# serious ibs



## trbell (Nov 1, 2000)

Gastroenterology 2002 Dec;123(6):1972-9 Related Articles, Links Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome.Tornblom H, Lindberg G, Nyberg B, Veress B.Karolinska Institutet Department of Medicine and Department of Surgery at Huddinge University Hospital, Stockholm, Sweden; and University of Lund, Department of Pathology at Malmo University Hospital, Malo, Sweden.BACKGROUND & AIMS: Irritable bowel syndrome (IBS) is regarded as a functional bowel disorder. Few studies have looked for histopathologic changes in the gut and only then in biopsy specimens from intestinal mucosa. Because bowel function is governed mainly by nerve plexuses in the bowel wall, we have investigated full-thickness bowel biopsy specimens in patients with severe IBS. METHODS: We used a laparoscopy-assisted technique to obtain full-thickness biopsy specimens from the proximal jejunum. Tissue specimens were investigated with light microscopy using routine stainings and immunohistochemical techniques. Horizontal sectioning was done to visualize large areas of the myenteric plexus. Fifteen autopsy specimens were used as controls regarding the myenteric plexus. Colorectal adenoma controls with terminal ileum biopsy specimens and full-thickness jejunal biopsy specimens from patients with degenerative enteric neuropathy were used as control groups for intraepithelial lymphocyte counts. RESULTS: Ten patients (2 males, 8 females) were studied. In 9 patients, we found low-grade infiltration of lymphocytes in the myenteric plexus. Lymphocytes had peri- and intraganglionic location. The mean number of lymphocytes per ganglion ranged from 1.9 to 7.1 per patient, with an overall mean of 3.4. No intraganglionic lymphocytes were found in the control group and only a few periganglionic lymphocytes (mean, 0.2). Four patients had concomitant intraepithelial lymphocytosis. Neuron degeneration was evident in 6 of 9 patients with and 1 patient without ganglionic lymphocyte infiltration. CONCLUSIONS: Our findings indicate that inflammation and neuronal degeneration in the myenteric plexus are involved in the pathogenesis of IBS.tom


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## Jeffrey Roberts (Apr 15, 1987)

We seem to be heading in the direction of inflammation playing a role in IBS. This study seems to support that.Thanks Tom for posting.Jeff


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## Blair (Dec 15, 1998)

"The next thing is not that stress causes IBS either, but possible contributing factors to the condition.There has also been quite a bit of reaserch going on in the last five years in inflammation and IBS and the potentialmechanisms of chronic stress which has been shown to cause inflammation in gut cells through the hpa axis,something called neurogenic inflammation. Chronic stress may cause chemicals that can active or contribute to verymicroscopic inflammation which is being studied in animals and IBS patients. NOT TO BE confused with inflammatorybowel disease, but minute celluar inflammation that can reactivate the symptoms of IBS or continously generate themperhaps, by the chemicals the brain can release in the gut. They have tested this in animals and seen it in humans.They are testing now to see if someone gets a gut infection that causes inflammation (and may also cause the gutreceptors cells to increase or decrease or malfunction in the first place and hence specific serotonin systems tomalfunction in the gut which they have evidence on and two important players in this are enterochromaffin cells thatstore the most gut serotonin and mast cells which are also involved in the hpa axis and other chemicals, but alsoserotonin as well ) and when the intial inflammation goes away, microspocic inflammation can persist in certain cellsfrom chronic stress that chemically activates certain pathways through the brain gut loop (back and forth) that workback on gut inflammation and may contribute to keeping it activated."I copied and pasted this from one of Eric's long posts, "attempt 4 " I think it was called. Yep, some times I do read them.


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