title: Is irritable bowel syndrome an organic disorder?
abstract: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that is generally considered to be functional because there appears to be no associated anatomical defect. Stress and psychological factors are thought to play an important role in IBS. The gut neuroendocrine system (NES), which regulates all functions of the gastrointestinal tract, consists of endocrine cells that are scattered among the epithelial cells of the mucosa, and the enteric nervous system. Although it is capable of operating independently from the central nervous system (CNS), the gut NES is connected to and modulated by the CNS. This review presents evidence for the presence of an anatomical defect in IBS patients, namely in the gastrointestinal endocrine cells. These cells have specialized microvilli that project into the lumen and function as sensors for the luminal content and respond to luminal stimuli by releasing hormones into the lamina propria, which starts a chain reaction that progresses throughout the entire NES. The changes in the gastrointestinal endocrine cells observed in IBS patients are highly consistent with the other abnormalities reported in IBS patients, such as visceral hypersensitivity, dysmotility, and abnormal secretion.
authors.affiliation: Magdy El-Salhy, Section for Gastroenterology, Department of Medicine, Stord Helse-Fonna Hospital, 5409 Stord, Norway.
authors.forename: Magdy
authors.initials: M
authors.lastname: El-Salhy
authors.affiliation: Magdy El-Salhy, Section for Gastroenterology, Department of Medicine, Stord Helse-Fonna Hospital, 5409 Stord, Norway.
authors.forename: Doris
authors.initials: D
authors.lastname: Gundersen
authors.affiliation: Magdy El-Salhy, Section for Gastroenterology, Department of Medicine, Stord Helse-Fonna Hospital, 5409 Stord, Norway.
authors.forename: Odd Helge
authors.initials: OH
authors.lastname: Gilja
authors.affiliation: Magdy El-Salhy, Section for Gastroenterology, Department of Medicine, Stord Helse-Fonna Hospital, 5409 Stord, Norway.
authors.forename: Jan Gunnar
authors.initials: JG
authors.lastname: Hatlebakk
authors.affiliation: Magdy El-Salhy, Section for Gastroenterology, Department of Medicine, Stord Helse-Fonna Hospital, 5409 Stord, Norway.
authors.forename: Trygve
authors.initials: T
authors.lastname: Hausken
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000378:metabolism; D000818:Animals; D003106:Colon / Q000294:innervation / Q000378:metabolism* / Q000473:pathology; D019858:Enteroendocrine Cells / Q000378:metabolism* / Q000473:pathology; D005769:Gastrointestinal Motility; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D055099:Neuroendocrine Cells / Q000378:metabolism* / Q000473:pathology; D012307:Risk Factors; D015398:Signal Transduction
keywords: Cholecystokinin; Dysmotility; Endocrine cells; Enteric nervous system; Ghrelin; Peptide YY; Secretin; Secretion; Serotonin; Visceral hypersensitivity