1176 Selected Summaries
FUNCTIONAL BOWEL SYMPTOMS IN QUIESCENT INFLAMMATORY BOWEL DISEASE: MORE THAN JUST IRRITABLE BOWEL SYNDROME? Vivinus-Nébot M, Frin-Mathy G, Bzioueche H, et al. Functional bowel symptoms in quiescent IBD: role of epithelial barrier disruption and low grade inflammation. Gut 2014;63:744–752. Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD) result from a complex interaction between host genetic factors and the mucosal immune system, as well as disruption of the intestinal epithelial barrier and the intestinal microbiota. At present, the mainstay of treatment targets modulation of the intestinal immune system, but this approach fails to address a subset of individuals who have persistent symptoms, in the absence of quantifiable disease activity. Given that irritable bowel syndrome (IBS) is so common in the community (Clin Gastroenterol Hepatol 2012;10:712–721), such individuals may be presumed to have coincidental functional abdominal symptoms akin to those of IBS (Nat Rev Gastroenterol Hepatol 2013;10:58–61). However, it remains unclear whether IBS-type symptoms in quiescent IBD reflect true coincident IBS or ongoing low-grade mucosal inflammation. The authors carried out a prospective case-control study whose primary aim was to identify whether subclinical inflammation contributes to the development of IBS-like symptoms in individuals with clinically quiescent IBD. They recruited IBD patients in remission (n ¼ 49; n ¼ 18 UC, n ¼ 31 CD), IBS patients (n ¼ 51), and healthy controls (n ¼ 27) undergoing ileocolonoscopy. Each participant had 12 biopsy specimens taken from the cecum and completed questionnaires evaluating the severity of IBS symptoms. Quiescent IBD individuals were defined as those meeting specified criteria including a physicians’ global assessment confirming disease remission, C-reactive protein
FUNCTIONAL BOWEL SYMPTOMS IN QUIESCENT INFLAMMATORY BOWEL DISEASE: MORE THAN JUST IRRITABLE BOWEL SYNDROME? Vivinus-Nébot M, Frin-Mathy G, Bzioueche H, et al. Functional bowel symptoms in quiescent IBD: role of epithelial barrier disruption and low grade inflammation. Gut 2014;63:744–752. Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD) result from a complex interaction between host genetic factors and the mucosal immune system, as well as disruption of the intestinal epithelial barrier and the intestinal microbiota. At present, the mainstay of treatment targets modulation of the intestinal immune system, but this approach fails to address a subset of individuals who have persistent symptoms, in the absence of quantifiable disease activity. Given that irritable bowel syndrome (IBS) is so common in the community (Clin Gastroenterol Hepatol 2012;10:712–721), such individuals may be presumed to have coincidental functional abdominal symptoms akin to those of IBS (Nat Rev Gastroenterol Hepatol 2013;10:58–61). However, it remains unclear whether IBS-type symptoms in quiescent IBD reflect true coincident IBS or ongoing low-grade mucosal inflammation. The authors carried out a prospective case-control study whose primary aim was to identify whether subclinical inflammation contributes to the development of IBS-like symptoms in individuals with clinically quiescent IBD. They recruited IBD patients in remission (n ¼ 49; n ¼ 18 UC, n ¼ 31 CD), IBS patients (n ¼ 51), and healthy controls (n ¼ 27) undergoing ileocolonoscopy. Each participant had 12 biopsy specimens taken from the cecum and completed questionnaires evaluating the severity of IBS symptoms. Quiescent IBD individuals were defined as those meeting specified criteria including a physicians’ global assessment confirming disease remission, C-reactive protein
