Irritable bowel syndrome and related disorders of gut-brain interaction.

This Lancet review examines irritable bowel syndrome, chronic constipation, and functional diarrhoea, collectively termed disorders of gut-brain interaction, which affect about 20% of people worldwide. It asks what drives these conditions, how they are diagnosed and managed, and why current options are limited, noting that risk factors include female sex, younger age, common mental disorders, and prior enteric infection, with pathophysiology linked to disordered gut motility and visceral hypersensitivity. The authors conclude that empathetic care, diet and lifestyle changes, fibre modification, and symptom-directed drugs are the mainstays of treatment, while devices, biofeedback, and psychological therapies serve severe cases, and that the modest effectiveness of existing therapies underscores the need for novel drugs now in development.