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IBS is listed as not causing inflammation, and one potential cause of feverish symptoms is inflammation

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There is growing evidence that inflammation may be involved in IBS. One hypothesis is that an infection can cause IBS symptoms by several mechanisms, including injuries to the enteric nervous system which may alter the function of enteroendocrine cells and T lymphocytes and induce a chronic state of inflammation and visceral sensitivity. There is evidence that postulates that previous transient or chronic inflammation can lead to development of persistent gut dysfunction. The prevalence of IBS symptoms in IBD patients in long-standing remission is two to three times higher than in the normal population. Approximately 15–30% of patients with IBS report onset of disease after an enteric infection. These observations implicate that IBS may be an inflammatory disorder. During the last years a low grade inflammatory process in various compartments of the small and the large bowel has been suggested to be associated with gut symptoms in IBS patients. Apart from gastroenteritis, different factors such as altered gut flora, increased permeability, genetic susceptibility and unrecognised food reactions have all been suggested as possible mediators of an inflammatory response in IBS patients.

Evidence now accumulates to suggest an association between IBS, in general, and immune activation. Colonic biopsies have demonstrated, in some cases, frank inflammation and, in others, more subtle evidence of immune activation. More recently, studies on cytokine levels in peripheral blood mononuclear cells and even in serum have revealed a pro-inflammatory state. It is interesting to note that constipation has also been associated with a partially reversible inflammatory activation of the colonic mucosa.

Probiotics such as VSL#3 and Align may play an anti-inflammatory role in the management of IBS. The probiotic cocktail, VSL#3 (composed of Streptococcus thermophilus and several species of Lactobacillus and Bifidobacteria) has been shown to promote secretion of the anti-inflammatory cytokine IL-10, and suppress the secretion of the pro-inflammatory cytokine IL-12. A detailed evaluation of the various organisms that comprise this cocktail indicated that most of the immune modulating activity resided in bifidobacterial species. The suggestion that bifidobacteria may be especially potent as immuno-modulatory agents is consistent with the observation that a symptomatic response to bifidobacterium infantis 35624 (Align) in IBS was associated with a normalization of the ratio of IL-10 to IL-12 which was tilted towards a pro-inflammatory state. The finding that some IBS patients exhibit polymorphisms in the anti-inflammatory cytokine IL-10 suggests that IBS subjects may be predisposed to an abnormal immune response to an infectious agent.

If you scan previous postings on the board you will find many people report fever like symptoms during an IBS attach.

I understand you anxiety about a colonoscopy. I am the same. However, my doctor suggest 2mg of Ativan under the tongue 10 minutes before the procedure. It worked like a dream. When it was time for my colonoscopy I did have a care in the world. It is really worth the piece of mind to have a colonoscopy.

References
Podovei, M., & Kuo, B. (2006). Irritable bowel syndrome: a practical review . Southern Medical Journal, 99(11), 1235

Ohman, L., & Simren, M. (2007). New insights into the pathogenesis and pathophysiology of irritable bowel syndrome . Digestive and Liver Disease, 39(3), 201-215

Quigley, E. M. M. (2007). Probiotics in Irritable Bowel Syndrome: An Immunomodulatory Strategy? J Am Coll Nutr, 26(6), 684S-690

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STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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