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IBS and IBD — separate entities or on a spectrum?

Nature Reviews Gastroenterology & Hepatology volume 13, pages 613–621 (2016)Cite this article

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Abstract

The acute phase of IBD with inflamed gut and often ulcerated mucosa is clearly different from the apparently normal mucosa characteristic of IBS. However, more detailed assessment has detected immune activation, increased gut permeability, increased mucosal serotonin availability, abnormalities of enteric nerve structure and function, and dysbiosis in gut microbiota in IBS — all features seen in IBD. Furthermore, as treatments for inflammation in IBD have become more effective it is now apparent that ∼1 in 3 patients with IBD in remission from inflammation still have persistent abnormalities of sensation, motility and gut microbiota, which might cause IBS-like symptoms. This Perspective explores the overlap between IBS and IBD and their treatments, proposing future directions for research in this stimulating area.

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Figure 1
Figure 2: Serotonin signalling in the gut.
Figure 3: Mechanisms of symptoms in IBD and IBS.

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Acknowledgements

This Perspetive is a summary of independent research written by the authors who are funded by the National Institute for Health Research Biomedical Research Unit (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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  1. Robin Spiller and Giles Major are at NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases at Nottingham University Hospitals NHS Trust and The University of Nottingham, Queens Medical Centre, E Floor West Block, Nottingham NG7 2UH, UK.,

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Correspondence to Robin Spiller.

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R.S. has received research funding from Ironwood and Lesaffre and free drug for clinical trial from Falk Pharma and Norgine. He has also acted on Advisory Boards for Allergan, Almirall, Astellas, Danone and Yuhan. G.M. declares no competing interests.

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Spiller, R., Major, G. IBS and IBD — separate entities or on a spectrum?. Nat Rev Gastroenterol Hepatol 13, 613–621 (2016). https://doi.org/10.1038/nrgastro.2016.141

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