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Is irritable bowel syndrome an infectious disease?
World J Gastroenterol. 2016 Jan 28; 22(4):1331-4.WJ

Abstract

Irritable bowel syndrome (IBS) is the most common of all gastroenterological diseases. While many mechanisms have been postulated to explain its etiology, no single mechanism entirely explains the heterogeneity of symptoms seen with the various phenotypes of the disease. Recent data from both basic and clinical sciences suggest that underlying infectious disease may provide a unifying hypothesis that better explains the overall symptomatology. The presence of small intestinal bowel overgrowth (SIBO) has been documented in patients with IBS and reductions in SIBO as determined by breath testing correlate with IBS symptom improvement in clinical trials. The incidence of new onset IBS symptoms following acute infectious gastroenteritis also suggests an infectious cause. Alterations in microbiota-host interactions may compromise epithelial barrier integrity, immune function, and the development and function of both central and enteric nervous systems explaining alterations in the brain-gut axis. Clinical evidence from treatment trials with both probiotics and antibiotics also support this etiology. Probiotics appear to restore the imbalance in the microflora and improve IBS-specific quality of life. Antibiotic trials with both neomycin and rifaximin show improvement in global IBS symptoms that correlates with breath test normalization in diarrhea-predominant patients. The treatment response to two weeks of rifaximin is sustained for up to ten weeks and comparable results are seen in symptom reduction with retreatment in patients who develop recurrent symptoms.

Authors+Show Affiliations

John Richard Thompson, Department of Pharmacy Practice, Lipscomb University College of Pharmacy, One University Park Drive, Nashville, TN 37204, United States.

Pub Type(s)

Editorial
Review

Language

eng

PubMed ID

26819502

Citation

Thompson, John Richard. "Is Irritable Bowel Syndrome an Infectious Disease?" World Journal of Gastroenterology, vol. 22, no. 4, 2016, pp. 1331-4.
Thompson JR. Is irritable bowel syndrome an infectious disease? World J Gastroenterol. 2016;22(4):1331-4.
Thompson, J. R. (2016). Is irritable bowel syndrome an infectious disease? World Journal of Gastroenterology, 22(4), 1331-4. https://doi.org/10.3748/wjg.v22.i4.1331
Thompson JR. Is Irritable Bowel Syndrome an Infectious Disease. World J Gastroenterol. 2016 Jan 28;22(4):1331-4. PubMed PMID: 26819502.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is irritable bowel syndrome an infectious disease? A1 - Thompson,John Richard, PY - 2015/04/29/received PY - 2015/10/06/revised PY - 2015/11/24/accepted PY - 2016/1/29/entrez PY - 2016/1/29/pubmed PY - 2017/1/18/medline KW - Antibiotics KW - Etiology KW - Infectious disease KW - Irritable bowel syndrome KW - Pathopohysiology KW - Probiotics SP - 1331 EP - 4 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 22 IS - 4 N2 - Irritable bowel syndrome (IBS) is the most common of all gastroenterological diseases. While many mechanisms have been postulated to explain its etiology, no single mechanism entirely explains the heterogeneity of symptoms seen with the various phenotypes of the disease. Recent data from both basic and clinical sciences suggest that underlying infectious disease may provide a unifying hypothesis that better explains the overall symptomatology. The presence of small intestinal bowel overgrowth (SIBO) has been documented in patients with IBS and reductions in SIBO as determined by breath testing correlate with IBS symptom improvement in clinical trials. The incidence of new onset IBS symptoms following acute infectious gastroenteritis also suggests an infectious cause. Alterations in microbiota-host interactions may compromise epithelial barrier integrity, immune function, and the development and function of both central and enteric nervous systems explaining alterations in the brain-gut axis. Clinical evidence from treatment trials with both probiotics and antibiotics also support this etiology. Probiotics appear to restore the imbalance in the microflora and improve IBS-specific quality of life. Antibiotic trials with both neomycin and rifaximin show improvement in global IBS symptoms that correlates with breath test normalization in diarrhea-predominant patients. The treatment response to two weeks of rifaximin is sustained for up to ten weeks and comparable results are seen in symptom reduction with retreatment in patients who develop recurrent symptoms. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/26819502/Is_irritable_bowel_syndrome_an_infectious_disease L2 - https://www.wjgnet.com/1007-9327/full/v22/i4/1331.htm DB - PRIME DP - Unbound Medicine ER -