A review on pathophysiology of irritable bowel syndrome with emphasis on the role of brain factors

Irritable bowel syndrome (IBS) is a common and chronic functional gastrointestinal disorder that causes a great burden on the individual and society. Despite many studies, there is no consent about the etiology, diagnostic and treatment method of IBS. In recent years, neurologic factors have been given attention for better understanding and management of this disorder. The aim of the present study was a narrative review on the pathophysiology of IBS with emphasis on the role of the central neural system especially brain factors. Based on the literature review, variant factors have a role in the pathophysiology of IBS and recently the hypothesis of gut-brain axis dysfunction is considered as an important factor to induce the IBS symptoms. The Gut-brain axis is a neuro-structural context in that happen connection between brain and gut by interaction among the central nervous system, autonomic nervous system, and enteric nervous system. The review of studies about brain function and structure of patients with IBS indicated that cortical and subcortical areas related to pain, emotion, and cognition are different in IBS patients than in healthy people. These results lead to a better understanding of the underlying mechanism of irritable bowel syndrome that can be used in diagnostic and treatment processes in clinical and research settings.