Researchers Describe New Form of Irritable Bowel Syndrome

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 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.

“We’ve known for a long time that after some people develop diverticulitis, they’re a different person,” said senior author Brennan Spiegel, MD, David Geffen School of Medicine, at the University of California Los Angeles, Los Angeles, California. “They experience recurrent abdominal pains, cramping, and diarrhoea that they didn’t have before. 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 findings are published in the journal Clinical Gastroenterology and Hepatology.

“A major surprise in our study was that patients with diverticulitis 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,” said Dr. Spiegel. “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.

“Patients often report ongoing IBS symptoms after the diverticulitis has long passed and this study supports their beliefs and introduces a new diagnosis,” he 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 2-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 co-morbidities. 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,” said Dr. Spiegel. “It’s such a common condition and there may be different flavours. We’ve now added a new flavour 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.”

SOURCE: University of California - Los Angeles Health Sciences