Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place

Rani, Rafiz Abdul; Ali, Raja Affendi Raja; Lee, Yeong Yeh

doi:10.5217/ir.2016.14.4.297

Cited by 48 publications

(31 citation statements)

References 65 publications

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“…Both reflect MT-associated immune activation ( Monnig et al, 2016 ). Previous studies have reported that MT is an exclusive pathogenic characteristics in IBD/IBS ( Abdul et al, 2016 ), graft-versus-host disease ( Eriguchi et al, 2012 ) and HIV disease ( Yim et al, 2009 ), which feature increased levels of LPS-sCD14 and EndoCAb-IgM. Indeed, the commensal flora operate synergistically with the intestinal barrier, and interact with the innate immune system well.…”

Section: Discussionmentioning

confidence: 99%

Altered Gut Microbiota in Myasthenia Gravis

et al. 2018

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Myasthenia gravis (MG) is an autoimmune-mediated disorder, the etiology of which involves both environmental factors and genetics. While the exact factors responsible for predisposition to MG remain elusive, it is hypothesized that gut microbiota play a critical role in the pathogenesis of MG. This study investigated whether gut microbiota are altered in MG patients by comparing the fecal microbiota profiles of MG patients to those of age- and sex-matched healthy controls. Phylotype profiles of gut microbial populations were generated using hypervariable tag sequencing of the V4 region of the 16S ribosomal RNA gene. Fecal short-chain fatty acids (SCFAs) were assessed by gas chromatographic analyses. The results demonstrated that, compared to the healthy cohort, the gut microbiota of the MG group was changed in terms of the relative abundances of bacterial taxa, with sharply reduced microbial richness, particularly in the genus Clostridium. The fecal SCFA content was significantly lower in the MG group. Furthermore, microbial dysbiosis was closely related to the levels of inflammatory biomarkers in the sera of MG patients.

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Section: Discussionmentioning

confidence: 99%

Altered Gut Microbiota in Myasthenia Gravis

et al. 2018

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“…Previously, IBS was considered completely different from IBD; however, recent studies have suggested that some overlap may exist between these two disease entities [ 17 ]. Although the degrees of inflammation and visceral hypersensitivity between IBD and IBS are different, they have similarities regarding the brain-gut axis, some genetic factors, dysbiosis, and impaired epithelial barrier function [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors of bowel symptoms in Korean patients with ulcerative colitis in endoscopic remission: a retrospective study

Nam

Park

et al. 2021

BMC Gastroenterol

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Background Many patients with ulcerative colitis (UC) in clinical remission frequently complain of bowel symptoms such as increased stool frequency (SF) and rectal bleeding (RB). However, studies on these patient-reported outcomes in patients with inactive UC are limited, especially in Korea. Therefore, we investigated the prevalence and risk factors of bowel symptoms in Korean patients with inactive UC. Methods We investigated the prevalence of bowel symptoms in patients with endoscopically quiescent UC between June 1989 and December 2016 using a well-characterized referral center-based cohort. The Mayo clinic score (MCS) was used to evaluate bowel symptoms at the most recent visit near the date of endoscopy. Clinical characteristics of the patients were compared based on the presence or absence of bowel symptoms. Results Overall, 741 patients with endoscopically quiescent UC were identified, of whom 222 (30%) and 48 (6.5%) had an SF and RB subscore of ≥ 1, respectively. Patients with bowel symptoms (SF + RB ≥ 1; n = 244 [32.9%]) had higher rates of left-sided colitis (E2) or extensive colitis (E3) than patients without bowel symptoms (SF + RB = 0; n = 497 [67.1%]; P = 0.002). Multivariate analysis revealed that female sex (odds ratio [OR]: 1.568; 95% confidence interval [CI]: 1.023–2.402; P = 0.039) and E2 or E3 (OR 1.411; 95% CI 1.020–1.951; P = 0.038) were the significant risk factors for increased SF. Conclusions This study revealed that one-third of patients with endoscopically quiescent UC reported increased SF. Female sex and disease extent may be associated with bowel symptoms.

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“…The pathophysiology of IBS is not completely understood; however, dysregulation of the brain-gut axis is believed to lead to IBS [3]. Various central and peripheral mechanisms are indicated to be involved, such as altered GI motility, visceral hypersensitivity, alternation in the intestinal microbiota, low-grade immune activation, and intestinal inflammation, which may be linked to enhanced exposure to antigens due to increased intestinal permeability [3-7]. Therefore, IBS is a very heterogeneous disorder and can be subtyped based on the bowel habits of the patients, such as diarrhea or constipation [8].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, IBS is a very heterogeneous disorder and can be subtyped based on the bowel habits of the patients, such as diarrhea or constipation [8]. Furthermore, some of the organic mechanisms of IBS are partly shared with the pathophysiology of IBD, and similarities in clinical manifestations are also observed between IBS and IBD [3,9]. Postinfectious IBS (PI-IBS), which is diagnosed on the basis of acute onset of symptoms meeting the diagnostic criteria for IBS, has been regarded as a typical condition resulting from intestinal inflammation accompanied by other various pathophysiologic mechanisms [10].…”

Section: Introductionmentioning

confidence: 99%

Is fecal calprotectin always normal in children with irritable bowel syndrome?

Choi¹,

Jeong²

2019

Intest Res

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Background/AimsFecal calprotectin (FC) is a marker of intraluminal intestinal inflammation. Intestinal inflammation may contribute to the pathophysiology of irritable bowel syndrome (IBS). This study evaluated FC levels in children with IBS and differences in FC levels in children stratified by IBS subtype and healthy controls (HCs).MethodsA total of 157 children with IBS and 56 HCs aged 4–16 years (119 boys, 94 girls, mean age of 9.48 years) were included in this prospective study. Children with IBS were diagnosed using the Rome III criteria and classified into 4 subtypes: IBS with constipation (IBS-C, n=37), IBS with diarrhea (IBS-D, n=54), IBS with alternating constipation and diarrhea (IBS-M, n=49), and IBS unsubtyped (IBS-U, n=17); postinfectious IBS (PI-IBS) was also considered. The FC concentration in stool samples was analyzed using an enzyme-linked immunosorbent assay. All participants answered a questionnaire regarding several demographic and clinical characteristics.ResultsChildren with IBS had significantly higher levels of FC than the HCs (88.71 μg/g vs. 17.77 μg/g). Among the 4 IBS subtypes, the FC concentration was highest in children with IBS-D, followed by those with IBS-M, IBS-C, and IBS-U (169.94 μg/g vs. 45.04, 31.22, and 33.52 μg/g, respectively), and these differences were statistically significant. For PI-IBS, 90% of cases were in the IBS-D group.ConclusionsThe FC level was significantly higher in children with IBS than in HCs and differed depending on the IBS subtype, supporting the notion that IBS is a type of low-grade bowel inflammation.

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Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place

Cited by 48 publications

References 65 publications

Altered Gut Microbiota in Myasthenia Gravis

Altered Gut Microbiota in Myasthenia Gravis

Prevalence and risk factors of bowel symptoms in Korean patients with ulcerative colitis in endoscopic remission: a retrospective study

Is fecal calprotectin always normal in children with irritable bowel syndrome?

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