Digestion: New Form of Irritable Bowel Syndrome

09/09/2013
Photo: Belly

Better treatment of irritable bowel syndrome can ease the pain of many patients; © panthermedia.net/Axel Bückert

UCLA researchers have described a new form of irritable bowel syndrome (IBS) that occurs after an acute bout of diverticulitis, a finding that may help lead to better management of symptoms and relief for patients.

The discovery of this new condition, called Post-Diverticulitis Irritable Bowel Syndrome (PDV-IBS), validates the irritable bowel symptoms that many patients report long after suffering a bout of diverticulitis, but that many physicians wave off as being part of the original condition, said Dr. Brennan Spiegel.

"We've known for a long time that after some people develop diverticulitis, they're a different person. They experience recurrent abdominal pains, cramping and diarrhea that they didn't have before," Spiegel said. "The prevailing wisdom has been that once diverticulitis is treated, it's gone. But we've shown that IBS symptoms occur after the diverticulitis, and it may result from an inflammatory process like a bomb going off in the body and leaving residual damage."

As they age, most people develop diverticulosis, or pouches in the lining of the colon. More than 50 percent of people over 60 have the condition, but the pouches usually don't cause any problems. Occasionally, the pouches become inflamed, leading to diverticulitis, which causes pain and infection in the abdomen. Doctors usually treat it with antibiotics, or in more severe cases, surgery.

"A major surprise in our study was that diverticulitis patients not only developed IBS at a higher rate than the controls, but they also developed mood disorders like depression and anxiety at a higher rate," Spiegel said. "Because IBS and mood disorders often go hand in hand, this suggests that acute diverticulitis might even set off a process leading to long-standing changes in the brain-gut axis."

The discovery of PDV-IBS could mean better attention to patients complaining of symptoms after diverticulitis, symptoms that up until now may have been dismissed by physicians. Spiegel said the PDV-IBS "Patients often report ongoing IBS symptoms after the diverticulitis has long passed, and this study supports their beliefs and introduces a new diagnosis," Spiegel said. "If doctors recognize this, they may take the symptoms more seriously and manage them actively, just as they can manage IBS actively with various new drugs on the market and currently in development."

MEDICA.com; Source: UCLA Health System