The Irritable Bowel Syndrome

Section Editor(s): Wald, Arnold; Modlin, Irvin M.; Floch, Martin H.

The irritable bowel syndrome (IBS) persists as a major problem in clinical medicine. Patients suffering from the syndrome frequent the offices of primary care doctors and gastroenterologists. The visits are repetitive and treatments are debated.

In this supplement issue of the Journal, the classification, clinical findings, pathobiology, clinical management, and debatable issues are reviewed. One of the main goals of the workshop and this resultant publication is to help clinicians in the management of this large group of patients. Consequently we have reviewed the clinical management in several papers and the use of all therapeutic modalities, including psychological approaches, diet therapies and the use of available pharmacologic agents. It should be noted that in the United States there are few new agents available, but in other countries many new drugs are available to use in the treatment of IBS. Of particular interest is the new research and understanding of visceral hypersensitivity, the enteric nervous system and serotonin metabolic pathways that specifically focus on 5HT4 receptors. We hope that this supplement achieves our goal of bringing the clinician up to date in available therapy and future modalities of therapy.

All of the manuscripts were peer reviewed. I am particularly indebted to Dr. Arnold Wald for his intensive review of each manuscript and his recommendations to authors for improvements.

The contents of this supplement represent manuscripts presented at the workshop colloquium meeting held at Yale University, September 26, 2001. Dr. Irvin Modlin received an unrestricted educational grant from Glaxo-Wellcome to hold their colloquium on IBS at Yale, and I received an unrestricted grant from Novartis to publish a supplement on the same subject. We combined our efforts to invite the world's experts who were able to attend on that date to present their understanding of particular aspects of the syndrome. The faculty and participants felt the colloquium was a huge success. After their presentations, there were detailed discussions of specific case material by participants of the workshop and members of the Yale faculty.

This supplement publishes the manuscripts presented at the meeting, as well as a summation of discussions written by Drs. Moss and Modlin of the meeting and the discussions.

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