Inflammatory bowel diseases in remission with IBS-like symptoms

Abstract

The remaining disorders of stool, supposedly of a functional nature, similar to the symptoms of irritable bowel syndrome (IBS), in patients with inflammatory bowel disease (IBD) in remission during the last 16 years are actively discussed in the literature. A great similarity in the clinical manifestations and mechanisms of the formation of true IBS and IBD-IBS was revealed. As the combining factors of these two pathological conditions, occult inflammation in the intestinal wall, intestinal motility disorders, visceral hypersensitivity, intestinal microbiome disorder and increased permeability of the mucosa are considered. The role of psychological stress in the formation of the IBD-IBS remains underestimated and insufficiently investigated. In patients with true IBS and IBD-IBS, the indices of depression, actual and personal anxiety, alexithymia are statistically significantly higher than in healthy individuals and do not differ among themselves. An additional confirmation of similar changes in the psychovegetative status in patients with IBS and IBD-IBS is the study of one of the relatively new psychometric indicators, the Visceral Sensitivity Index (VSI), which characterizes specific anxiety with respect to gastroenterological symptoms of the disease. An integrative index of all psycho-vegetative changes in patients is an indicator of the quality of life. As in patients with true IBS, and with IBD-IBS, according to the literature, Noah decrease in both physical and mental QOL component. The article deals with modern information about similarities and differences mechanisms of IBS and IBD in remission with IBS-like symptoms, which indicate large differential diagnostic difficulties in distinguishing these disorders.