Symptoms compatible with irritable bowel syndrome are frequently present in patients with inflammatory bowel disease (IBD); however, the cause of this phenomenon is unclear.
Dr Berrill and colleagues from the United Kingdom determined the different contributions of ‘true irritable bowel syndrome’ and sub-clinical inflammation in producing irritable bowel syndrome-type symptoms in inflammatory bowel disease patients, and to ascertain the impact these symptoms have on the clinical assessment of inflammatory bowel disease activity.
The team performed a cross-sectional study, where 169 inflammatory bowel disease patients completed questionnaires to assess disease activity, presence of irritable bowel syndrome-type symptoms, and levels of anxiety and depression.
Stool samples were collected for analysis of fecal calprotectin.
The researchers found that irritable bowel syndrome-type symptoms were significantly more common in female patients and were associated with higher levels of anxiety.
|The prevalence of IBS-type symptoms with a normal fecal calprotectin level was 31%|
|Alimentary Pharmacology & Therapeutics|
There was no statistical difference between the fecal calprotectin levels of patients in clinical remission with irritable bowel syndrome-type symptoms compared with those without.
The doctors assessed that the prevalence of irritable bowel syndrome-type symptoms in patients with a normal fecal calprotectin level was 31%.
Dr Berrill's team commented "A substantial number of inflammatory bowel disease patients with normal faecal calprotectin level experience irritable bowel syndrome-type symptoms."
"These patients exhibit similar features to people diagnosed with irritable bowel syndrome in the general community, suggesting that the conditions are not mutually exclusive and may coexist in a considerable number of inflammatory bowel disease patients."
"A systematic diagnostic approach is required to assess inflammatory bowel disease patients with irritable bowel syndrome-type symptoms as sub-clinical inflammation may play a role in a proportion of cases."