Recent advances in the pathophysiology of visceral pain in irritable bowel syndrome

Abstract

Irritable bowel syndrome (IBS) is the most frequent functional bowel disorder seen by gastroenterologists in their daily practice, accounting for more than 30% of outpatient's visits. Recurrent abdominal pain in the absence of obvious physiological abnormalities is one of the principal symptoms of the IBS and can result in emotional distress and physical disability impacting the quality of life of the patient. This pain can be difficult to treat effectively, as the underlying etiology is not well understood. This review focuses on recent advances in the pathophysiology of visceral pain in IBS and describes the main molecular mechanism of visceral hypersensitivity.

Adding a liquid test meal to a standardized lactulose hydrogen breath test significantly influences abdominal symptom generation and hydrogen values

“…On a molecular basis, the increased number, sensitivity or dysfunction of several receptors like the transient receptor potential vanilloid-1(TRPV1) or purinergic receptors seem to play an important role in contributing to gut hypersensitivity and therefore an altered sensation of pain [31,32]. An increased number of mast cell population releases more mediators like serotonin, nerve growth factor (NGF) and histamine leading to a sensitization of primary afferent nerves and thus pain [33]. In our study, the increased occurrence of abdominal pain in the LHBT might be caused by a combination of all these factors in combination with the accelerated transit time.…”

Editorial

“…El siguiente artículo de este número lo elaboró un grupo de investigadores mexicanos de la Universidad Autónoma de Aguascalientes y la Universidad Autónoma del Estado de Hidalgo y está enfocado en los recientes avances del conocimiento de la fisiopatología del dolor visceral, síntoma clave del más frecuente de los TIIC, el SII 9 . El artículo analiza las vías neurales del dolor del tubo digestivo hasta el cerebro y, en segundo lugar, los mediadores moleculares de la hiperalgesia visceral en el SII.…”

“…Por supuesto, el artículo se refiere también al efecto del estrés y la microbiota sobre el dolor visceral. Los autores resumen todo lo anterior en una figura muy didáctica que integra los factores luminales con las vías ascendentes del dolor y las vías descendentes mediadas por el eje hipotálamo-hipófisis-suprarrenal 9 .…”