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Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?

Irritable bowel syndrome (IBS) and non-alcoholic fatty liver disease (NAFLD) are amongst the most common gastrointestinal and liver conditions encountered in primary and secondary care. Recently, there has been interest in the apparent co-incidence of NAFLD in patients with IBS mainly driven by impr...

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Autores principales: Purssell, Huw, Whorwell, Peter J, Athwal, Varinder S, Vasant, Dipesh H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727221/
https://www.ncbi.nlm.nih.gov/pubmed/35069992
http://dx.doi.org/10.4254/wjh.v13.i12.1816
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author Purssell, Huw
Whorwell, Peter J
Athwal, Varinder S
Vasant, Dipesh H
author_facet Purssell, Huw
Whorwell, Peter J
Athwal, Varinder S
Vasant, Dipesh H
author_sort Purssell, Huw
collection PubMed
description Irritable bowel syndrome (IBS) and non-alcoholic fatty liver disease (NAFLD) are amongst the most common gastrointestinal and liver conditions encountered in primary and secondary care. Recently, there has been interest in the apparent co-incidence of NAFLD in patients with IBS mainly driven by improved understanding of their shared risk factors and pathophysiology. In this paper we summarize the shared risk factors which include; overlapping nutritional and dietary factors as well as shared putative mechanisms of pathophysiology. These include changes in the gut microbiome, gut permeability, immunity, small bowel bacterial overgrowth and bile acid metabolism. This paper describes how these shared risk factors and etiological factors may have practical clinical implications for these highly prevalent conditions. It also highlights some of the limitations of current epidemiological data relating to estimates of the overlapping prevalence of the two conditions which have resulted in inconsistent results and, therefore the need for further research. Early recognition and management of the overlap could potentially have impacts on treatment outcomes, compliance and morbidity of both conditions. Patients with known IBS who have abnormal liver function tests or significant risk factors for NAFLD should be investigated appropriately for this possibility. Similarly, IBS should be considered in patients with NAFLD and symptoms of abdominal pain associated with defecation, an altered bowel habit and bloating.
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spelling pubmed-87272212022-01-20 Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence? Purssell, Huw Whorwell, Peter J Athwal, Varinder S Vasant, Dipesh H World J Hepatol Opinion Review Irritable bowel syndrome (IBS) and non-alcoholic fatty liver disease (NAFLD) are amongst the most common gastrointestinal and liver conditions encountered in primary and secondary care. Recently, there has been interest in the apparent co-incidence of NAFLD in patients with IBS mainly driven by improved understanding of their shared risk factors and pathophysiology. In this paper we summarize the shared risk factors which include; overlapping nutritional and dietary factors as well as shared putative mechanisms of pathophysiology. These include changes in the gut microbiome, gut permeability, immunity, small bowel bacterial overgrowth and bile acid metabolism. This paper describes how these shared risk factors and etiological factors may have practical clinical implications for these highly prevalent conditions. It also highlights some of the limitations of current epidemiological data relating to estimates of the overlapping prevalence of the two conditions which have resulted in inconsistent results and, therefore the need for further research. Early recognition and management of the overlap could potentially have impacts on treatment outcomes, compliance and morbidity of both conditions. Patients with known IBS who have abnormal liver function tests or significant risk factors for NAFLD should be investigated appropriately for this possibility. Similarly, IBS should be considered in patients with NAFLD and symptoms of abdominal pain associated with defecation, an altered bowel habit and bloating. Baishideng Publishing Group Inc 2021-12-27 2021-12-27 /pmc/articles/PMC8727221/ /pubmed/35069992 http://dx.doi.org/10.4254/wjh.v13.i12.1816 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Opinion Review
Purssell, Huw
Whorwell, Peter J
Athwal, Varinder S
Vasant, Dipesh H
Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?
title Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?
title_full Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?
title_fullStr Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?
title_full_unstemmed Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?
title_short Non-alcoholic fatty liver disease in irritable bowel syndrome: More than a coincidence?
title_sort non-alcoholic fatty liver disease in irritable bowel syndrome: more than a coincidence?
topic Opinion Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727221/
https://www.ncbi.nlm.nih.gov/pubmed/35069992
http://dx.doi.org/10.4254/wjh.v13.i12.1816
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