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Síndrome del intestino irritable en pacientes con enfermedad inflamatoria intestinal: prevalencia, etiología y
David J Gracie1, Alexander C Ford1,2
1Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom.
Gastroenterology & hepatology
|September 2, 2025
Resumen
Muchos pacientes con enfermedad inflamatoria intestinal (EII) presentan síntomas gastrointestinales persistentes que se asemejan al síndrome del intestino irritable (SII). Dirigirse al eje cerebro-intestino puede mejorar los síntomas y la calidad de vida de estas personas.
Área de la Ciencia:
- Gastroenterología
- Neuro-gastroenterología
- Psicogastroenterología
Sus antecedentes:
- Una proporción significativa de pacientes con enfermedad inflamatoria intestinal en reposo (EII) reportan síntomas gastrointestinales persistentes similares al síndrome del intestino irritable (SII).
- Estos síntomas del tipo IBS en la EII están relacionados con la angustia psicológica, la reducción de la calidad de vida y el aumento del uso de la atención médica.
- El eje cerebro-intestino está implicado en la relación entre el sistema nervioso central y la función gastrointestinal, potencialmente mediando estos síntomas.
Objetivo del estudio:
- Revisar la prevalencia, el impacto, la etiología y el tratamiento de los síntomas tipo SII en pacientes con EII en reposo.
- Resaltar el papel del eje cerebro-intestino en la fisiopatología de la EII y la notificación de los síntomas.
- Para enfatizar la necesidad de ensayos clínicos que investiguen terapias dirigidas al eje cerebro-intestino en esta población de pacientes.
Principales métodos:
- Revisión de la literatura de los estudios observacionales y de las pruebas existentes.
- Análisis de la relación entre el estado de ánimo, la inflamación y la función del eje intestino-cerebro en la EII.
- Examen de las estrategias terapéuticas potenciales, incluida la manipulación dietética, los neuromoduladores y las terapias conductuales.
Principales resultados:
- Los datos de observación sugieren una conexión entre el estado de ánimo y la actividad inflamatoria en la EII, subrayando el papel del eje cerebro-intestino.
- La evidencia actual para las terapias del eje cerebro-intestino en pacientes con EII con síntomas de tipo IBS es limitada.
- Los enfoques de gestión integrada que combinan el tratamiento de la EII y las intervenciones del eje cerebro-intestino son prometedores.
Conclusiones:
- Los pacientes con EII en reposo experimentan con frecuencia síntomas del tipo de EII, lo que afecta su bienestar.
- Dirigirse al eje cerebro-intestino, junto con el manejo de la EII, ofrece una estrategia potencial para aliviar estos síntomas.
- Se necesitan más investigaciones y ensayos clínicos para validar los tratamientos para el eje cerebro-intestino en la EII.
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