Irritable bowel syndrome

Abstract Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder with an estimated prevalence from 5% to 20% in adults. Typical symptoms are abdominal discomfort and pain, bloating, and diarrhea changing with constipation. The majority of patients perceive their symptoms as being related to specific meals. Some types of IBS, especially diarrhea-predominant cases, are sensitive to gluten-containing foods and show symptomatic improvement on a gluten-free diet (GFD). The pathogenesis of IBS is poorly understood and may include bacterial overgrowth, increased intestinal permeability, visceral sensation, gut-brain interactions, stress, and psycho-social status. The diagnosis is not only based on the exclusion of other food hypersensitivities but also on symptom-related criteria. Strategies for treatment are based on general recommendations; small and frequent meals are recommended and foods, rich in fat and carbohydrates, as well as dairy products should be avoided. Diarrhea-predominant patients are advised to test a GFD for several months.