Mucosal inflammation as a potential etiological factor in irritable bowel syndrome: a systematic review

Abstract

Low-grade mucosal inflammation, particularly mast cell activation, may be a contributory factor in the pathogenesis of IBS. Mast cell stabilizers warrant further assessment as a potential therapy in the condition.

Negative Effects on Psychological Health and Quality of Life of Genuine Irritable Bowel Syndrome–type Symptoms in Patients With Inflammatory Bowel Disease

“…Higher levels of peripheral and mucosal pro-inflammatory cytokines have been demonstrated in IBS patients, 14 and it may be that in IBD a low-grade inflammation, distinct from that of overt disease activity, leads to activation of the enteric nervous system, epithelial barrier dysfunction, increased mucosal permeability, visceral hypersensitivity, and activation of the brain-gut axis, resulting in the generation of IBS-type symptoms. The cause of this ongoing low-grade inflammation could be perturbations in the intestinal microbiome, with a relative abundance of pro-inflammatory bacterial species having been previously described in IBS.…”

Analysis of Gastric and Duodenal Eosinophils in Children with Abdominal Pain Related Functional Gastrointestinal Disorders According to Rome III Criteria

“…42,43 For instance, perturbation of luminal contents, such as dietary antigens or gastrointestinal pathogens, through an abnormally increased intestinal permeability may facilitate an inappropriate stimulation of the host immune response in post-infectious IBS patients. 12,44 Increased infiltration of the lamina propria T cells, mast cells, and enterochromaffin cells have also been observed in the colon or ileum of patients with post-infectious IBS. 30 The mediators released by these activated cells types may stimulate sensory afferent pathways and induce visceral hyperalgesia.…”

“…32,33 Previous studies also show an increase in T lymphocyte infiltrates. 12,14,25,29,30,33 Conversely, there appears to be no significant differences in tissue eosinophil counts of patients with IBS. 12,14,31,34 However, histopathological studies in pediatric patients with AP-FGID are relatively scarce, moreover, the results of some studies are discrepant from those of studies on adults.…”

“…[6][7][8][9][10] Recent studies suggest that mild inflammation of the intestines is essentially involved in the pathophysiology of functional gastrointestinal disorder (FGID). [11][12][13][14][15][16] Adult studies on FGID, especially functional dyspepsia (FD) and irritable bowel syndrome (IBS), 13,14 have found that increased infiltration of eosinophils, mast cells, and intraepithelial lymphocytes represent low-grade mucosal inflammation in the gastrointestinal tract. In adult FD patients, gastric eosinophil counts tend not to be significantly increased, but the duodenal eosinophil count and duodenal degranulation is prominently increased.…”

“…13,[16][17][18][19][20][21] On the other hand, several studies also show increased infiltration and degranulation of gastric and duodenal mast cells in adult FD patients. 16,[22][23][24] In adult patients with IBS, most studies demonstrate increased infiltration of mast cells in all parts of the duodenum, 14 jejunum, 25 ileum, 26 and colon, 12,[27][28][29][30][31] with the exception of a few studies. 32,33 Previous studies also show an increase in T lymphocyte infiltrates.…”