Irritable bowel syndrome and ulcerative colitis: touch points. Analysis of a clinical case


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Abstract

Background. Irritable bowel syndrome (IBS) and ulcerative colitis (UC) remain an urgent problem in gastroenterology due to the high incidence among the working population, the difficulties of diagnosis and treatment. Traditional ideas about UC and IBS as independent nosologies are currently undergoing changes. The search for biological markers associated with IBS and UC is becoming significant. Description of the clinical case. A clinical case of the onset of ulcerative colitis under the mask of post-infectious irritable bowel syndrome is presented; in the absence of a standard examination (fibrocolonoscopy with biopsy), it led to a belated diagnosis of UC. Against the background of basic therapy for UC, the patient is in remission of the disease. However, with errors in nutrition and psycho-emotional stress, episodes of diarrhea up to 3-4 times a day without pathological impurities and mild pain in the lower abdomen occur periodically. With normal values of fecal calprotectin, this can be considered as remission of UC with IBS-like symptoms, or a manifestation of the syndrome of overlap of UC and IBS. As a commentary on this clinical case, the article provides general and specific clinical, morphological, genetic factors for the development of IBS and UC, current and potential biomarkers of these diseases, approaches to assessing IBS-like symptoms in patients with UC. Conclusion. The relationship between IBS and UC has not been fully elucidated. Some triggers, mechanisms of development and certain clinical characteristics of these diseases become universal for both nosologies. On the one hand, the clinical example we have considered illustrates the similarity of the onset of UC and post-infectious IBS, which, in the absence of a standard examination (fibrocolonoscopy with biopsy), led to underdiagnosis. On the other hand, abdominal pain and frequent stools that appear in a patient in remission of UC with a normal level of fecal calprotectin may represent IBS-like symptoms and a manifestation of the overlap syndrome between UC and IBS.

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About the authors

I. V Kozlova

Saratov State Medical University n.a. V.I. Razumovsky

Tatyana A. Tikhonova

Saratov State Medical University n.a. V.I. Razumovsky

Email: jdipisma@mail.ru
Cand. Sci. (Med.), Teaching Assistant at the Department of Therapy, Gastroenterology and Pulmonology

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