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1、InflammatoryBowelDiseaseandIrritableBowelSyndrome:SeparateorUnified?SylvieBradesi,PhD,JamesA.McRoberts,Ph.D,PeterA.Anton,MD,EmeranA.Mayer,MDCurrOpinGastroenterol. 2003;19(4) AbstractBothirritablebowelsyndromeandinflammatoryboweldiseasessharesymptomsofalteredbowel
2、habitsassociatedwithabdominalpainordiscomfort.Irritablebowelsyndromehasbeenreferredtoasafunctionalboweldisorder,whichisdiagnosedbyacharacteristicclusterofsymptomsintheabsenceofdetectablestructuralabnormalities.Inflammatoryboweldiseaseisaheterogeneousgroupofdisord
3、erscharacterizedbyvariousformsofchronicmucosaland/ortransmuralinflammationoftheintestine.Inthisreview,theauthorsdiscussrecentevidencesuggestingseveralpotentialmechanismsthatmightplayapathophysiologicroleinbothsyndromes.Possiblesharedpathophysiologicmechanismsincl
4、udealteredmucosalpermeability,analteredinteractionofluminalflorawiththemucosalimmunesystem,persistentmucosalimmuneactivation,alterationsingutmotility,andaroleofsevere,sustainedlifestressorsinsymptommodulation.Itisproposedthatsimilaritiesanddifferencesbetweenthetw
5、osyndromescanbestbeaddressedwithintheframeworkofinteractionsbetweenthecentralnervoussystemandthegutimmunesystem.Basedonrecentreportsoflow-grademucosalinflammationinsubpopulationsofpatientsmeetingcurrentdiagnosticcriteriaforirritablebowelsyndrome,therapeuticapproa
6、chesshowntobeeffectiveininflammatoryboweldisease,suchasprobiotics,antibiotics,andantiinflammatoryagents,havebeensuggestedaspossibletherapiesforcertainpatientswithirritablebowelsyndrome.IntroductionInflammatoryboweldisease(IBD)andirritablebowelsyndrome(IBS)represe
7、nttwoconditionscharacterizedbychronicallyrecurringsymptomsofabdominalpain,discomfort(urgencyandbloating)andalterationsinbowelhabits.However,whereasIBDischaracterizedbyinflammationorulcerationsinthesmalland/orlargeintestine,such"organic"changeshavetraditionallynot
8、beenassociatedwithIBS.IBDisusuallyclassifiedasulcerativecolitisorCrohndisease,butitalsoincludesformsofmicroscopiccolitis, eg, histologicevidenceofmucosalinflam
