Integrative Perspectives on Irritable Bowel Syndrome (IBS): Pathophysiology and Therapeutic Approaches in Western and Unani Medicine
Year: 2025
Type: article
Abstract: Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by recurrent abdominal pain, bloating, and altered bowel habits, occurring in the absence of any identifiable structural abnormalities. Despite extensive research, the exact pathophysiology of IBS remains unclear, and current treatment approaches in modern medicine are primarily focused on symptomatic relief. IBS is among the most prevalent functional gastrointestinal disorders and is attributed to a complex interplay of gut-brain axis dysfunction, visceral hypersensitivity, dysbiosis of gut microbiota, and psychosocial stressors. In contrast, Unani medicine conceptualizes IBS within the framework of humoral imbalance, emphasizing disturbances in digestive temperament and dysfunctions of the liver and intestines. Symptoms resembling IBS are elaborated in Unani literature under various conditions affecting the sub-faculties of Quwa-e-Tabi‘iyah (natural faculties), including entities such as Ishaal-eDimāghī, Ishāl-e-Idwārī, Zarb-wa-Khulfa, Asbi Dast, and disorders involving Balgham and Safrā’. Other contributing factors described include altered Harkat-e-Dūdiyah (peristaltic movements), increased activity of Urūq-e-Jāzibah (absorptive vessels), and disturbances in Asbāb-e-Sitta Zarūriyya (six essential factors), as well as various forms of Qaulanj (colic). Unani scholars advocate for a holistic treatment approach involving dietary regulation (Ilāj bil Ghidhā), herbal formulations (Ilāj bil Dawa), and regimental therapies (Ilāj bil Tadbīr) such as cupping (Hijāmah) and massage to restore gastrointestinal balance and overall health Irritable Bowel Syndrome (IBS), Functional Gastrointestinal Disorder, Gut-Brain Axis, Visceral Hypersensitivity, Unani Medicine, Quwa-e-Tabi‘iyah, Humoral Imbalance, Herbal Medicine 1. Shahid A, Riyazuddin M, Bhat MDA. Irritable Bowel Syndrome - Reviewed Through the Lens of Unani System of Medicine. Res Rev J Unani Siddha Homeopathy. 2020;9(1):1-6. 2. Malone M, Allen S, Katz J, McCauley M, Watson H. Irritable Bowel Syndrome: A Review and Update. SL Gastroenterol. 2018;1(2):118. 3. Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016;150:1257-61. 4. Rome Foundation. Rome IV diagnostic criteria for functional gastrointestinal disorders [Internet]. Rome Foundation; [cited 2025 May 29]. Available from: https://theromefoundation.org/rome-iv/ 5. Ahuja NK. A Case Study in the IBS-C Management Continuum: Assessing Patient Response and Tailoring Treatment. [No journal details provided]. 6. Hyams JS. Irritable bowel syndrome, functional dyspepsia, and functional abdominal pain syndrome. Adolesc Med Clin. 2004;15(1):1- 15. doi: 10.1016/S1547336803000032. PMID: 15272253. 7. Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, et al. Childhood functional gastrointestinal disorders: child/ adolescent. Gastroenterology. 2006;130(5):1527-37. doi: 10.1053/j. gastro.2005.08.063. PMID: 16678566. 8. Ohman L, Simrén M. Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions. Nat Rev Gastroenterol Hepatol. 2010;7(3):163-73. doi: 10.1038/nrgastro.2010.4. PMID: 20101257. 9.Faizan M, Khan IMT, Ali M, Khan NA. Therapeutic effect of Unani medicine in the management of irritable bowel syndrome (IBS): A case report. [No journal provided]. 10. Gwee KA, Ghoshal UC, Chen M. Irritable bowel syndrome in Asia: Pathogenesis, natural history, epidemiology, and management. J Gastroenterol Hepatol. 2018;33(1):99-110. 11. Malone M, Allen S, Katz J, McCauley M, Watson H. Irritable Bowel Syndrome: A Review and Update. SL Gastroenterol. 2018;1(2):118. 12. Moazzam SW, Mobeen A, Siddiqui MA. Efficacy of fawarish Shahi and herbal formulation in irritable bowel syndrome: An open-labeled single-arm clinical trial. J Tradit Complement Med.2022;12(6):529-350 13. Ghoshal UC, Sachdeva S, Pratap N, et al. Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology. Indian J Gastroenterol. 2023;42:249-73. doi: 10.1007/s12664-022-01333-5. 14. Furness JB, Callaghan BP, Rivera LR, Cho HJ. The enteric nervous system and gastrointestinal innervation: integrated local and central control. Adv Exp Med Biol. 2014;817:39-71. 15. Gu Y, Zhou G, Qin X, Huang S, Wang B, Cao H. The potential role of gut mycobiome in irritable bowel syndrome. Front Microbiol. 2019;10:2215. 16. Walker BR, Colledge NR, Ralston SH, Penman ID. Davidson's Principles and Practice of Medicine. 22nd ed. Edinburgh: Churchill Livingstone Elsevier; 2014. p. 907. 17. Jurjani I, Shahi ZK. Idara Kitabus Shifa. New Delhi: Idara Kitabus Shifa; 2010. p. 10-13. 18. Ali SA. Tarjuma Zakheera Sabit Ibn Qurrah. Aligarh: Lithocolour Printers; 1987. p. 233. 19. Yasir M, Fahad A, Ahmad I, Khan MF. Etiopatho-genesis of Mälankhüliyä Maraqé (A syndrome of depression and anxiety due to gastrointestinal pathology). [No journal info provided]. 20. Farheen F. Case studies of irritable bowel syndrome & its management with Unani medicine. Int J Unani Integ Med. 2020;4(3):73-7. doi: 10.33545/2616454X.2020.v4.i3b.145. 21. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA. 2015;313(9):949-58. doi: 10.1001/jama.2015.0954. PMID: 25734736. 22. Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. J Gastroenterol Hepatol. 2010;25(2):252-8. doi: 10.1111/j.1440- 1746.2009.06149.x. PMID: 20136989.
Authors: Mohd Mushfiq, Mursaleen Naseer, Mohammad Afif Khan, Naved Ahmad
Institution: Aligarh Muslim University
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4411622317