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Loose ends in the differential diagnosis of IBS-like symptoms

Two thirds of the patients we believed to have IBS in the 1970’s have since been possible to diagnose with treatable conditions like bile acid diarrhea, inflammatory bowel disease, microscopic colitis, celiac disease, disaccharide malabsorption, exocrine pancreatic insufficiency, or rare genetic var...

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Autores principales: Lindberg, Greger, Mohammadian, Ghazaleh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357384/
https://www.ncbi.nlm.nih.gov/pubmed/37484861
http://dx.doi.org/10.3389/fmed.2023.1141035
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author Lindberg, Greger
Mohammadian, Ghazaleh
author_facet Lindberg, Greger
Mohammadian, Ghazaleh
author_sort Lindberg, Greger
collection PubMed
description Two thirds of the patients we believed to have IBS in the 1970’s have since been possible to diagnose with treatable conditions like bile acid diarrhea, inflammatory bowel disease, microscopic colitis, celiac disease, disaccharide malabsorption, exocrine pancreatic insufficiency, or rare genetic variants. Despite advances in diagnostic techniques a substantial proportion of patients continue suffering from IBS-like symptoms that cannot be explained by current knowledge. Although it is likely that further research will reveal small but important subgroups of patients with treatable mechanisms for IBS-like symptoms, we propose that only two large groups remain for being addressed in the clinic: those with connective tissue disorders such as Ehlers-Danlos syndrome or hypermobility spectrum disorders and those with autism spectrum disorders. Patients with connective tissue disorders exhibit identifiable disturbances of gut motor function and possibly increased gut permeability as underlying mechanisms for IBS-like symptoms. Autism spectrum disorders pose a much more difficult problem in the clinic. Disturbances of perception combined with anxiety and excessive worry about signals from the gut can lead to an endless but futile search for something being wrong. The search can involve large numbers of care givers, no one understanding the patient’s suffering. Others may try to change their diet to lessen symptoms, only to find that almost all foods may cause worrying perceptions from the gut. Early recognition of autism spectrum disorders is essential for finding better ways to help patients with gastrointestinal and, as is often the case, extraintestinal symptoms.
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spelling pubmed-103573842023-07-21 Loose ends in the differential diagnosis of IBS-like symptoms Lindberg, Greger Mohammadian, Ghazaleh Front Med (Lausanne) Medicine Two thirds of the patients we believed to have IBS in the 1970’s have since been possible to diagnose with treatable conditions like bile acid diarrhea, inflammatory bowel disease, microscopic colitis, celiac disease, disaccharide malabsorption, exocrine pancreatic insufficiency, or rare genetic variants. Despite advances in diagnostic techniques a substantial proportion of patients continue suffering from IBS-like symptoms that cannot be explained by current knowledge. Although it is likely that further research will reveal small but important subgroups of patients with treatable mechanisms for IBS-like symptoms, we propose that only two large groups remain for being addressed in the clinic: those with connective tissue disorders such as Ehlers-Danlos syndrome or hypermobility spectrum disorders and those with autism spectrum disorders. Patients with connective tissue disorders exhibit identifiable disturbances of gut motor function and possibly increased gut permeability as underlying mechanisms for IBS-like symptoms. Autism spectrum disorders pose a much more difficult problem in the clinic. Disturbances of perception combined with anxiety and excessive worry about signals from the gut can lead to an endless but futile search for something being wrong. The search can involve large numbers of care givers, no one understanding the patient’s suffering. Others may try to change their diet to lessen symptoms, only to find that almost all foods may cause worrying perceptions from the gut. Early recognition of autism spectrum disorders is essential for finding better ways to help patients with gastrointestinal and, as is often the case, extraintestinal symptoms. Frontiers Media S.A. 2023-07-06 /pmc/articles/PMC10357384/ /pubmed/37484861 http://dx.doi.org/10.3389/fmed.2023.1141035 Text en Copyright © 2023 Lindberg and Mohammadian. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Lindberg, Greger
Mohammadian, Ghazaleh
Loose ends in the differential diagnosis of IBS-like symptoms
title Loose ends in the differential diagnosis of IBS-like symptoms
title_full Loose ends in the differential diagnosis of IBS-like symptoms
title_fullStr Loose ends in the differential diagnosis of IBS-like symptoms
title_full_unstemmed Loose ends in the differential diagnosis of IBS-like symptoms
title_short Loose ends in the differential diagnosis of IBS-like symptoms
title_sort loose ends in the differential diagnosis of ibs-like symptoms
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357384/
https://www.ncbi.nlm.nih.gov/pubmed/37484861
http://dx.doi.org/10.3389/fmed.2023.1141035
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