IBS and IBD - separate entities or on a spectrum?

Nat Rev Gastroenterol Hepatol. 2016 Sep 26;13(10):613-21. doi: 10.1038/nrgastro.2016.141.

Abstract

The acute phase of IBD with inflamed gut and often ulcerated mucosa is clearly different from the apparently normal mucosa characteristic of IBS. However, more detailed assessment has detected immune activation, increased gut permeability, increased mucosal serotonin availability, abnormalities of enteric nerve structure and function, and dysbiosis in gut microbiota in IBS - all features seen in IBD. Furthermore, as treatments for inflammation in IBD have become more effective it is now apparent that ∼1 in 3 patients with IBD in remission from inflammation still have persistent abnormalities of sensation, motility and gut microbiota, which might cause IBS-like symptoms. This Perspective explores the overlap between IBS and IBD and their treatments, proposing future directions for research in this stimulating area.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / physiology
  • Diagnosis, Differential
  • Forecasting
  • Gastrointestinal Microbiome
  • Gastrointestinal Tract / physiology
  • Genetic Predisposition to Disease
  • Humans
  • Immunity, Mucosal / immunology
  • Inflammatory Bowel Diseases / diagnosis*
  • Inflammatory Bowel Diseases / etiology
  • Inflammatory Bowel Diseases / therapy
  • Intestinal Mucosa / immunology
  • Intestines / innervation
  • Irritable Bowel Syndrome / diagnosis*
  • Irritable Bowel Syndrome / etiology
  • Irritable Bowel Syndrome / therapy
  • Permeability
  • Serotonin / metabolism
  • Signal Transduction / physiology

Substances

  • Serotonin