Book Chapter Details
Mandatory Fields
O'Malley, D
2011 November
Advances in Medicine and Biology. Volume 23
Crosstalk Between the Stress and Immune Factors Contribute to the Pathophysiology of Irritable Bowel Syndrome
Nova Publishers
New York, USA
Optional Fields
Irritable Bowel Syndrome (IBS) is a common, debilitating gastrointestinal (GI) disorder, with a worldwide prevalence of between 10 and 20%. In the western world this translates to over 100 million sufferers. This functional gut disorder is characterized by episodic bouts of abdominal pain, bloating and altered bowel habit, including diarrhea and/or constipation. A symptom-based assessment using the Rome criteria with the exclusion of other organic GI diseases is currently used for diagnosis but is hampered by the lack of reliable biomarkers. Dysregulation of GI motility is associated with increased frequency in bowel movements, diarrhea and/or constipation. Risk factors for the development of IBS include a family history of the disorder, childhood trauma and prior gastrointestinal infection. It is generally accepted that brain-gut axis dysfunction is fundamental to the development of IBS; however the underlying pathophysiological changes remain elusive. An additional consideration for comprehending the underlying pathophysiology of IBS is the effects of both psychosocial and infection-related stresses. Indeed, there is a high co-morbidity between mood disorders such as depression and anxiety, and IBS. A maladaptive stress response is central to the initiation, persistence and severity of IBS-associated symptoms and secretion of corticotropin-releasing factor in response to stress is an important mediator of functional GI alterations. Activation of the immune system also appears to be important in manifestation of IBS symptoms and a growing corpus of data now implicates low-grade inflammation and immune activation in IBS pathophysiology. This chapter shall review the current knowledge relating to the relative contributions of the stress and immune responses to IBS symptomatology. 
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