The pathogenesis of irritable bowel syndrome (IBS) has been intensively researched, and despite a long journey for unraveling all the structures and the pathways involved, it still remains partially obscure. Inflammation was the first to be hypothesized as a potential pathway for the pathogenesis of IBS. It remains a keystone in the complex machinery of the pathogenesis that is currently considered multifactorial. Elucidating the pathogenesis of IBS is crucial for a targeted therapy of the disease. In this chapter, we review information regarding gut inflammation in IBS, underlining some of the newest data or the cornerstones. Additionally, our aim was also to review treatment currently available and future perspectives regarding anti‐inflammatory treatments for IBS. Newer techniques allow detection and research of mediators involved in inflammation, as well as their potential role to be targeted by pharmacological agents. Recent data supports not only further research of the newer agents that are currently being developed but also some of the available ones that do not have sufficient evidence. Emerging therapies that target inflammation are under evaluation, in trials. A multidrug or a multidisciplinary approach needs to be considered in some cases that fail to respond to current treatment.
Part of the book: Irritable Bowel Syndrome
Anorectal biofeedback is a method used by specialists in gastrointestinal motility to treat disorders of defecation. In the case of the anorectal biofeedback, unlike in biofeedback applications in other medical fields, the signal is represented by the pressure in the anorectal canal. The pressure is assessed by anorectal manometry. Patients are trained to become aware of this signal in an attempt to reeducate them for a correct defecation. Following the variation of the signals, patients can learn how to modulate the anal sphincter pressure and to improve their defecation disorders. Anorectal biofeedback is therefore used for fecal incontinence and for chronic terminal constipation. Despite its potential, the method is not intensively used and many patients ignore it. The specialists’ evaluation of the method is controversial: from enthusiastic to deceiving results, different data are available. The aim of this presentation is to analyze factors of success and of failure in the use of anorectal biofeedback in a single center specialized in anorectal manometry and to compare our data with results described by other authors.
Part of the book: Biofeedback