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All Boards >> Irritable Bowel Syndrome Research Library


Reged: 12/09/02
Posts: 7677
Loc: Seattle, WA
New insights into the pathogenesis and pathophysiology of irritable bowel syndrome
      03/01/07 01:17 PM

Digestive and Liver Disease
Volume 39, Issue 3 , March 2007, Pages 201-215

New insights into the pathogenesis and pathophysiology of irritable bowel syndrome

L. Öhmana and M. Simrén, a,

aDepartment of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

Received 11 September 2006; accepted 25 October 2006. Available online 30 January 2007.

The pathogenesis and pathophysiology of irritable bowel syndrome is complex and still incompletely known. Potential pathogenetic factors include genes, infectious events, psychological symptoms and other loosely defined environmental factors. Both alterations at the central and peripheral level are thought to contribute to the symptoms of irritable bowel syndrome, including psychosocial factors, abnormal gastrointestinal motility and secretion, and visceral hypersensitivity. Today irritable bowel syndrome is viewed upon as a disorder of dysregulation of the so-called brain–gut axis, involving abnormal function in the enteric, autonomic and/or central nervous systems, with peripheral abnormalities probably dominating in some patients and disturbed central processing of signals from the periphery in others. Lines of evidence also suggest that inflammation within the gastrointestinal tract may be of great importance in at least subgroups of irritable bowel syndrome patients. To conclude, a complex picture of the pathogenesis and pathophysiology of irritable bowel syndrome is emerging, with interactions between several different alterations resulting in the divergent symptom pattern in these patients.

Keywords: Brain–gut axis; Gastrointestinal motility; Inflammation; Irritable bowel syndrome; Serotonin; Visceral hypersensitivity

Abbreviations: ANS, autonomic nervous system; CNS, central nervous system; EC, enterochromaffin; ENS, enteric nervous system; fMRI, functional magnetic resonance imaging; GI, gastrointestinal; HPA, hypothalamic-pituitary-adrenal; IBD, inflammatory bowel disease; IBS, irritable bowel syndrome; Ig, immunoglobulin; IL, interleukin; NMDA, N-methyl-d-aspartic acid; PET, positron emission tomography; SERT, serotonin reuptake transporter; TNF, tumour necrosis factor; Treg, regulatory T cells; TNBS, trinitrobenzenesulfonic acid

Corresponding author at: Section of Gastroenterology & Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, S-41345 Gothenburg, Sweden. Tel.: +46 31 342 10 00; fax: +46 31 82 21 52.

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