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1. Introduction
2. Irritable Bowel Syndrome (IBS)
3. What is IBS?
4. "Classical" IBS is a coherent entity
5. IBS in the "real" world!
6. IBS features
7. IBS: Rome III definition (1)
8. IBS: Rome III definition (2)
9. A more clinician-friendly definition?
10. Criteria-based definition of IBS
11. The irritable colon syndrome study (1)
12. The irritable colon syndrome study (2)
13. We have ignored the rest of the world!
14. Global prevalence of IBS 2005
15. Regional variations
16. IBS pathophysiology
17. The gut brain axis in IBS (1)
18. The gut brain axis in IBS (2)
19. A new paradigm
20. Evidence for a role for the gut flora in IBS
21. Post infectious IBS
22. Walkerton, Ontario
23. Long term outcome, does PI- IBS go away?
24. CSGNA outbreak - Norovirus
25. Lessons from PI- IBS
26. Direct evidence of an altered gut flora, SIBO
27. Another explanation for antibiotic effect in IBS?
28. Altered colonic flora
29. GI microbiota in IBS
30. The fecal flora in IBS
31. Colonic biofilm
32. Physiological effects of an altered flora
33. Altered flora causing alterations in gas volume
34. Mediator of pro-inflammatory state
35. Pro-inflammatory state
36. Systemic and mucosal immune system
37. Systemic compartment (1)
38. Systemic immune compartment in IBS
39. Alternative approach to IBS pathophysiology (1)
40. IBS and somatic co-morbidity
41. Alternative approach to IBS pathophysiology (2)
42. Significance of changes in inflammatory markers
43. ACTH response to CRH
44. The mucosal immune system
45. Mucosal compartment (1)
46. Beta-defensin 2 in IBS
47. Mucosal compartment (2)
48. Can we link bacteria, inflammation and IBS?
49. Is this a form of IBD?
50. Calprotectin in IBS
51. IBS symptoms in IBD?
52. Crohn's Disease
53. Ulcerative Colitis
54. Therapeutic impact of altering flora
55. Antibiotics
56. Rifaximin
57. Probiotics
58. Anti-inflammatories
59. Mesalazine in IBS
60. Food, diet and IBS: role in pathophysiology
61. Food intake and GI symptoms
62. Food scores in IBS
63. Why does food provoke symptoms in IBS?
64. Physiological effects of food
65. Diet and IBS
66. Food allergy in IBS
67. IgG responses in IBS (1)
68. IgG responses in IBS (2)
69. Gluten-reactive IBS (1)
70. Gluten-reactive IBS (2)
71. Food intolerance in IBS
72. Diagnosis
73. Yield of tests in IBS
74. Prevalence of organic disease in IBS
75. Management
76. Food, diet and IBS: role in management
77. Fiber/bulking agents for IBS
78. Probiotics
79. Prebiotics (1)
80. Probiotics in IBS, pre 2000
81. Probiotics in IBS, from 2000
82. Study design
83. Pain, VAS scale
84. Composite score
85. Systemic compartment (2)
86. Bifidobacterium in IBS
87. Abdominal pain or discomfort
88. Bloating
89. Global assessment of symptom relief
90. Bif. animalis in C-IBS
91. Bifidobacterium lactis DN 173 010 (1)
92. Bifidobacterium lactis DN 173 010 (2)
93. What about the long-term?
94. Prebiotics (2)
95. Prebiotics and synbiotics in IBS
96. IBS: pharmacological and other approaches
97. Antispasmodics
98. Cochrane study
99. Anti-depressants for IBS
100. Anti-depressants in IBS
101. New approaches
102. Targets
103. Challenges in drug development
104. Significance
105. New targets (1)
106. Serotonin
107. Tegaserod
108. Alosetron
109. New targets (2)
110. Lubiprostone in C-IBS
111. Psychotherapy and hypnotherapy
112. What do we need to know?
113. Conclusions

Topics Covered

• A common symptom-based disorder which affects 5-15% of the adult population world-wide
• For some, symptoms can be severe, frequent and significantly impact on quality of life
• Commonly regarded as reflecting a dysfunction of the gut-brain axis, low grade inflammation and dysbiosis of the microbiota have been implicated of late
• Management continues to be challenging with approaches which aim to alleviate individual symptoms (pain, constipation, diarrhoea) continuing to dominate in the absence of truly disease-modifying therapies.

Links

Series:

• Gastroenterology and Hepatology

Categories:

• Clinical Practice

Therapeutic Areas:

• Gastroenterology & Nephrology

Talk Citation

Publication History

• Published on January 5, 2011

Financial Disclosures

• Prof. Eamonn M. M. Quigley, Consultant: Alimentary Health, Allergen, Commonwealth Laboratories, Rhythm, Salix, Synergy, Vibrant Speaker’s Bureau: Procter and Gamble Grant/Research Support (Principal Investigator): Rhythm, Therevance, Vibrant Stock Shareholder (Self-managed): Alimentary Health