Abstract
Objective:To compare the post-infectious irritable bowel syndrome (PI-IBS) and none post-infectious irritable bowel syndrome (NPI-IBS) clinically and experimentally.Methods:From May 2013 to January 2015, eighty-nine patients with irritable bowel syndrome (IBS)were recruited in the internal department of the affiliated hospital of Shandong University of Traditional Chinese Medicine. The clinical data were collected for all the patients, and a blood sample was collected to detect the level of C-reactive protein (CRP) and intestinal fatty acid binding protein (IFABP), an investigation questionnaire of gastrointestinal symptom rating scale (GSRS) and self-rating anxiety scale (SAS) were carried out to evaluate the gastrointestinal function and anxiety status.Results:In the study, forty-eight patients were included in PI-IBS group and 41 in Non-PI-IBS group. There was no significant difference in age, gender and GSRS between the two groups (p>0.05). In PI-IBS group 70.8% patients presented with the primary symptom of diarrhea and 60.4% presented with a SAS scores over 50, but in Non-PI-IBS group, the values were only 19% (p<0.05) and 34.1% (p<0.05). The level of IFABP and CRP were significantly higher in PI-IBS group than those in Non-PI-IBS group (p<0.05).Conclusion:The PI-IBS may be different from Non-PI-IBS in mechanism and should be treated using different strategies.
Highlights
Irritable bowel syndrome (IBS) is a common intestinal disorder characterized by persistent or intermittent abdominal pain or discomfort, distention, and changes in stool patterns.[1]
In the postinfectious irritable bowel syndrome (PI-IBS) group 70.8% patients presented with the primary symptom of diarrhea, but in the NonPI-IBS group, only 19% patients presented with the primary symptom
Many authors have suggested that previous gastrointestinal infection or inflammation plays an important role in the pathogenesis of IBS.[3,13]
Summary
Irritable bowel syndrome (IBS) is a common intestinal disorder characterized by persistent or intermittent abdominal pain or discomfort, distention, and changes in stool patterns.[1]. Intestinal fatty acid binding protein (IFABP) is a 15-kDa cytoplasmic protein located in small intestinal enterocytes involved in the uptake and transport of polar lipids such as fatty acids from the small-bowel lumen, which has been associated with injury to the intestinal mucosa and injury common to inflammatory bowel diseases.[6] When the integrity of the enterocyte membrane is compromised, I-FABP are rapidly released into the circulation This makes them a potentially suitable biomedical predictor of small bowel ischemia.[7] Kittaka, in a clinical study of 37 patients diagnosed with small bowel obstruction, concluded the I-FABP level is a useful marker for discriminating between strangulated small bowel obstruction and simple small bowel obstruction.[7] Using a prospective observational study of fifty patients with severe sepsis, Zhu found the IFABP concentrations in all patients were significantly increased.[8] In addition, C-reactive protein (CRP) is an inflammation marker, confirmed by many studies. We speculate that as the PI-IBS is closely correlated with low-grade infection, the blood level of IFABP or CRP in PI-IBS patients may be higher than common IBS patients, but up till this viewpoint haven’t been confirmed
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