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Pseudo-obstruction, enteric dysmotility and irritable bowel syndrome
1Karolinska Institutet, Department of Medicine, Huddinge and Karolinska University Hospital Huddinge, Patient Area Gastroenterology, Dermatology, and Rheumatology, SE-14186, Stockholm, Sweden.
Best Practice & Research. Clinical Gastroenterology
|October 10, 2019
Summary
New diagnostic methods are improving irritable bowel syndrome (IBS) understanding. Many IBS patients are now diagnosed with conditions like celiac disease, microscopic colitis, or enteric dysmotility, requiring specific treatments.
Area of Science:
- Gastroenterology
- Internal Medicine
Background:
- Irritable Bowel Syndrome (IBS) was historically considered largely psychosomatic.
- Advancements in diagnostics reveal underlying organic causes for many IBS-like symptoms.
Purpose of the Study:
- To highlight how new diagnostic techniques are redefining IBS.
- To discuss the spectrum from functional gastrointestinal disorders to motility disorders.
Main Methods:
- Review of diagnostic advancements in gastroenterology.
- Clinical observation of patient cohorts with severe gastrointestinal symptoms.
Main Results:
- Endoscopy aids early diagnosis of celiac disease and microscopic colitis.
- Enteric dysmotility is identified as a key factor in severe cases, bordering functional and motility disorders.
- Joint hypermobility and Ehlers-Danlos syndrome are associated with enteric dysmotility.
Conclusions:
- Many presumed IBS cases have identifiable organic origins.
- Enteric dysmotility and associated conditions like Ehlers-Danlos syndrome represent a distinct category of motility disorders.
- Management of chronic intestinal pseudo-obstruction requires nutritional support and symptom control, with home parenteral nutrition being crucial for survival.
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