الفهرس 
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Abstract
Background: Irritable bowel syndrome (IBS) is a common chronic, relapsing gastrointestinal disorder characterized by abdominal pain and altered bowel habit for at least 3 months. IBS is prevalent, expensive to treat, and is associated with significantly impaired health-related quality of life and reduced productivity. Aim: The aim of this work is to search new lines of management of IBS according to evidence based medicine. Method: The American Journal of Gastroenterology, American Journal of Medical Science, Evidence-Based Medicine Reviews (EBMR) and Journal of Clinical Gastroenterology were allocated particular areas to produce review documents. Literature searching included systematic searches using electronic databases such as Pubmed, Web of Science, and Cochrane databases. Result: Patients can usefully be classified by predominant bowel habit. Few investigations are needed except when diarrhea is a prominent feature. Alarm features may warrant further investigation. Adverse psychological features and somatization are often present. IBS is a heterogeneous condition with a range of treatments, each of which benefits a small proportion of patients. Treatment of associated anxiety and depression often improves bowel and other symptoms. Randomized placebo controlled trials show benefit as follows: cognitive behavioral therapy and psychodynamic interpersonal therapy improve coping; antispasmodics and tricyclic antidepressants improve pain; ispaghula improves pain and bowel habit; 5-HT3 antagonists improve global symptoms, diarrhea, and pain but may rarely cause unexplained colitis; 5-HT4 agonists improve global symptoms, constipation, and bloating; selective serotonin reuptake inhibitors improve global symptoms. Conclusions: Better ways of identifying which patients will respond to specific treatments are urgently needed. Abstract Background: Irritable bowel syndrome (IBS) is a common chronic, relapsing gastrointestinal disorder characterized by abdominal pain and altered bowel habit for at least 3 months. IBS is prevalent, expensive to treat, and is associated with significantly impaired health-related quality of life and reduced productivity. Aim: The aim of this work is to search new lines of management of IBS according to evidence based medicine. Method: The American Journal of Gastroenterology, American Journal of Medical Science, Evidence-Based Medicine Reviews (EBMR) and Journal of Clinical Gastroenterology were allocated particular areas to produce review documents. Literature searching included systematic searches using electronic databases such as Pubmed, Web of Science, and Cochrane databases. Result: Patients can usefully be classified by predominant bowel habit. Few investigations are needed except when diarrhea is a prominent feature. Alarm features may warrant further investigation. Adverse psychological features and somatization are often present. IBS is a heterogeneous condition with a range of treatments, each of which benefits a small proportion of patients. Treatment of associated anxiety and depression often improves bowel and other symptoms. Randomized placebo controlled trials show benefit as follows: cognitive behavioral therapy and psychodynamic interpersonal therapy improve coping; antispasmodics and tricyclic antidepressants improve pain; ispaghula improves pain and bowel habit; 5-HT3 antagonists improve global symptoms, diarrhea, and pain but may rarely cause unexplained colitis; 5-HT4 agonists improve global symptoms, constipation, and bloating; selective serotonin reuptake inhibitors improve global symptoms. Conclusions: Better ways of identifying which patients will respond to