Potential Pitfalls in the Differential Diagnosis of Irritable Bowel Syndrome

Smout, A. J. P. M.; Azpiroz, Fernando; Coremans, Georges; Dapoigny, Michel; Collins, S. M.; Müller-Lissner, S; Pace, F.; Stockbrügger, R.W.; Vatn, Morten H.; Whorwell, Peter J.

doi:10.1159/000007765

Cited by 10 publications

(7 citation statements)

References 58 publications

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“…The causes of a prominent colonic mast cell infiltrate and activation observed in IBS patients are unknown. Data suggest that factors including previous episodes of infectious enteritis 35 and undiagnosed food allergies 53 may contribute either individually or in combination. In this study, we discarded the possibility to investigate postinfectious IBS to avoid the bias related to retrospective analyses.…”

Section: Discussionmentioning

confidence: 99%

Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome

et al. 2004

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“…Furthermore, food reactions may contribute to the pathophysiology of IBS and mucosal immune activation, since some patients with IBS may benefit from specific elimination diets 73,74 . Therefore, occult food allergies, that remain unrecognized because of the lack of sensitive and specific diagnostic tests, are strong candidates for tissue MC infiltration and activation in IBS 75 …”

Section: Mast Cells and Ibsmentioning

confidence: 99%

Functional gastrointestinal disorders and mast cells: implications for therapy

Barbara

Stanghellini

Giorgio

et al. 2005

Neurogastroenterology Motil

157

142

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The pathophysiology of functional gastrointestinal disorders is poorly understood. Accepted common mechanisms include psychosocial factors, abnormal gastrointestinal motility and disturbed visceral sensory perception, but the underlying causes remain unclear. Mast cells (MCs) are immunocytes widely distributed throughout the gastrointestinal tract. Several stimuli (e.g. allergens, neuropeptides and stress) lead to MC activation with consequent mediator release (e.g. histamine, tryptase and prostanoids). The MC mediators interact with nerves supplying the gut leading to altered gut physiology and increased sensory perception. The intestinal mucosa of irritable bowel syndrome patients contains on average an increased number of MCs. These cells release an increased amount of mediators in close vicinity to mucosal innervation. The MC activation and their close proximity to nerve fibres is correlated with the severity of perceived abdominal painful sensations. These data provide a strong basis for considering MCs as important participants in visceral hypersensitivity and pain perception in irritable bowel syndrome. Inhibition of MC function may ameliorate irritable bowel symptoms. Novel drugs with an increased potential in the control of MC function (e.g., anti-IgE antibodies, the intracellular protein tyrosine kinase inhibitor Syk) and mediator release (e.g., second generation antihistamines, proteinase-activated receptor antagonists) may be useful pharmacological tools for these common disorders.

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“…Previous episodes of infectious enteritis, 10 genetic factors, 26 undiagnosed food allergies, 27 and changes in intestinal microflora 28 may all play a role, either individually or in combination.…”

Section: Putative Causes Of Low Grade Intestinal Inflammationmentioning

confidence: 99%