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Refractory inflammatory bowel disease-could it be an irritable bowel?
Jie Meng1, Anurag Agrawal, Peter J Whorwell
1Department of Gastroenterology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078 China.
Nature Reviews. Gastroenterology & Hepatology
|September 12, 2012
Summary
Patients with Inflammatory Bowel Disease (IBD) in remission may still have symptoms. Considering co-existent Irritable Bowel Syndrome (IBS) and its treatments can improve their quality of life.
Area of Science:
- Gastroenterology
- Internal Medicine
Background:
- Patients with Inflammatory Bowel Disease (IBD) often report persistent symptoms despite achieving clinical remission, evidenced by normal blood tests, endoscopy, and ultrasonography.
- Standard practice of increasing anti-inflammatory medication in such cases is often ineffective and may lead to adverse events.
Approach:
- This study suggests considering the possibility of co-existent Irritable Bowel Syndrome (IBS) in IBD patients experiencing ongoing symptoms without clear inflammatory activity.
- Evaluating and treating for IBS alongside IBD management is proposed as a potential strategy.
Key Points:
- Persistent symptoms in IBD patients may not always indicate active inflammation.
- Co-existent IBS is a potential cause of symptoms in seemingly remissive IBD patients.
- Targeting IBS symptoms can lead to significant patient improvement.
Conclusions:
- When objective measures show remission in IBD patients, but symptoms persist, clinicians should consider IBS as a co-existing condition.
- Non-anti-inflammatory treatments for IBS, including dietary changes, antispasmodics, antidepressants, and behavioral therapies, may effectively manage residual symptoms.
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