Irritable bowel syndrome is a very frequent cause for consulting. The clinical entity is ill-defined and diagnosis is based on clinical features (Rome criteria), as no specific feature helps guide the diagnosis. Since its pathophysiology is currently being better described, this study was aimed at reviewing recent data.After involvement of the motor system had been suggested, more recent pathophysiological studies have focused on diffuse abnormalities of visceral perception with decrease in pain thresholds. Involvement of other physiopathological factors, particularly of psychological disturbances, has been suggested.Management of patients suffering from irritable bowel syndrome is still disappointing as pharmacological agent acting on gut motility are only partly efficacious. Better understanding of its physiopathology will open new avenues for the development of therapeutical agents truly efficacious on visceral hypersensitivity.