Studies Suggest Overlap of IBS Symptoms and IBD

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LAS VEGAS—Recent research suggests a possible overlap of symptoms of two prevalent GI disorders: irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) and further suggests a possible link between subtle GI tract inflammation and IBS symptoms. This link is also the focus of the first systemic review of the literature on this topic, and of an editorial, both of which are published in last month’s American Journal of Gastroenterology.

One study presented today found that mesalamine granules, an anti-inflammatory drug used to treat ulcerative colitis, improved abdominal pain and stool consistency in diarrhea-predominant IBS. In the second study, researchers found that tricyclic antidepressants (TCAs)—which are commonly used to treat IBS patients—may be effective in managing moderately-severe functional symptoms such as abdominal pain and diarrhea in patients with inflammatory bowel disease.

Crohn’s disease (CD) and ulcerative colitis (UC) are two of the most common forms of inflammatory bowel disease which affects about 1.4 million Americans, with approximately 30,000 new cases diagnosed each year, according to the Crohn’s and Colitis Foundation of America. UC is marked by inflammation of the lining of the colon and rectum, together known as the large intestine while CD can cause inflammation anywhere from the mouth to the anus anywhere along the lining of the digestive tract. It most commonly affects the small intestine and the colon.

“This inflammation can lead to symptoms of abdominal pain and diarrhea, symptoms which are typical of many IBS patients, for instance those IBS patients with diarrhea predominant symptoms or mixed diarrhea and constipation," said Brian E. Lacy, MD, PhD, professor of medicine at the Dartmouth Medical School and the director of the GI Motility Laboratory at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

“One theory is that IBS develops subsequent to an inflammatory process or infectious process in the GI tract. Microscopic inflammation can then persist in the lining of the GI tract, or the adjacent lymph nodes. This inflammation may produce symptoms of pain and diarrhea similar to those experienced by patients with Crohn’s disease. Thus, it is quite likely that an overlap exists between IBS and IBD, both with respect to etiology and symptoms," added Dr. Lacy.

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