-01450-5.
Duan R, Zhu S, Wang B, Duan L. Alterations of Gut Microbiota in Patients With Irritable Bowel Syndrome Based on 16S rRNA-Targeted Sequencing: A Systematic Review. Clin Transl Gastroenterol. 2019;10(2):e00012. doi: 10.14309/ ctg.0000000000000012.
Schaus SR, Vasconcelos Pereira G, Luis AS, Madlambayan E, Terrapon N, Ostrowski MP, et al. Ruminococcus torques is a keystone degrader of intestinal mucin glycoprotein, releasing oligosaccharides used by Bacteroides thetaiotaomicron. 15(8):e00039-24. doi: 10.1128/mbio.00039-24.
Aggeletopoulou I, Triantos C. Microbiome Shifts and Their Impact on Gut Physiology in Irritable Bowel Syndrome. Int J Mol Sci. 2024;25(22):12395. doi: 10.3390/ijms252212395.
Luck B, Horvath TD, Engevik KA, Ruan W, Haidacher SJ, Hoch KM, et al. Neurotransmitter Profiles Are Altered in the Gut and Brain of Mice Mono-Associated with Bifidobacterium dentium. Biomolecules. 2021;11(8):1091. doi: 10.3390/biom11081091.
Engevik MA, Luck B, Visuthranukul C, Ihekweazu FD, Engevik AC, Shi Z, et al. Human-Derived Bifidobacterium dentium Modulates the Mammalian Serotonergic System and GutBrain Axis. Cell Mol Gastroenterol Hepatol. 2021;11(1):221- 248. doi: 10.1016/j.jcmgh.2020.08.002.
Duranti S, Ruiz L, Lugli GA, Tames H, Milani C, Mancabelli L, et al. Bifidobacterium adolescentis as a key member of the human gut microbiota in the production of GABA. Sci Rep. 2020;10(1):14112. doi: 10.1038/s41598-020-70986-z.
Ghoshal U, Shukla R, Srivastava D, Ghoshal UC. Irritable Bowel Syndrome, Particularly the Constipation-Predominant Form, Involves an Increase in Methanobrevibacter smithii, Which Is Associated with Higher Methane Production. Gut Liver. 2016;10(6):932-8. doi: 10.5009/gnl15588.
Linden DR. Hydrogen sulfide signaling in the gastrointestinal tract. Antioxid Redox Signal. 2014;20(5):818-30. doi: 10.1089/ ars.2013.5312.
Chen L, Zhang L, Hua H, Liu L, Mao Y, Wang R. Interactions between toll-like receptors signaling pathway and gut microbiota in host homeostasis. Immun Inflamm Dis. 2024;12(7):e1356. doi: 10.1002/iid3.1356.
Li X, Yuan Q, Huang H, Wang L. Gut microbiota in irritable bowel syndrome: a narrative review of mechanisms and microbiomebased therapies. Front Immunol. 2025;16:1695321. doi: 10.3389/fimmu.2025.1695321.
Burns GL, Roberts F, Wark JA, Fowler S, Jones MP, Duncanson K, et al. Serological and faecal markers of irritable bowel syndrome: a systematic review and meta-analysis. 2026;126:106198. doi: 10.1016/j.ebiom.2026.106198.
Hasler WL, Grabauskas G, Singh P, Owyang C. Mast cell mediation of visceral sensation and permeability in irritable bowel syndrome. Neurogastroenterol Motil. 2022;34(7):e14339. doi: 10.1111/nmo.14339.
Singh P, Sayuk GS, Rosenbaum DP, Edelstein S, Kozuka K, Chang L. An Overview of the Effects of Tenapanor on Visceral Hypersensitivity in the Treatment of Irritable Bowel Syndrome with Constipation. Clinical and Experimental Gastroenterology. 2024;17:87-96. doi: 10.2147/CEG.S454526.
Mujagic Z, Jonkers DM a. E, Ludidi S, Keszthelyi D, Hesselink MA, Weerts ZZRM, et al. Biomarkers for visceral hypersensitivity in patients with irritable bowel syndrome. Neurogastroenterol Motil. 2017;29(12). doi: 10.1111/nmo.13137.
van Wanrooij SJM, Wouters MM, Van Oudenhove L, Vanbrabant W, Mondelaers S, Kollmann P, et al. Sensitivity testing in irritable bowel syndrome with rectal capsaicin stimulations: role of TRPV1 upregulation and sensitization in visceral hypersensitivity? Am J Gastroenterol. 2014;109(1):99- 109. doi: 10.1038/ajg.2013.371.
Akbar A, Yiangou Y, Facer P, Walters JRF, Anand P, Ghosh S. Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain. Gut. 2008;57(7):923-9. doi: 10.1136/ gut.2007.138982.
Spiller R. Recent advances in understanding the role of serotonin in gastrointestinal motility in functional bowel disorders: alterations in 5-HT signalling and metabolism in human disease. Neurogastroenterol Motil. 2007;19 Suppl 2:25-31. doi: 10.1111/j.1365-2982.2007.00965.x.
Spiller R, Jenkins D, Thornley J, Hebden J, Wright T, Skinner M, et al. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut. 2000;47(6):804-11. doi: 10.1136/gut.47.6.804.
Barbara G, Cremon C, De Giorgio R, Dothel G, Zecchi L, Bellacosa L, et al. Mechanisms Underlying Visceral Hypersensitivity in Irritable Bowel Syndrome. Curr Gastroenterol Rep. 2011;13(4):308-15. doi: 10.1007/s11894-011-0195-7.
Keating C, Pelegrin P, Martínez CM, Grundy D. P2X7 receptordependent intestinal afferent hypersensitivity in a mouse model of postinfectious irritable bowel syndrome. J Immunol. 2011;187(3):1467-74. doi: 10.4049/jimmunol.1100423.
Petrushenko OA, Stratiievska AO, Petrushenko MO, Lukyanetz EA. Resensitization of TRPV1 channels after the P2 receptor activation in sensory neurons of spinal ganglia in rats. Front Cell Neurosci. 2023;17:1192780. doi: 10.3389/fncel.2023.1192780.
Deiteren A, van der Linden L, de Wit A, Ceuleers H, Buckinx R, Timmermans JP, et al. P2X3 Receptors Mediate Visceral Hypersensitivity during Acute Chemically-Induced Colitis and in the Post-Inflammatory Phase via Different Mechanisms of Sensitization. PLoS One. 2015;10(4):e0123810. doi: 10.1371/ journal.pone.0123810.
Meng MY, Paine LW, Sagnat D, Bello I, Oldroyd S, Javid F, et al. TRPV4 stimulates colonic afferents through mucosal release of ATP and glutamate. Br J Pharmacol. 2025;182(6):1324-40. doi: 10.1111/bph.17408.
Morales-Soto W, Gonzales J, Jackson WF, Gulbransen BD. Enteric glia promote visceral hypersensitivity during inflammation through intercellular signaling with gut nociceptors. Sci Signal. 2023;16(812):eadg1668. doi: 10.1126/scisignal.adg1668.
Fujikawa Y, Tominaga K. Enhanced neuron-glia network in the submucosa and increased neuron outgrowth into the mucosa are associated with distinctive expressions of neuronal factors in the colon of rat IBS model. Neurogastroenterol Motil. 2023;35(9):e14595. doi: 10.1111/nmo.14595.
Seguella L, Gulbransen BD. Enteric glial biology, intercellular signalling and roles in gastrointestinal disease. Nat Rev Gastroenterol Hepatol. 2021;18(8):571-87. doi: 10.1038/ s41575-021-00423-7.
Bashashati M, Moossavi S, Cremon C, Barbaro MR, Moraveji S, Talmon G, et al. Colonic immune cells in irritable bowel syndrome: A systematic review and meta-analysis. Neurogastroenterol Motil. 2018;30(1). doi: 10.1111/ nmo.13192.
Robles A, Perez Ingles D, Myneedu K, Deoker A, Sarosiek I, Zuckerman MJ, et al. Mast cells are increased in the small intestinal mucosa of patients with irritable bowel syndrome: A systematic review and meta-analysis. Neurogastroenterol Motil. 2019;31(12):e13718. doi: 10.1111/nmo.13718.
Burns G, Carroll G, Mathe A, Horvat J, Foster P, Walker MM, et al. Evidence for Local and Systemic Immune Activation in Functional Dyspepsia and the Irritable Bowel Syndrome: A Systematic Review. Am J Gastroenterol. 2019;114(3):429-36. doi: 10.1038/s41395-018-0377-0.
Barbara G, Wang B, Stanghellini V, de Giorgio R, Cremon C, Di Nardo G, et al. Mast cell-dependent excitation of visceralnociceptive sensory neurons in irritable bowel syndrome. Gastroenterology. 2007;132(1):26-37. doi: 10.1053/j. gastro.2006.11.039.
Grabauskas G, Wu X, Gao J, Li JY, Turgeon DK, Owyang C. Prostaglandin E2, Produced by Mast Cells in Colon Tissues from Patients with Irritable Bowel Syndrome, Contributes to Visceral Hypersensitivity in Mice. Gastroenterology. 2020;158(8):2195- 2207.e6. doi: 10.1053/j.gastro.2020.02.022.
Bashashati M, Moossavi S, Cremon C, Barbaro MR, Moraveji S, Talmon G, et al. Colonic immune cells in irritable bowel syndrome: A systematic review and meta-analysis. Neurogastroenterology & Motility. 2018;30(1):e13192. doi: 10.1111/nmo.13192.
Xia Y, Hu HZ, Liu S, Ren J, Zafirov DH, Wood JD. IL-1β and IL-6 excite neurons and suppress nicotinic and noradrenergic neurotransmission in guinea pig enteric nervous system. J Clin Invest. 1999;103(9):1309-16. doi: 10.1172/JCI5823.
Yoo BB, Mazmanian SK. The Enteric Network: Interactions between the Immune and Nervous Systems of the Gut. Immunity. 2017;46(6):910-26. doi: 10.1016/j. immuni.2017.05.011.
Ye B, Fu Z, Zhou X, Wang S, Ouyang L, Chen Z, et al. LowGrade Inflammation: Pathophysiological Mechanisms and Drug Targets in Irritable Bowel Syndrome with Diarrhea. JIR. 2026;19:1-22. doi: 10.2147/JIR.S578822.
Shin AS, Xing Y, Waseem MR, Siwiec R, James-Stevenson T, Rogers N, et al. Microbiota and short chain fatty acid relationships underlie clinical heterogeneity and identify key microbial targets in irritable bowel syndrome (IBS). Sci Rep. 2025;15(1):35375. doi: 10.1038/s41598-025-19363-2.
Tana C, Umesaki Y, Imaoka A, Handa T, Kanazawa M, Fukudo S. Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome. Neurogastroenterol Motil. 2010;22(5):512-9. doi: 10.1111/j.1365-2982.2009.01427.x.
Sun QH, Liu ZJ, Zhang L, Wei H, Song LJ, Zhu SW, et al. Sexbased differences in fecal short-chain fatty acid and gut microbiota in irritable bowel syndrome patients. J Dig Dis. 2021;22(5):246-55. doi: 10.1111/1751-2980.12988.
Takeda M, Sashide Y, Utugi S. Neurophysiological Basis of Short-Chain Fatty Acid Action in Pain Modulation: Therapeutic Implications. Int J Mol Sci. 2025;26(16):8082. doi: 10.3390/ ijms26168082.
Zheng H, Chen Y, Lu S, Liu Z, Ma Y, Zhang C, et al. Mechanosensory Piezo2 regulated by gut microbiota participates in the development of visceral hypersensitivity and intestinal dysmotility. Gut Microbes. 2025;17(1):2497399. doi: 10.1080/19490976.2025.2497399.
Sánchez-Carranza O, Chakrabarti S, Kühnemund J, Schwaller F, Bégay V, García-Contreras JA, et al. Piezo2 voltage-block regulates mechanical pain sensitivity. Brain. 2024;147(10):3487- 500. doi: 10.1093/brain/awae227.
Jia Z, Ikeda R, Ling J, Viatchenko-Karpinski V, Gu JG. Regulation of Piezo2 Mechanotransduction by Static Plasma Membrane Tension in Primary Afferent Neurons. J Biol Chem. 2016;291(17):9087-104. doi: 10.1074/jbc.M115.692384.
Mayer EA, Ryu HJ, Bhatt RR. The neurobiology of irritable bowel syndrome. Mol Psychiatry. 2023;28(4):1451-65. doi: 10.1038/s41380-023-01972-w.
Gros M, Gros B, Mesonero JE, Latorre E. Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management. J Clin Med. 2021;10(15):3429. doi: 10.3390/jcm10153429.
Keshteli AH, Madsen KL, Mandal R, Boeckxstaens GE, Bercik P, De Palma G, et al. Comparison of the metabolomic profiles of irritable bowel syndrome patients with ulcerative colitis patients and healthy controls: new insights into pathophysiology and potential biomarkers. Aliment Pharmacol Ther. 2019;49(6):723- 32. doi: 10.1111/apt.15141.
Chojnacki C, Błońska A, Kaczka A, Chojnacki J, Stępień A, Gąsiorowska A. Evaluation of serotonin and dopamine secretion and metabolism in patients with irritable bowel syndrome. Pol Arch Intern Med. 2018;128(11):711-3. doi: 10.20452/pamw.4364.
Grundy L, Erickson A, Brierley SM. Visceral Pain. Annu Rev Physiol. 2019;81:261-84. doi: 10.1146/annurevphysiol-020518-114525.
Chang X, Zhang H, Chen S. Neural circuits regulating visceral pain. Commun Biol. 2024;7(1):457. doi: 10.1038/s42003-024- 06148-y.
Herman JP, McKlveen JM, Ghosal S, Kopp B, Wulsin A, Makinson R, et al. Regulation of the hypothalamic-pituitaryadrenocortical stress response. Compr Physiol. 2016;6(2):603- 21. doi: 10.1002/cphy.c150015.
Huang S, Chen B, Song Z, Tang H, Hua R, Zhang Y. Unraveling the role of Epac1-SOCS3 signaling in the development of neonatal-CRD-induced visceral hypersensitivity in rats. CNS Neurosci Ther. 2022;28(9):1393-408. doi: 10.1111/cns.13880.
Zhang G, Yu L, Chen ZY, Zhu JS, Hua R, Qin X, et al. Activation of corticotropin-releasing factor neurons and microglia in paraventricular nucleus precipitates visceral hypersensitivity induced by colorectal distension in rats. Brain Behav Immun. 2016;55:93-104. doi: 10.1016/j.bbi.2015.12.022.
Li MG, Qu ST, Yu Y, Xu Z, Zhang FC, Li YC, et al. Upregulation of NR2A in Glutamatergic VTA Neurons Contributes to Chronic Visceral Pain in Male Mice. Neurosci Bull. 2025;41(12):2113- 26. doi: 10.1007/s12264-025-01402-7.
Ji NN, Kang J, Hua R, Zhang YM. Involvement of dopamine system in the regulation of the brain corticotropin-releasing hormone in paraventricular nucleus in a rat model of chronic visceral pain. Neurol Res. 2018;40(8):650-7. doi: 10.1080/01616412.2018.1460702.
Li YC, Wang Q, Li MG, Hu SF, Xu GY. A paraventricular hypothalamic nucleus input to ventral of lateral septal nucleus controls chronic visceral pain. Pain. 2023;164(3):625- 37. doi: 10.1097/j.pain.0000000000002750.
Cao Z, Wu X, Chen S, Fan J, Zhang R, Owyang C, et al. Anterior cingulate cortex modulates visceral pain as measured by visceromotor responses in viscerally hypersensitive rats. Gastroenterology. 2008;134(2):535-43. doi: 10.1053/j. gastro.2007.11.057.
Mertz H, Morgan V, Tanner G, Pickens D, Price R, Shyr Y, et al. Regional cerebral activation in irritable bowel syndrome and control subjects with painful and nonpainful rectal distention. Gastroenterology. 2000;118(5):842-8. doi: 10.1016/s0016- 5085(00)70170-3.
Mayer EA, Gupta A, Kilpatrick LA, Hong JY. Imaging Brain Mechanisms in Chronic Visceral Pain. Pain. 2015;156(0 1):S50- 63. doi: 10.1097/j.pain.0000000000000106.
Li Y. Synaptic Plasticity and Synchrony in the Anterior Cingulate Cortex Circuitry: A Neural Network Approach to Causality of Chronic Visceral Pain and Associated Cognitive Deficits. Adv Neurobiol. 2018;21:219-45. doi: 10.1007/978-3- 319-94593-4_8.
Xu QY, Zhang HL, Du H, Li YC, Ji FH, Li R, et al. Identification of a Glutamatergic Claustrum-Anterior Cingulate Cortex Circuit for Visceral Pain Processing. J Neurosci. 2022;42(43):8154-68. doi: 10.1523/JNEUROSCI.0779-22.2022.
Xiao Y, Xie L, Xu QY, Chen L, Chen H, Xu GY, et al. Transcranial direct current stimulation relieves visceral hypersensitivity via normalizing GluN2B expression and neural activity in anterior cingulate cortex. J Neurophysiol. 2021;125(5):1787-97. doi: 10.1152/jn.00025.2021.
Aziz I, Mumtaz S, Bholah H, Chowdhury FU, Sanders DS, Ford AC. High Prevalence of Idiopathic Bile Acid Diarrhea Among Patients With Diarrhea-Predominant Irritable Bowel Syndrome Based on Rome III Criteria. Clin Gastroenterol Hepatol. 2015;13(9):1650-1655.e2. doi: 10.1016/j.cgh.2015.03.002.
Liu SH, Yang XF, Liang L, Song BB, Song XM, Yang YJ, et al. Regulatory mechanisms of the gut microbiota-short chain fatty acids signaling axis in slow transit constipation and progress in multi-target interventions. Front Microbiol. 2025;16:1689597. doi: 10.3389/fmicb.2025.1689597.
Mawe GM, Hoffman JM. Serotonin Signaling in the Gastrointestinal Tract: Nat Rev Gastroenterol Hepatol. 2013;10(8):473-86. doi: 10.1038/nrgastro.2013.105.
Akiho H, Tokita Y, Nakamura K, Satoh K, Nishiyama M, Tsuchiya N, et al. Involvement of Interleukin-17AInduced Hypercontractility of Intestinal Smooth Muscle Cells in Persistent Gut Motor Dysfunction. PLOS ONE. 2014;9(5):e92960. doi: 10.1371/journal.pone.0092960.
Casado-Bedmar M, Keita ÅV. Potential neuro-immune therapeutic targets in irritable bowel syndrome. Therap Adv Gastroenterol. 2020;13:1756284820910630. doi: 10.1177/1756284820910630.
Aubé AC, Blottière HM, Scarpignato C, Cherbut C, Rozé C, Galmiche JP. Inhibition of acetylcholine induced intestinal motility by interleukin 1 beta in the rat. Gut. 1996;39(3):470- 4. doi: 10.1136/gut.39.3.470.
Ng QX, Soh AYS, Loke W, Lim DY, Yeo WS. The role of inflammation in irritable bowel syndrome (IBS). J Inflamm Res. 2018;11:345-9. doi: 10.2147/JIR.S174982.
Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020;11:25. doi: 10.3389/ fendo.2020.00025.
Ju X, Jiang Z, Ma J, Yang D. Changes in Fecal Short-Chain Fatty Acids in IBS Patients and Effects of Different Interventions: A Systematic Review and Meta-Analysis. Nutrients. 2024;16(11):1727. doi: 10.3390/nu16111727.
Sadeghi A, Biglari M, Nasseri Moghaddam S. Post-infectious Irritable Bowel Syndrome: A Narrative Review. Middle East J Dig Dis. 2019;11(2):69-75. doi: 10.15171/mejdd.2019.130.
Dunlop SP, Jenkins D, Neal KR, Spiller RC. Relative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS. Gastroenterology. 2003;125(6):1651-9. doi: 10.1053/j.gastro.2003.09.028.
Tao E, Zhu Z, Hu C, Long G, Chen B, Guo R, et al. Potential Roles of Enterochromaffin Cells in Early Life Stress-Induced Irritable Bowel Syndrome. Front Cell Neurosci. 2022;16:837166. doi: 10.3389/fncel.2022.837166.
Atkinson W, Lockhart S, Whorwell PJ, Keevil B, Houghton LA. Altered 5-Hydroxytryptamine Signaling in Patients With Constipation- and Diarrhea-Predominant Irritable Bowel Syndrome. Gastroenterology. 2006;130(1):34-43. doi: 10.1053/j.gastro.2005.09.031.
Fritz N, Berens S, Dong Y, Martínez C, Schmitteckert S, Houghton LA, et al. The serotonin receptor 3E variant is a risk factor for female IBS-D. J Mol Med. 2022;100(11):1617- 27. doi: 10.1007/s00109-022-02244-w.
Barbaro MR, Di Sabatino A, Cremon C, Giuffrida P, Fiorentino M, Altimari A, et al. Interferon-γ is increased in the gut of patients with irritable bowel syndrome and modulates serotonin metabolism. Am J Physiol Gastrointest Liver Physiol. 2016;310(6):G439-47. doi: 10.1152/ajpgi.00368.2015.
Camilleri M, Nurko S. Bile Acid Diarrhea in Adults and Adolescents. Neurogastroenterol Motil. 2022;34(4):e14287. doi: 10.1111/nmo.14287.
Wong BS, Camilleri M, Carlson PJ, Guicciardi ME, Burton D, McKinzie S, et al. A Klothoβ variant mediates protein stability and associates with colon transit in irritable bowel syndrome with diarrhea. Gastroenterology. 2011;140(7):1934-42. doi: 10.1053/j.gastro.2011.02.063.
Camilleri M, Nurko S. Bile Acid Diarrhea in Adults and Adolescents. Neurogastroenterol Motil. 2022;34(4):e14287. doi: 10.1111/nmo.14287.
Zhan K, Zheng H, Li J, Wu H, Qin S, Luo L, et al. Gut Microbiota-Bile Acid Crosstalk in Diarrhea-Irritable Bowel Syndrome. Biomed Res Int. 2020;2020:3828249. doi: 10.1155/2020/3828249.
Dior M, Delagrèverie H, Duboc H, Jouet P, Coffin B, Brot L, et al. Interplay between bile acid metabolism and microbiota in irritable bowel syndrome. Neurogastroenterology & Motility. 2016;28(9):1330-40. doi: 10.1111/nmo.12829.
Duboc H, Rainteau D, Rajca S, Humbert L, Farabos D, Maubert M, et al. Increase in fecal primary bile acids and dysbiosis in patients with diarrhea-predominant irritable bowel syndrome. Neurogastroenterol Motil. 2012;24(6):513-20. doi: 10.1111/j.1365-2982.2012.01893.x.
Chang DS, Soni KG, Preidis GA. Smooth muscle contractile responses to bile acids in mouse ileum require TGR5 but not ASBT. Front Neurol. 2024;15:1334319. doi: 10.3389/ fneur.2024.1334319.
Keely SJ, Urso A, Ilyaskin AV, Korbmacher C, Bunnett NW, Poole DP, et al. Contributions of bile acids to gastrointestinal physiology as receptor agonists and modifiers of ion channels. Am J Physiol Gastrointest Liver Physiol. 2022;322(2):G201-22. doi: 10.1152/ajpgi.00125.2021.
Kim NH, Park JH, Park JS, Joung YH. The Effect of Deoxycholic Acid on Secretion and Motility in the Rat and Guinea Pig Large Intestine. J Neurogastroenterol Motil. 2017;23(4):606- 15. doi: 10.5056/jnm16201.
Vijayvargiya P, Busciglio I, Burton D, Donato L, Lueke A, Camilleri M. Bile Acid Deficiency in Subgroup of Patients With Irritable Bowel Syndrome With Constipation Based on Biomarkers in Serum and Fecal Samples. Clin Gastroenterol Hepatol. 2018;16(4):522-7. doi: 10.1016/j.cgh.2017.06.039.
Min YW, Rezaie A, Pimentel M. Bile Acid and Gut Microbiota in Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2022;28(4):549-61. doi: 10.5056/jnm22129.
Wong BS, Camilleri M, Carlson P, McKinzie S, Busciglio I, Bondar O, et al. Increased bile acid biosynthesis is associated with irritable bowel syndrome with diarrhea. Clin Gastroenterol Hepatol. 2012;10(9):1009-1015.e3. doi: 10.1016/j.cgh.2012.05.006.
Sun N, Ogulur I, Mitamura Y, Yazici D, Pat Y, Bu X, et al. The epithelial barrier theory and its associated diseases. Allergy. 2024;79(12):3192-237. doi: 10.1111/all.16318.
Camilleri M, Lasch K, Zhou W. Irritable bowel syndrome: methods, mechanisms, and pathophysiology. The confluence of increased permeability, inflammation, and pain in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol. 2012;303(7):G775-785. doi: 10.1152/ajpgi.00155.2012.
Martínez C, Lobo B, Pigrau M, Ramos L, González-Castro AM, Alonso C, et al. Diarrhoea-predominant irritable bowel syndrome: an organic disorder with structural abnormalities in the jejunal epithelial barrier. Gut. 2013;62(8):1160-8. doi: 10.1136/gutjnl-2012-302093.
Ivashkin V, Poluektov Y, Kogan E, Shifrin O, Sheptulin A, Kovaleva A, et al. Disruption of the pro-inflammatory, antiinflammatory cytokines and tight junction proteins expression, associated with changes of the composition of the gut microbiota in patients with irritable bowel syndrome. PLoS One. 2021;16(6):e0252930. doi: 10.1371/journal.pone.0252930.
Di Vincenzo F, Del Gaudio A, Petito V, Lopetuso LR, Scaldaferri F. Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review. Intern Emerg Med. 2024;19(2):275-93. doi: 10.1007/s11739-023-03374-w.
Valitutti F, Mennini M, Monacelli G, Fagiolari G, Piccirillo M, Di Nardo G, et al. Intestinal permeability, food antigens and the microbiome: a multifaceted perspective. Front Allergy. 2025;5. doi: 10.3389/falgy.2024.1505834.
Martínez C, Vicario M, Ramos L, Lobo B, Mosquera JL, Alonso C, et al. The jejunum of diarrhea-predominant irritable bowel syndrome shows molecular alterations in the tight junction signaling pathway that are associated with mucosal pathobiology and clinical manifestations. Am J Gastroenterol. 2012;107(5):736-46. doi: 10.1038/ajg.2011.472.
Martínez C, Lobo B, Pigrau M, Ramos L, González-Castro AM, Alonso C, et al. Diarrhoea-predominant irritable bowel syndrome: an organic disorder with structural abnormalities in the jejunal epithelial barrier. Gut. 2013;62(8):1160-8. doi: 10.1136/gutjnl-2012-302093.
Jakobsson HE, Rodríguez-Piñeiro AM, Schütte A, Ermund A, Boysen P, Bemark M, et al. The composition of the gut microbiota shapes the colon mucus barrier. EMBO Rep. 2015;16(2):164-77. doi: 10.15252/embr.201439263.
Xu J, Wang B, Ao H. Corticosterone effects induced by stress and immunity and inflammation: mechanisms of communication. Front Endocrinol (Lausanne). 2025;16:1448750. doi: 10.3389/ fendo.2025.1448750.
Molotla-Torres DE, Guzmán-Mejía F, Godínez-Victoria M, Drago-Serrano ME. Role of Stress on Driving the Intestinal Paracellular Permeability. Current Issues in Molecular Biology. 2023;45(11):9284. doi: 10.3390/cimb45110581.
Schol J, Huang IH, Balsiger L, Tóth J, Van den Houte K, Verheyden A, et al. The effect of corticotropin-release hormone on duodenal permeability and immune activation in healthy volunteers in a double-blind placebo-controlled study. American Journal of Physiology-Gastrointestinal and Liver Physiology. 2025;328(5):G457-64. doi: 10.1152/ ajpgi.00130.2024.
Vanuytsel T, van Wanrooy S, Vanheel H, Vanormelingen C, Verschueren S, Houben E, et al. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut. 2014;63(8):1293-9. doi: 10.1136/gutjnl-2013-305690.
Ng QX, Yaow CYL, Moo JR, Koo SWK, Loo EXL, Siah KTH. A systematic review of the association between environmental risk factors and the development of irritable bowel syndrome. J Gastroenterol Hepatol. 2024;39(9):1780-7. doi :10.1111/ jgh.16587.
Chen Y, Yang H, Song J, Chen W, Liu K, Liu B, et al. Associations of modifiable factors with risk of irritable bowel syndrome. Front Nutr. 2024;11:1362615. doi:10.3389/fnut.2024.1362615.
Van Pee T, Hogervorst J, Dockx Y, Witters K, Thijs S, Wang C, et al. Accumulation of Black Carbon Particles in Placenta, Cord Blood, and Childhood Urine in Association with the Intestinal Microbiome Diversity and Composition in Fourto Six-Year-Old Children in the ENVIRONAGE Birth Cohort. Environ Health Perspect. 2023;131(1):017010. doi: 10.1289/ EHP11257.
Liu T, Chen X, Xu Y, Wu W, Tang W, Chen Z, et al. Gut microbiota partially mediates the effects of fine particulate matter on type 2 diabetes: Evidence from a populationbased epidemiological study. Environment International. 2019;130:104882. doi: 10.1016/j.envint.2019.05.076.
Sommer AJ, Peters A, Rommel M, Cyrys J, Grallert H, Haller D, et al. A randomization-based causal inference framework for uncovering environmental exposure effects on human gut microbiota. PLOS Computational Biology. 2022;18(5):e1010044. doi: 10.1371/journal.pcbi.1010044.
Estevinho MM, Midya V, Cohen-Mekelburg S, Allin KH, Fumery M, Pinho SS, et al. Emerging role of environmental pollutants in inflammatory bowel disease risk, outcomes and underlying mechanisms. Gut. 2025;74(3):477-86. doi: 10.1136/gutjnl-2024-332523.
Berumen A, Edwinson AL, Grover M. Post-infection Irritable Bowel Syndrome. Gastroenterol Clin North Am. 2021;50(2):445-461. doi: 10.1016/j.gtc.2021.02.007.
Ng QX, Soh AYS, Loke W, Lim DY, Yeo WS. The role of inflammation in irritable bowel syndrome (IBS). J Inflamm Res. 2018;11:345-9. doi: 10.2147/JIR.S174982.
Sadeghi A, Biglari M, Nasseri Moghaddam S. Post-infectious Irritable Bowel Syndrome: A Narrative Review. Middle East J Dig Dis. 2019;11(2):69-75. doi: 10.15171/mejdd.2019.130.
Zhang F, Lau RI, Liu Q, Su Q, Chan FKL, Ng SC. Gut microbiota in COVID-19: key microbial changes, potential mechanisms and clinical applications. Nat Rev Gastroenterol Hepatol. 2023;20(5):323-37. doi: 10.1038/s41575-022-00698-4.
Noviello D, Costantino A, Muscatello A, Bandera A, Consonni D, Vecchi M, et al. Functional gastrointestinal and somatoform symptoms five months after SARS-CoV-2 infection: A controlled cohort study. Neurogastroenterol Motil. 2022;34(2):e14187. doi: 10.1111/nmo.14187.
Wu S, Yang Z, Liu S, Zhang Q, Zhang S, Zhu S. Ultra-Processed Food Consumption and Long-Term Risk of Irritable Bowel Syndrome: A Large-Scale Prospective Cohort Study. Clin Gastroenterol Hepatol. 2024;22(7):1497-1507.e5. doi: 10.1016/j.cgh.2024.01.040.
Wu S, Yang Z, Liu S, Zhang Q, Zhang S, Zhu S. SugarSweetened Beverages, Artificially Sweetened Beverages and Sugar Forms With Long-Term Risk of Irritable Bowel Syndrome: A Large-Scale Prospective Cohort Study. Food Sci Nutr. 2025;13(3):e70094. doi: 10.1002/fsn3.70094.
Li L, Ran Y, Zhuang Y, Xu Y, Wang L, Chen L, et al. Proinflammatory Diet Increases the Risk of Irritable Bowel Syndrome: A Prospective Study of 129,408 UK Biobank Participants and Mendelian Randomization Analysis. Dig Dis Sci. 2024;69(11):4140-51. doi: 10.1007/s10620-024-08638-9.
Li Y, Liu S, Zhang Q, Zhang S, Wu S. Dietary index for gut microbiota and risk of incident irritable bowel syndrome: a large-scale prospective cohort study. Nutr J. 2025;24(1):157. doi: 10.1186/s12937-025-01224-3.
Baghdadi G, Feyzpour M, Shahrokhi SA, Amiri R, Rahimlou M. The association between the Mediterranean Diet and the prime diet quality score and new-diagnosed irritable bowel syndrome: a matched case-control study. Front Med (Lausanne). 2025;12:1529374. doi: 10.3389/ fmed.2025.1529374.
van Lanen AS, de Bree A, Greyling A. Efficacy of a lowFODMAP diet in adult irritable bowel syndrome: a systematic review and meta-analysis. Eur J Nutr. 2021;60(6):3505-22. doi: 10.1007/s00394-020-02473-0.
Jayasinghe M, Karunanayake V, Mohtashim A, Caldera D, Mendis P, Prathiraja O, et al. The Role of Diet in the Management of Irritable Bowel Syndrome: A Comprehensive Review. Cureus. 2024;16(2):e54244. doi: 10.7759/ cureus.54244.
Zhou Y, Liu S, Xie S, Zhang Q, Zhang S, Zhu S, et al. Longterm risk of irritable bowel syndrome associated with adverse childhood and adulthood experiences: a large-scale prospective cohort study. Transl Psychiatry. 2026;16(1):70. doi: 10.1038/s41398-026-03833-w.
Nicholl BI, Halder SL, Macfarlane GJ, Thompson DG, O’Brien S, Musleh M, et al. Psychosocial risk markers for new onset irritable bowel syndrome - Results of a large prospective population-based study. Pain. 2008;137(1):147-55. doi: 10.1016/j.pain.2007.08.029.
Hashempour B, Ansari FK, Asadiof F, Naeim M. Psychological self-efficacy and coping styles as mediators between perceived stress and IBS symptom severity: a cross-sectional study. Ann Med Surg (Lond). 2025;87(11):7074-9. doi: 10.1097/MS9.0000000000003876.
Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20(39):14126-31. doi: 10.3748/wjg.v20.i39.14126.
Bertollo AG, Santos CF, Bagatini MD, Ignácio ZM. Hypothalamus-pituitary-adrenal and gut-brain axes in biological interaction pathway of the depression. Front Neurosci. 2025;19:1541075. doi: 10.3389/fnins.2025.1541075.
Klem F, Wadhwa A, Prokop L, Sundt W, Farrugia G, Camilleri M, et al. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: a Systematic Review and Meta-analysis. Gastroenterology. 2017;152(5):1042-1054.e1. doi: 10.1053/j.gastro.2016.12.039.
Berumen A, Lennon R, Breen-Lyles M, Griffith J, Patel R, Boxrud D, et al. Characteristics and Risk Factors of PostInfection Irritable Bowel Syndrome After Campylobacter Enteritis. Clin Gastroenterol Hepatol. 2021;19(9):1855-1863. e1. doi: 10.1016/j.cgh.2020.07.033.
Lacy BE, Pimentel M, Brenner DM, Chey WD, Keefer LA, Long MD, et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. Am J Gastroenterol. 2021;116(1):17-44. doi: 10.14309/ajg.0000000000001036.
Ford AC, Sperber AD, Corsetti M, Camilleri M. Irritable bowel syndrome. The Lancet. 2020;396(10263):1675-88. doi: 10.1016/S0140-6736(20)31548-8.
Spiller R, Garsed K. Postinfectious irritable bowel syndrome. Gastroenterology. 2009;136(6):1979-88. doi: 10.1053/j. gastro.2009.02.074.
Darkoh C, Comer L, Zewdie G, Harold S, Snyder N, DuPont HL. Chemotactic Chemokines Are Important in the Pathogenesis of Irritable Bowel Syndrome. PLoS One. 2014;9(3):e93144. doi: 10.1371/journal.pone.0093144.
Wang LH, Fang XC, Pan GZ. Bacillary dysentery as a causative factor of irritable bowel syndrome and its pathogenesis. Gut. 2004;53(8):1096-101. doi: 10.1136/gut.2003.021154.
Burns GL, Roberts F, Wark JA, Fowler S, Jones MP, Duncanson K, et al. Serological and faecal markers of irritable bowel syndrome: a systematic review and meta-analysis. 2026;126:106198. doi: 10.1016/j.ebiom.2026.106198.
Pimentel M, Morales W, Rezaie A, Marsh E, Lembo A, Mirocha J, et al. Development and Validation of a Biomarker for Diarrhea-Predominant Irritable Bowel Syndrome in Human Subjects. PLoS One. 2015;10(5):e0126438. doi: 10.1371/ journal.pone.0126438.
Vasapolli R, Schulz C, Schweden M, Casèn C, Kirubakaran GT, Kirste KH, et al. Gut microbiota profiles and the role of antiCdtB and anti-vinculin antibodies in patients with functional gastrointestinal disorders (FGID). European Journal of Clinical Investigation. 2021;51(12):e13666. doi: 10.1111/eci.13666.
Rezaie A, Park SC, Morales W, Marsh E, Lembo A, Kim JH, et al. Assessment of Anti-vinculin and Anti-cytolethal Distending Toxin B Antibodies in Subtypes of Irritable Bowel Syndrome. Dig Dis Sci. 2017;62(6):1480-5. doi: 10.1007/s10620-017-4585-z.
Hung KW, Leiman DA, Kaza A, Watson R, Chang L, Maratt JK, et al. AGA Institute Quality Indicator Development for Irritable Bowel Syndrome. Gastroenterology. 2025;168(3):612-622.e4. doi: 10.1053/j.gastro.2024.11.003.
Smalley W, Falck-Ytter C, Carrasco-Labra A, Wani S, Lytvyn L, Falck-Ytter Y. AGA Clinical Practice Guidelines on the Laboratory Evaluation of Functional Diarrhea and DiarrheaPredominant Irritable Bowel Syndrome in Adults (IBS-D). Gastroenterology. 2019;157(3):851-4. doi: 10.1053/j. gastro.2019.07.004.
Gros B, Kaplan GG. Ulcerative Colitis in Adults: A Review. JAMA. 2023;330(10):951-65. doi: 10.1001/jama.2023.15389.
Menees SB, Powell C, Kurlander J, Goel A, Chey WD. A metaanalysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol. 2015;110(3):444-54. doi: 10.1038/ajg.2015.6.
Aziz I, Simrén M. The overlap between irritable bowel syndrome and organic gastrointestinal diseases. The Lancet Gastroenterology & Hepatology. 2021;6(2):139-48. doi: 10.1016/S2468-1253(20)30212-0.
Zhang H, Luan J, He L, Pan X, Zhang H, Li Y, et al. Role of the gut-brain axis in neurological diseases: Molecular connections and therapeutic implications (Review). Int J Mol Med. 2025;56(5):192. doi: 10.3892/ijmm.2025.5633.
Appleton J. The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health. Integr Med (Encinitas). 2018;17(4):28-32.
Stasi C, Bellini M, Gambaccini D, Duranti E, de Bortoli N, Fani B, et al. Neuroendocrine Dysregulation in Irritable Bowel Syndrome Patients: A Pilot Study. J Neurogastroenterol Motil. 2017;23(3):428-34. doi: 10.5056/jnm16155.
Konsman JP. Cytokines in the Brain and Neuroinflammation: We Didn’t Starve the Fire! Pharmaceuticals (Basel). 2022;15(2):140. doi: 10.3390/ph15020140.
Köhler A, Delbauve S, Smout J, Torres D, Flamand V. Very early-life exposure to microbiota-induced TNF drives the maturation of neonatal pre-cDC1. Gut. 2021;70(3):511-21. doi: 10.1136/gutjnl-2019-319700.
Agirman G, Yu KB, Hsiao EY. Signaling inflammation across the gut-brain axis. Science. 2021;374(6571):1087-92. doi: 10.1126/science.abi6087.
Chang L, Sultan S, Lembo A, Verne GN, Smalley W, Heidelbaugh JJ. AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Constipation. Gastroenterology. 2022;163(1):118-36. doi: 10.1053/j.gastro.2022.04.016.
Lembo A, Sultan S, Chang L, Heidelbaugh JJ, Smalley W, Verne GN. AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Diarrhea. Gastroenterology. 2022;163(1):137-51. doi: 10.1053/j. gastro.2022.04.017.
Arnold MJ. Medications for Irritable Bowel Syndrome: Guidelines From the AGA. afp. 2023;108(5):527-9.
Black CJ, Burr NE, Camilleri M, Earnest DL, Quigley EM, Moayyedi P, et al. Efficacy of pharmacological therapies in patients with IBS with diarrhoea or mixed stool pattern: systematic review and network meta-analysis. Gut. 2020;69(1):74-82. doi: 10.1136/gutjnl-2018-318160.
Chey WD, Hashash JG, Manning L, Chang L. AGA Clinical Practice Update on the Role of Diet in Irritable Bowel Syndrome: Expert Review. Gastroenterology. 2022;162(6):1737-1745.e5. doi: 10.1053/j.gastro.2021.12.248.
Black CJ, Staudacher HM, Ford AC. Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis. Gut. 2022;71(6):1117-1126. doi: 10.1136/gutjnl-2021-325214.
Sikaroudi MK, Soltani S, Ghoreishy SM, Ebrahimi Z, Shidfar F, Dehnad A. Effects of a low FODMAP diet on the symptom management of patients with irritable bowel syndrome: a systematic umbrella review with the meta-analysis of clinical trials. Food Funct. 2024;15(10):5195-208. doi: 10.1039/ D3FO03717G.
Thakur ER, Khasawneh M, Moayyedi P, Black CJ, Ford AC. Efficacy of behavioural therapies for irritable bowel syndrome: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2025;10(12):1075-1088. doi: 10.1016/S2468-1253(25)00238-9.
Goodoory VC, Khasawneh M, Thakur ER, Everitt HA, Gudleski GD, Lackner JM, et al. Effect of Brain-Gut Behavioral Treatments on Abdominal Pain in Irritable Bowel Syndrome: Systematic Review and Network Meta-Analysis. Gastroenterology. 2024;167(5):934-943.e5. doi: 10.1053/j.gastro.2024.05.010.
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Derechos de autor 2026 Jose Augusto Urrego, Hernando Marulanda, Juan Sebastián Frías, Hugo Cedrón, Jorge Espinoza-Ríos, Lina Otero, William Otero
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Revista de Gastroenterología del Perú by Sociedad Peruana de Gastroenterología del Perú is licensed under a Licencia Creative Commons Atribución 4.0 Internacional..
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