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Treatment for Bacterial Overgrowth in the Irritable Bowel Syndrome

Douglas A. Drossman, MD
[+] Article, Author, and Disclosure Information

From the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Douglas A. Drossman, MD, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, CB7080, 4150 Bioinformatics Building, Chapel Hill, NC 27599-7080.

Ann Intern Med. 2006;145(8):626-628. doi:10.7326/0003-4819-145-8-200610170-00012
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Over the last 10 to 20 years, the irritable bowel syndrome (IBS) has garnered considerable scientific interest. The acceptance of the biopsychosocial model (1), the application of symptom-based diagnostic criteria (for example, Rome diagnostic criteria), and the growth in biological and behavioral measurement technology (23) has created a fertile area for new research in IBS with the potential for more effective treatments. Research now focuses on altered motility and neuroenteric signaling; visceral hypersensitivity and its enhancement by inflammation and altered mucosal immunity; and brain–gut dysfunction via altered pain, autonomic, and stress-related (for example, corticotropin-releasing hormone) pathways (23). It is now evident that IBS is not a single disease but is a well-characterized symptom complex that relates symptoms to a variety of underlying physiologic determinants from gut to brain and back. Thus, a single “magic bullet” for the disorder is unlikely: Treatments will be used alone or in combination to target the altered physiologic determinants that are unique to each individual.

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