Brown bowel syndrome: a systematic review

Area of Science:

• Gastroenterology
• Rare Diseases
• Histopathology

Background:

• Brown bowel syndrome (BBS) is a rare condition characterized by intestinal brown pigmentation.
• Lipofuscin accumulation is the suspected cause of BBS.
• Celiac disease and vitamin E deficiency are potential risk factors.

Purpose of the Study:

• To systematically review and synthesize clinical information on patients diagnosed with BBS.
• To identify common symptoms, risk factors, and outcomes associated with BBS.

Main Methods:

• Systematic literature search of PubMed, Embase, Web of Science, and Cochrane databases.
• Inclusion of case reports and abstracts with confirmed BBS diagnoses.
• Analysis of clinical data from 63 confirmed BBS patients across 42 studies.

Main Results:

• Diarrhea (50.8%) and malnutrition (50.8%) were the most frequent symptoms.
• Abdominal pain (39.7%) and vomiting (22.2%) were also common.
• BBS patients with celiac disease had lower hypoalbuminemia rates (15.4% vs. 45.5%) and a trend towards higher mortality (36.4% vs. 15.4%).
• Vitamin E deficiency was present in 31.7% of BBS patients, with similar outcomes to those without deficiency.
• Clinical presentation and outcomes were comparable between patients with and without celiac disease or vitamin E deficiency.

Conclusions:

• BBS presents with significant gastrointestinal symptoms like diarrhea and malnutrition.
• Celiac disease may influence BBS patient outcomes, particularly albumin levels and mortality.
• Further research is needed to establish optimal diagnostic and therapeutic strategies for BBS.