There is growing interest in the area of irritable bowel syndrome (IBS) in developing tools to separate various subgroups of this disease in order to identify potentially different pathogenetic mechanisms. From such work, the ultimate goal is tailored treatment for the various subtypes of the disease. Among major achievements in this research, the finding of increased gut permeability is of great interest and suggests a luminal factor as a cause of disease, which would be able to maintain low-grade inflammation. There are various treatment options and significant activity in developing drugs that have the capability to inhibit gut motility and increase luminal secretion. The development of analogues to gut peptide hormones, such as glucagon-like peptide 1, is of primary interest, as these drugs rarely give rise to inconvenient adverse reactions at therapeutic doses. Some of these drugs even exert their action directly on the luminal membranes, such as linaclotide, which means that oral administration is favored to diminish the risk of systemic reactions. The concept of IBS is anticipated to evolve into different disease mechanisms that will serve as the basis for customized treatments.
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