Norovirus: A Masked Relationship With Inflammatory Bowel Disease

In this narrative review, we discuss the association between norovirus infection and one of the most debilitating gastrointestinal pathologies: inflammatory bowel disease (IBD), comprising ulcerative colitis and Crohn's disease. Norovirus is the leading cause of viral gastroenteritis worldwide, and IBD is an autoimmune disorder resulting from an interplay of environmental factors, genetics, and the gut microbiome. We reviewed updated information from PubMed and Google Scholar to discuss various mechanisms of this association, from Norovirus being a trigger and second hit in the genetically predisposed patients to causing a flare-up of IBD. Norovirus causes immune dysregulation as well as changes in intestinal Paneth cells. By exploring this literature, we emphasize the importance of preventing Norovirus through the development of vaccines, as well as the rapid diagnosis, management, and eradication of infections. A crucial purpose of this review article is not only to gain a better understanding of the pathology but also to highlight the need for further prospective studies to establish a causal relationship, which can help establish novel treatment protocols to enhance patient outcomes.