1. Irritable Bowel Syndrome: Modern Concepts and Management Options
Gregory S. Sayuk, MD, MPH, C. Prakash Gyawali, MD 
The American Journal of Medicine 
Volume 128, Issue 8, Pages (August 2015)
DOI: /j.amjmed
Copyright © 2015 Elsevier Inc. Terms and Conditions

2. Figure 1
A biopsychosocial model of irritable bowel syndrome pathophysiology. Irritable bowel syndrome is thought to be a multifactorial disorder, deriving from a potential multitude of etiopathogenic factors, including environmental, psychologic, and physiologic factors. This model highlights the complex, often bidirectional interplay of these factors in the experience of irritable bowel syndrome symptoms. cGMP = cyclic guanosine monophosphate; 5-HT3 = serotonin type 3; 5-HT4 = serotonin type 4; FODMAPS = fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; HRQOL = health-related quality of life; IBS = irritable bowel syndrome.
The American Journal of Medicine  , DOI: ( /j.amjmed )
Copyright © 2015 Elsevier Inc. Terms and Conditions

3. Figure 2
Overview of irritable bowel syndrome treatment strategy. Irritable bowel syndrome management involves the use of a continuum of peripheral (gut)-based and centrally acting (brain-gut) strategies. The selection of an appropriate treatment approach for a particular patient with irritable bowel syndrome considers patient severity (eg, effect on daily function/quality of life and overlapping mood disorders) and dominant symptoms (eg, transit vs pain). Patients with more straightforward, mild presentations respond well to gut-centric approaches,1,2 whereas complex presentations are likely to achieve improvement with treatments that address central nervous system influences on symptom presentation.3,4 HRQOL = health-related quality of life; IBS = irritable bowel syndrome.
The American Journal of Medicine  , DOI: ( /j.amjmed )
Copyright © 2015 Elsevier Inc. Terms and Conditions