Recognizing and managing patients with irritable bowel syndrome

PURPOSE: To address the diagnosis and clinical management of irritable bowel syndrome (IBS) and provide a discussion of the available serotonergic agents. DATA SOURCES: Recent studies examining the pathophysiology of IBS. CONCLUSIONS: Diagnostic testing may be required in the subset of patients with IBS who present with alarm symptoms, or "red flags," suggestive of underlying organic disease. An important role has been suggested for the neurotransmitter serotonin in both gut motility and visceral pain sensitivity. IMPLICATIONS FOR PRACTICE: A diagnosis of IBS is largely based on symptoms; therefore, effective clinician-patient communication and careful attention to details of patient presentation, history, and physical examination are essential.