Division of Gastroenterology and Hepatology, Houston Methodist, Houston, TX, USA.
Expert Rev Gastroenterol Hepatol. 2014 Feb;8(2):139-45. doi: 10.1586/17474124.2014.876361.
The nature and clinical implications of irritable bowel syndrome (IBS)-type symptoms in patients with inflammatory bowel disease (IBD) who are in apparent remission have generated considerable debate. While, on the one hand, these symptoms satisfy Rome III criteria for IBS and their occurrence correlates highly with anxiety, a known trigger for IBS, on the other hand, recent studies have shown that many of these patients exhibit subtle inflammatory changes. Are these symptoms 'true' IBS superimposed on IBD, or an active but sub-clinical form of IBD? We propose a unifying model to explain and reconcile current knowledge on this topic, a model that could provide a conceptual framework for understanding the nature of these symptoms and point towards effective management strategies. We propose that IBS symptoms in IBD patients who are in remission be termed irritable inflammatory bowel syndrome in order to emphasize their unique presentation and etiology and to distinguish them from both IBS and IBD.
肠易激综合征（IBS）样症状在炎症性肠病（IBD）患者中具有显著的临床意义，这一现象引发了广泛的讨论。这些症状一方面符合罗马 III 诊断标准，且与焦虑密切相关，后者是 IBS 的已知诱发因素；另一方面，最近的研究表明，这些患者中许多人存在细微的炎症变化。这些症状是 IBD 基础上的“真正”IBS，还是一种隐匿但活跃的 IBD 形式？我们提出了一个统一的模型来解释和调和目前对这一主题的认识，该模型可以为理解这些症状的本质提供一个概念框架，并指出有效的管理策略。我们建议将缓解期 IBD 患者的 IBS 样症状称为激惹性炎性肠易激综合征，以强调其独特的表现和病因，并将其与 IBS 和 IBD 区分开来。
