Post-infectious irritable bowel syndrome.
OBJECTIVE
Irritable bowel syndrome patients form a heterogeneous group with a variable contribution of central and peripheral components. The peripheral component is prominent in irritable bowel syndrome developing after infection (post-infectious irritable bowel syndrome) and this has proved a profitable area of research.


RESULTS
Recent studies have overthrown the dogma that irritable bowel syndrome is characterized by no abnormality of structure by demonstrating low-grade lymphocytic infiltration in the gut mucosa, increased permeability and increases in other inflammatory components including enterochromaffin and mast cells. Furthermore, increased inflammatory cytokines in both mucosa and blood have been demonstrated in irritable bowel syndrome. While steroid treatment has proved ineffective, preliminary studies with probiotics exerting an anti-inflammatory effect have shown benefit.


CONCLUSIONS
The study of post-infectious irritable bowel syndrome has revealed the importance of low-grade inflammation in causing irritable bowel syndrome symptoms. It has suggested novel approaches to irritable bowel syndrome including studies of serotonin and histamine metabolism which may be relevant to other subtypes of the disease.
Spiller
Robin
R
Wolfson Digestive Diseases Centre, University Hospital, Nottingham, UK. Robin.Spiller@nottingham.ac.uk
Campbell
Eugene
E
D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016207:Cytokines / Q000378:metabolism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000175:diagnosis; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008407:Mast Cells / Q000502:physiology; D051379:Mice; D019936:Probiotics / Q000627:therapeutic use; D011379:Prognosis; D018570:Risk Assessment; D012701:Serotonin / Q000378:metabolism*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D016207:Cytokines; D018836:Inflammation Mediators; D012701:Serotonin