Irritable bowel syndrome and endometriosis.

A chronic inflammation is a key characteristic in both diseases.

Key Points

Highlight:

• A chronic low-grade inflammation is a common characteristic in Irritable bowel syndrome (IBS) and endometriosis.

Aim:

• The Dr. Usai group has analyzed the pathophysiological mechanisms common to both IBS and endometriosis, showing the complexity of the relationship between these two clinical entities.

Key points:

• Chronic low-grade inflammation results in the progression and persistence of a detrimental process leading to the structural and functional alteration of the organs involved.
• In both IBS and endometriosis disease, a state of low-grade chronic inflammation has been detected, essentially maintaining the pathological condition.
• IBS and endometriosis share the presence of the common key factors in the genesis of low-grade chronic inflammation.
• The pivotal role of mast cells in the IBS and endometriosis.
• Patients with IBS or endometriosis have an increase in the mast cells count in the colonic mucosa or peritoneal.
• The development of neurogenic inflammation in IBS and endometriosis.
• Accumulating evidence shows a consistent neurogenic inflammation which would promote the persistence of a low-grade chronic inflammation in both IBS and endometriosis.
• Dysbiosis influence in the pathogenesis of IBS and endometriosis.
• The composition of the microbiota is significantly altered in both IBS and endometriosis.
• Role of intestinal permeability in IBS and endometriosis.
• An altered intestinal permeability can contribute to IBS and its related symptoms.

Conclusions:

• IBS and endometriosis are two diseases affecting a significant part of the female population, either together or individually, with important consequences in the quality of life.
• These diseases share the presence of a chronic inflammatory state on the basis of the disease persistence.
• Some of the key players in the generation and maintenance of chronic inflammation are found in IBS and endometriosis.

Limitations:

• Further studies on other pathogenic aspects characterizing these two disorders, such as hormonal component and menstrual reflux for endometriosis or the IBS motility changes, are highly required.

Lay Summary

Irritable bowel syndrome (IBS) and endometriosis are two diseases affecting a significant part of the female population, either together or individually, with remarkable consequences in the quality of life. Several studies suggest an epidemiological association between them. Their association may not be just an epidemiological phenomenon, but the manifestation of a pathophysiological correlation, which probably generates a mutual promotion phenomenon. In particular, both clinical entities share the presence of a chronic low-grade inflammatory state at the basis of the disease persistence.

The Dr. Usai group from University of Cagliari in Italy has analyzed some common pathophysiological mechanisms, such as activation of mast cell line, neuronal inflammation, dysbiosis and impaired intestinal permeability. The aim was to investigate their presence in both IBS and endometriosis and to show the complexity of their relationship in the generation and maintenance of chronic inflammation. Dr. Usai has shown an increase of mast cells count and neurogenic inflammation in both IBS and endometriosis. They also found significant changes in the composition of the microbiota and intestinal permeability in both diseases.

In conclusion, IBS and endometriosis are two diseases affecting a significant part of the female population, either together or individually, with important consequences in the quality of life. These diseases share the presence of a chronic inflammatory state on the basis of the disease persistence. Some of the key players in the generation and maintenance of chronic inflammation are found in IBS and endometriosis.

Because of the great complexity of the subjects considered, this group did not discuss some of the pathogenic aspects, such as the hormonal component and menstrual reflux for endometriosis or the IBS motility changes. Therefore, further studies on other pathogenic aspects characterizing these two disorders are highly required.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29396128