Irritable bowel syndrome in quiescent inflammatory bowel disease

A review

R. E. Burgell, A. K. Asthana, P. R. Gibson

Research output: Contribution to journalReview ArticleResearchpeer-review

3 Citations (Scopus)

Abstract

Ongoing troublesome bowel symptoms despite quiescent inflammatory disease are a frequent management challenge when caring for patients with inflammatory bowel disease (IBD). Even when active disease has been excluded the prevalence of residual gastrointestinal symptoms is surprisingly high and the cause often obscure. The presence of a concurrent functional disorder such as irritable bowel syndrome (IBS) is associated with worse quality of life, worse physical functioning, higher prevalence of anxiety and greater health care utilization. Potential etiological mechanisms leading to the development of IBS like symptoms include the development of visceral hypersensitivity following the original inflammatory insult, alteration in cortical processing, dysbiosis and residual subacute inflammation. Therapeutic options for managing IBS in patients with IBD include dietary modification, interventions targeted at correction of visceral sensory dysfunction or cortical processing and modulation of the gut microbiota. As there are few studies specifically examining the treatment of IBS in patients with IBD, the majority of therapeutic interventions are extrapolated from the IBS literature. Given the frequency of residual functional symptoms in IBS, significantly more research is warranted in this field.

Original languageEnglish
Pages (from-to)201-213
Number of pages13
JournalMinerva Gastroenterologica e Dietologica
Volume61
Issue number4
Publication statusPublished - 1 Dec 2015

Keywords

  • Colitis, ulcerative
  • Crohn disease
  • Irritatile bowel syndrome

Cite this

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Irritable bowel syndrome in quiescent inflammatory bowel disease : A review. / Burgell, R. E.; Asthana, A. K.; Gibson, P. R.

In: Minerva Gastroenterologica e Dietologica, Vol. 61, No. 4, 01.12.2015, p. 201-213.

Research output: Contribution to journalReview ArticleResearchpeer-review

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AU - Burgell, R. E.

AU - Asthana, A. K.

AU - Gibson, P. R.

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AB - Ongoing troublesome bowel symptoms despite quiescent inflammatory disease are a frequent management challenge when caring for patients with inflammatory bowel disease (IBD). Even when active disease has been excluded the prevalence of residual gastrointestinal symptoms is surprisingly high and the cause often obscure. The presence of a concurrent functional disorder such as irritable bowel syndrome (IBS) is associated with worse quality of life, worse physical functioning, higher prevalence of anxiety and greater health care utilization. Potential etiological mechanisms leading to the development of IBS like symptoms include the development of visceral hypersensitivity following the original inflammatory insult, alteration in cortical processing, dysbiosis and residual subacute inflammation. Therapeutic options for managing IBS in patients with IBD include dietary modification, interventions targeted at correction of visceral sensory dysfunction or cortical processing and modulation of the gut microbiota. As there are few studies specifically examining the treatment of IBS in patients with IBD, the majority of therapeutic interventions are extrapolated from the IBS literature. Given the frequency of residual functional symptoms in IBS, significantly more research is warranted in this field.

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