Irritable Bowel Syndrome in Inflammatory Bowel Disease: An Evidence-Based Practical Review

Area of Science:

• Gastroenterology
• Gut-Brain Interaction
• Inflammatory Bowel Disease Research

Background:

• Irritable bowel syndrome (IBS) is a gut-brain interaction disorder.
• Approximately one-third of patients with quiescent inflammatory bowel disease (IBD) experience IBS-type symptoms.
• These symptoms negatively impact quality of life and complicate diagnosis.

Purpose of the Study:

• To review the mechanisms, diagnostic challenges, and management of IBS-type symptoms in quiescent IBD patients.
• To explore the interplay between functional and organic factors contributing to these symptoms.
• To provide an updated perspective on addressing the overlap between IBS and IBD.

Main Methods:

• Narrative review of current literature.
• Examination of proposed pathophysiological mechanisms.
• Analysis of diagnostic and management strategies.

Main Results:

• IBS symptoms in quiescent IBD result from a combination of low-grade inflammation, altered gut permeability, dysbiosis, visceral hypersensitivity, and psychosocial factors.
• Diagnosis requires a symptom-focused approach, excluding active inflammation.
• Effective management involves a biopsychosocial strategy including diet, behavioral therapies, and medications.

Conclusions:

• The coexistence of IBS and IBD necessitates integrated management strategies.
• Addressing both physiological and psychological aspects is crucial for improving patient outcomes.
• Future research should focus on biomarkers and personalized therapies for better precision.