Intestinal Secretory Mechanisms in Irritable Bowel Syndrome-Diarrhea

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18 Scopus citations


Although diarrhea is the predominant bowel dysfunction in as many as one-third of patients with irritable bowel syndrome (IBS), it is unclear whether there is a specific disorder of intestinal fluid or electrolyte secretion in IBS. Diarrhea is generally considered a result of accelerated colonic transit in patients with IBS. Although a primary secretory diathesis has not been well-documented in patients with IBS with diarrhea (IBS-D), several mechanisms that could potentially contribute to intestinal secretion have been reported. Some of these mechanisms also influence motor and secretory dysfunctions that contribute to the pathophysiology of IBS-D. We review the evidence supporting secretion in IBS-D caused by peptides and amines produced by enteroendocrine cells or submucosal neurons, enterocyte secretory processes, and intraluminal factors (bile acids and short-chain fatty acids). Understanding these mechanisms and developing clinical methods for their identification could improve management of patients with IBS-D.

Original languageEnglish (US)
Pages (from-to)1051-1057
Number of pages7
JournalClinical Gastroenterology and Hepatology
Issue number6
StatePublished - Jun 1 2015


  • Absorption
  • Intestine
  • Pathogenesis
  • SCFA

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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