The pathophysiology of irritable bowel syndrome

ArticleinMinerva medica 95(5):419-26 · November 2004with4 Reads
Source: PubMed
Recent studies have provided evidence to suggest a possible role for mucosal immune activation in the pathophysiology of irritable bowel syndrome (IBS). On the other hand, novel findings using functional brain-imaging techniques support the concept that altered perception of visceral stimuli plays a key role in IBS symptom generation. These seemingly contradictory findings have revived the discussion about the relative contribution of peripheral versus central mechanisms in the symptom generation of IBS. In this review, we will provide evidence for the hypothesis that, in the absence of changes in visceral perception and alterations in endogenous pain modulation systems, chronic inflammatory mucosal changes in the gut are not a plausible mechanism to explain the presence of chronic abdominal pain, a clinical hallmark of IBS.
    • "Also a direct causal link between immune dysfunction and the severity of MUS still needs to be established. From a recent literature review Schwetz, Bradesi and Mayer (2004), for example, concluded that chronic inflammatory mucosal changes in the gut are not a plausible mechanism to explain the presence of abdominal pain in IBS. Instead, the altered perception of visceral stimuli seemed to play a key role, suggestive of a more pronounced role of central rather than peripheral mechanisms. "
    [Show abstract] [Hide abstract] ABSTRACT: Medically unexplained symptoms (MUS) are frequently associated with a history of traumatization. The first purpose of the present review paper was to investigate systematically the evidence for such relation in a subset of clinical samples with MUS presenting with functional somatization: chronic pelvic pain, irritable bowel syndrome and conversion and somatization disorder. The second purpose was to critically review three dominant models explaining the relation between trauma and MUS (i.e. dissociation, conversion and hierarchical cognitive models). The latter model in particular adequately accounts for the non-volitional and non-intentional character of MUS and explains how traumata can affect the development of MUS without assuming that previous trauma is a necessary prerequisite of MUS. The cognitive model, however, lacks integration with current neurobiological findings, indicative of central stress-and central nervous system alterations in MUS. The final purpose of the present paper was, therefore, to review current neurobiological studies focused on trauma and MUS and to formulate a research agenda to integrate these neurobiological developments with cognitive models for MUS.
    Full-text · Article · Nov 2007
  • [Show abstract] [Hide abstract] ABSTRACT: Evaluation of thyroid function tests in patients with irritable Bowel Syndrome
    Article · · World Chinese Journal of Digestology
  • [Show abstract] [Hide abstract] ABSTRACT: AIM: To analyze the differential expression of proteome in colonic mucosa between patients with constipation-predominant irritable bowel syndrome (C-IBS) and the healthy controls. METHODS: Two dimensional polyacrylamide gel electrophoresis (2-DE) technique and computer-assisted image analysis were used to separate the protein spots and analyze the differential expression of proteome in the colonic mucosa of the healthy controls and patients with C-IBS. RESULTS: A total of 308 protein spots were identified in the av-erage gel of the healthy controls, and 238 in patients with C-IBS. A total of 178 protein spots were matched, and the mean matching rate was 74.49%. There were 18 protein spots that were significantly differentially expressed. Of those 18 protein spots, the expression of 3 spots were increased markedly, while 15 were decreased significantly. CONCLUSION: The proteomic expression in colonic mucosa of patients with C-IBS is significantly different from that of the healthy contr ols, which may be associated with the pathogenesis of C-IBS.
    Article · Oct 2005
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