Irritable Bowel Symptoms Tied to Intestinal, Brain Abnormalities

A greater number of intestinal and brain function abnormalities increases the burden of irritable bowel syndrome (IBS), according to a study recently published in Gastroenterology.

Magnus Simrén, M.D., Ph.D., from the University of Gothenburg in Sweden, and colleagues retrospectively analyzed pathophysiologic alterations and patient-reported outcomes from three cohorts of patients with IBS (407 participants; 74 percent female; mean age, 36 years) seen at a Swedish specialized unit for functional gastrointestinal disorders from 2002 through 2014.

The researchers found that 36 percent of patients had allodynia, 22 percent had hyperalgesia, 18 percent had accelerated colonic transit, 7 percent had delayed transit, 52 percent had anxiety, and 24 percent had depression. Each of these conditions was associated with severity of at least one symptom of IBS. One in five patients had at least three pathophysiologic factors, while two factors were present in 30 percent and one factor was present in 31 percent. Eighteen percent of patients had no pathophysiologic factors. There was a gradual increase in IBS symptom severity and somatic symptom severity and a gradual reduction in quality of life with an increasing number of pathophysiologic abnormalities.

"These factors have a cumulative effect on gastrointestinal and nongastrointestinal symptoms, as well as on quality of life, in patients with IBS and are therefore relevant treatment targets," the authors write.

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