What is postinfectious IBS (PI-IBS)? IBS symptoms develop in approximately 10% of healthy individuals after an infectious gastroenteritis. PI-IBS is most commonly reported after a bacterial infection such as Campylobacter, Salmonella, and Shigella, but has also been reported after viral, bacterial, protozoa, and nematode infections. Even after clearing the infection, there remains an increase in inflammatory (including CD3 lymphocytes, …
Significance of visceral hypersensitivity in IBS IBS patients have lower pain thresholds to balloon-distention volumes specific to the GI tract (i.e., rectosigmoid, descending colon, small intestine, stomach, and esophagus) in comparison with healthy individuals. The cause of visceral hypersensitivity in IBS is not completely understood. However, researchers now believe that noxious stimuli can change the …
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Role of the intestinal microbiota in IBS Several studies have suggested that some differences exist in the intestinal microflora of IBS patients compared with healthy individuals. Using conventional microbiologic techniques, fecal microfloras of IBS patients have been shown to have higher numbers of facultative organisms, such as Klebsiella species and enterococci, and lower numbers of Enterobacteriaceae, lactobacilli, and …
Role of abnormal central processing of pain Abnormal central processing, such as down-regulation of incoming visceral sensations, has also been found in patients with IBS. In IBS patients, rectal distention fails to activate the perigenual anterior cingulated cortex (ACC), the area containing large amounts of B-endorphin activity, which may serve to down-regulate pain, but instead …
Role of intestinal dysmotility in IBS Although abnormal motor patterns have been found in patients with IBS, these patterns are also found in healthy individuals and are therefore not diagnostic for IBS. IBS patients have both a reduction and an increase in the number of contractions per minute in IBS patients compared with healthy individuals. …
What is the current belief about the causes and risk factors for IBS? The pathogenesis of IBS appears to be multifactorial. Factors believed to play a role in the pathogenesis of IBS include heritability and genetics, environment and social learning, diet, intestinal microbiota, low-grade inflammation, central processing of visceral sensations, gut dysmotility, and disturbances in …
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Economic burden of IBS Only approximately 25% to 50% of individuals with IBS symptoms ever seek health care. Nevertheless, given the prevalence of symptoms, IBS has a significant economic burden. IBS is one of the top 10 reasons for consultation with a primary care physician, and the most common reason for consulting a gastroenterologist. Nearly …