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Background There is an implied perception that little scientific information on irritable bowel syndrome (IBS) comes out of Mexico and Latin America in the international medical literature, but the number and tendencies of articles from the region on IBS are not known. Aims To determine the number and type of Mexican and Latin American articles on IBS published between 1990-2015. Methods A systematic search of Medline was carried out employing the terms «Irritable Bowel Syndrome» or its abbreviation (IBS). Mexico and every other Latin American country were added to specify the search. The articles were selected if they were published in Mexico and/or the rest of Latin America, if they were international papers on IBS in the region, or if they were written by Mexican and/or Latin American authors. In addition, the articles were classified into the following categories: Review Articles/Editorials/Letters to the Editor (REV/ED), studies emphasizing aspects of Epidemiology/Quality of Life/Psychosocial Factors (EPI/QOL), articles dealing with Diagnoses (DX), with Treatment (TX), and Translational/Pathophysiologic studies (TRANS). Results A total of 66 articles from Mexico and 47 from Latin America were identified, but only 87.7 and 48.9%, respectively, fit the selection criteria. Category distribution was: EPI/QOL: 36.2%, REV/ED: 27.5%, TRANS: 18.8, TX: 10%, and DX: 7.5% and was similar between Mexico and Latin America (p = 0.33). The year 2005 saw an increase in the number of articles in Mexico, with a peak in 2010. The figures for Latin American articles remained stable over the years, with a peak in 2012. Conclusions A noticeable increase has been observed over the last decade in the research conducted on IBS in Mexico and Latin America. Even though the EPI/QOL studies predominate, the sophistication of research is reflected in the TRANS studies that are in third place of frequency. The information referred to herein demonstrates maturity in the field, making it possible to carry out consensuses based on local data.

ResumenAntecedentesExisten controversias sobre la prevalencia del síndrome de intestino irritable (SII)-postinfeccioso (PI), sobrepoblación bacteriana (SPB), alteraciones en la microbiota, inflamación de bajo grado y antibioticoterapia en SII.ObjetivosRealizar una revisión basada en evidencia de estos factores.MétodosSe realizó una revisión de la literatura hasta julio del 2012 y se incluyeron artículos adicionales hasta agosto del 2013, los cuales fueron analizados mediante el sistema del Centro para Medicina Basada en Evidencia de la Universidad de Oxford (OCEBM).Resultados1.Existe mayor probabilidad de SPB mediante pruebas de aliento pero la prevalencia es muy variable (2-84%). 2.La microbiota intestinal es diferente en SII que en sujetos sanos, pero no se ha establecido una característica común presente en todos los pacientes. 3.La incidencia y prevalencia del SII-PI varía del 9-10% y 3-17%, respectivamente; esta última disminuye con el tiempo. La etiología bacteriana es la más frecuente, pero se han reportado casos posvirales y parasitarios. 4.Existe un subgrupo de pacientes con incremento de células enterocromafines, linfocitos intraepiteliales y mastocitos en la mucosa intestinal, pero no se han determinado diferencias entre SII-PI y SII-NoPI. 5.La microbiota metanogénica se asocia con el SII con estreñimiento. 6.La rifaximina en dosis de 400mg TID/10días o 550mg TID/14días es efectiva en la mejoría de síntomas globales y distensión abdominal en SII. La efectividad del retratamiento parece ser similar a la del primer ciclo.ConclusionesSe requieren más estudios para determinar la microbiota intestinal propia del SII y las diferencias en inflamación de bajo grado entre SII-PI y SII-NoPI. La rifaximina ha demostrado efectividad en el tratamiento del SII independientemente de los factores anteriores.AbstractBackgroundPost-infectious irritable bowel syndrome (PI-IBS) prevalence, small intestinal bacterial overgrowth (SIBO), altered microbiota, low-grade inflammation, and antibiotic therapy in IBS are all controversial issues.AimsTo conduct an evidence-based review of these factors.MethodsA review of the literature was carried out up to July 2012, with the inclusion of additional articles as far as August 2013, all of which were analyzed through the Oxford Centre for Evidence-Based Medicine (OCEBM) system.Results1.There is greater SIBO probability in IBS when breath tests are performed, but prevalence varies widely (2-84%). 2.The gut microbiota in individuals with IBS is different from that in healthy subjects, but a common characteristic present in all the patients has not been established. 3.The incidence and prevalence of PI-IBS varies from 9-10% and 3-17%, respectively, and the latter decreases over time. Bacterial etiology is the most frequent but post-viral and parasitic cases have been reported. 4.A sub-group of patients has increased enterochromaffin cells, intraepithelial lymphocytes, and mast cells in the intestinal mucosa, but no differences between PI-IBS and non-PI-IBS have been determined. 5.Methanogenic microbiota has been associated with IBS with constipation. 6.Rifaximin at doses of 400mg TID/10days or 550mg TID/14days is effective treatment for the majority of overall symptoms and abdominal bloating in IBS. Retreatment effectiveness appears to be similar to that of the first cycle.ConclusionsFurther studies are required to determine the nature of the gut microbiota in IBS and the differences in low-grade inflammation between PI-IBS and non-PI-IBS. Rifaximin has shown itself to be effective treatment for IBS, regardless of prior factors.