The Functional-Organic Dichotomy: Postinfectious Irritable Bowel Syndrome and Inflammatory Bowel Disease-Irritable Bowel Syndrome
The Functional-Organic Dichotomy: Postinfectious Irritable Bowel Syndrome and Inflammatory Bowel Disease-Irritable Bowel Syndrome
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DOI：
10.1016/j.cgh.2008.08.032
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发表时间：
2009-01-01
影响因子：
12.6
通讯作者：
Drossman, Douglas A.
中科院分区：
文献类型：
--
作者：
Grover, Madhusudan;Herfarth, Hans;Drossman, Douglas A.
Gastroenterologists often encounter situations when the clinical and pathophysiological features that typically distinguish functional from organic disorders overlap. This "blurring of boundaries" can occur with post-infectious irritable bowel syndrome (PI-IBS), a subset of IBS and a newly described entity IBD-IBS. The key associating features include pain and usually diarrheal symptoms that are disproportionate to the observed pathology, microscopic inflammation, and often a co-association with psychological distress. A previous initiating gastrointestinal infection is required for PI-IBS and assumed for IBD-IBS. Using this perspective we discuss the clinical and pathophysiological features of PI-IBS and IBD-IBS and the growing evidence for the overlapping features of these two disorders in terms of alteration of gut flora, immune dysregulation, and role of stress. A unifying model of PI-IBS and IBD-IBS is proposed that may have important clinical and research implications. It obligates us to reframe our understanding of illness and disease from the dualistic biomedical model into a more integrated biopsychosocial (BPS) perspective.
