By the way, inflammation cannot be a biological marker because it does not always cause pain.
Irritable Bowel Syndrome:
How Far Do You Go in the Workup?
But microscopic inflammation cannot be
a diagnostic marker for IBS because it does nor typically produce pain in those who have it. All patients
with active celiac disease have microscopic inflammation, but a large proportion do not have abdominal
pain, and patients with ulcerative colitis who also have microscopic inflammation when compared with
patients with IBS seem to have higher pain thresholds.24 In individuals with these disorders, there may be
central nervous system counter-regulatory measures responding to the peripheral pain/inflammatory
processes that increase pain thresholds.
With regard to IBS, the gut-related effects of microscopic inflammation may be only one component of a
dysfunctional brain-gut system. In addition, and often in response to stress, there may be a failure to
activate pain inhibition systems that lead to the perception of pain and produce other symptoms that typify
this disorder.25 In one prospective study of postinfectious IBS, it was found that those who retained their
symptoms 3 months after an enteric infection had not only increased inflammation in the intestinal lining,
but also had increased psychosocial distress at the time of the infection. Furthermore, lowered visceral
pain thresholds and increased motility were present after the infection regardless of whether or not the
patients retained their symptoms.26 Therefore, the microscopic inflammation and its physiologic effects on
motility and sensation contribute to, but are not always sufficient for, the clinical expression of IBS pain.
At least for postinfectious IBS, this provides some evidence that psychologic distress alters brain pain
regulatory pathways to amplify incoming visceral signals leading to the full clinical expression of this
syndrome.27,28
http://www.med.unc.edu/medicine/fgidc/IBS_How_Far_do_you_go_in_the_workup.pdf
--------------------
My website on IBS is www.ibshealth.com
Print
Remind Me
Notify Moderator
|
Posts
Re: Anti-Inflammatory Diet?
