A new form of irritable bowel syndrome (IBS) that occurs after an
acute bout of diverticulitis was described by UCLA researchers. This is 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 study senior author Dr. Brennan Spiegel, an
associate professor of medicine at the David Geffen School of Medicine
at UCLA. "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." The study appears Sept. 5, 2013 in the peer-reviewed journal Clinical Gastroenterology and Hepatology. As they age, most people develop diverticulosis, or pouches in the
lining of the colon. More than 50% 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." More than 1,000 patient records from the West Los Angeles Veteran's
Affairs Medical Center were examined for the two-year study, including
patients that had suffered acute diverticulitis and another group of
patients that did not have it. The groups were matched for age and sex
and had similar comorbidities, or other existing health problems. The
groups were followed for many years as UCLA researchers tracked the
differences in IBS diagnoses and mood disorders. "This study expands our understanding a little bit about what might
cause IBS. It's such a common condition and there may be different
flavors," Spiegel said. "We've now added a new flavor to the menu, a new
risk factor for developing IBS. By learning more, we might be able to
expand the therapies we can use on these patients." The study was funded by Shire Pharmaceuticals. "Our findings support the evolving paradigm of diverticular disease as a
chronic illness- not merely an acute condition marked by abrupt
complications. Far from a self-limited episode, acute diverticulitis may
become a chronic disorder in some patients," the study states.
"Diverticulitis is correlated with not only chronic IBS symptoms, but
also long-term emotional distress beyond the event itself. Awareness of
this possible risk is important because persistent, untreated
gastrointestinal symptoms and comorbid depression may worsen outcome and
increase the economic burden of an already prevalent disease."
Source:
journal Clinical Gastroenterology and Hepatology.
Source:
journal Clinical Gastroenterology and Hepatology.
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