Authors: Yehuda Ringel, MD Douglas A. Drossman, MD

A detailed discussion of the irritable bowel syndrome and inflammation.

Infection and Inflammation: Stephen M. Collins[study link below] provided a comprehensive review of the evidence suggesting the need to consider infection and inflammation in the pathogenesis of some patients with IBS. He presented data from clinical studies showing the development of IBS symptoms following acute gastroenteritis (ie, postinfectious [PI] IBS) and a higher than expected prevalence of IBS symptoms among patients with inflammatory bowel disease that was in remission.

Additionally, data from animal studies demonstrated that altered gut physiology can persist even after the infection and associated inflammation have resolved. Furthermore, studies of mucosal biopsies, from both human and animal models, have shown increased inflammatory cells and inflammatory mediators in patients with IBS and in previously sensitized/stressed animals.

Finally, some recent studies have shown proximity between nerve trunks and the inflammatory cells, suggesting a local neuroimmune interaction that may contribute to the pathogenesis of IBS. With respect to the latter, several key studies presented during these meeting proceedings provided some supportive evidence relating the role of infection and inflammation to IBS.

Study link: http://www.medscape.com/viewarticle/434527

• A Role for Inflammation in Irritable Bowel Syndrome?
• Terminal Ileal Mucosal Mast Cells in Irritable Bowel Syndrome
• Increased Mast Cells in the Irritable Bowel Syndrome
• Activated Mast Cells in Proximity to Colonic Nerves Correlate with Abdominal Pain in Irritable Bowel Syndrome