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Intestinal barrier dysfunction in irritable bowel syndrome: a systematic review
Nikita Hanning1, Adam L Edwinson1, Hannah Ceuleers2
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Therapeutic Advances in Gastroenterology
|March 15, 2021
Summary
Intestinal barrier dysfunction is common in irritable bowel syndrome (IBS), particularly in diarrhea-predominant (IBS-D) and post-infectious IBS (PI-IBS) subtypes. This dysfunction correlates with abdominal pain and altered bowel habits in IBS patients.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pediatrics
Background:
- Irritable bowel syndrome (IBS) is a complex gastrointestinal disorder.
- Key physiological endophenotypes include sensory, motor, and barrier dysfunctions.
- Understanding barrier dysfunction is crucial for IBS management.
Purpose of the Study:
- To review studies on intestinal barrier dysfunction in adults and children with IBS.
- To link barrier changes with IBS symptoms and quality of life.
Main Methods:
- Systematic review of multiple databases up to March 2020.
- Included both in vivo and in vitro studies comparing intestinal permeability in IBS patients and controls.
- Identified 66 relevant studies.
Main Results:
- Barrier dysfunction prevalence varied: 17-50% in PI-IBS, 37-62% in IBS-D, 4-25% in IBS-C.
- Increased intestinal permeability observed in IBS-D and PI-IBS compared to controls.
- All pediatric IBS studies showed barrier dysfunction; associations found with abdominal pain and bowel disturbances.
Conclusions:
- Barrier dysfunction is prevalent in adults (especially IBS-D, PI-IBS) and all pediatric IBS cases.
- Loss of barrier function is associated with IBS symptoms like abdominal pain and altered bowel function.
- Further research into tight junction gene alterations is needed, particularly in children.
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