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This review is the first to compile the available evidence on the efficacy of the various pharmacological treatments for IBS on the basis of IBS subtype and specific symptoms. The low baseline abundance of mtDNA molecules may predispose smooth muscle cells of the muscularis propria external layer to the toxic effects of thymidine and deoxyuridine, and exposure to high circulating levels of nucleosides may account for the mtDNA depletion observed in the small vessel wall. Intestinal villi help to absorb nutrients from food, but when gluten is consumed, the immune system attacks these villi as a result.
The literature search identified 58 placebo-controlled trials of the efficacy of medications for treating IBS symptoms, which were critically evaluated and reported. We also observed mitochondrial proliferation and mtDNA depletion in small vessel endothelial and smooth muscle cells.
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