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• W2000244974 abstract "The article by Berrill et al.1 addresses an emerging topic in inflammatory bowel disease. Does the presence of symptoms always indicate organic disease? Intestinal dysfunction can be attributed to all kinds of bowel diseases and, thus, subsequent symptoms such as irregular bowel movements, pain or bloating are not specific either for patients with irritable bowel syndrome (IBS) or IBD. As initially described by Manning,2 these complaints may occur more often in functional gastrointestinal disease than organic disease, but considerable overlap exists. Over time, it has become increasingly unclear how functional disease in symptomatic patients is defined because structural work-up and molecular studies have demonstrated a variety of ‘organic’ alterations in IBS patients.3-5 Indices of clinical remission in IBD define a low level of symptoms, but they do not reflect healthiness. Apparently, from those considerations, symptoms compatible with functional disorders such as IBS have to be expected also in IBD patients in clinical remission. We should keep questioning the non-organic pathogenesis of symptoms. Findings of residual organic alterations in postinfectious IBS are stimulating evidence for this concern.6 In IBD, the ongoing discussion on new goals for treatments is challenging. Clinical remission is a classic objective of outcome, but it does not necessarily mean a patient being completely asymptomatic. In IBS, it will be necessary to develop more sensible tools to diagnose ‘occult’ organic alterations. Early attempts have been made to exclude organic disease in patients with ‘functional’ symptoms,7 but, unfortunately, little progress has been made in recent years. It will also be necessary to define more sensible methods to detect hidden inflammation in IBD, and faecal calprotectin may be helpful.1, 8 In summary, feeling unwell or experiencing symptoms is not exclusively an organic matter, but rather depends on perception. Perhaps we should not think of symptoms and organic disease as a dichotomy, but as a holistic association.9 To create possibilities of intervention is one of the most challenging tasks for us. Declaration of personal interests: W. Kruis served as an advisory board member for Tillots Pharma AG Switzerland. Declaration of funding interests: None." @default.
• W2000244974 created "2016-06-24" @default.
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• W2000244974 date "2013-07-16" @default.
• W2000244974 modified "2023-10-05" @default.
• W2000244974 title "Commentary: symptoms of irritable bowel syndrome in patients with inflammatory bowel disease - organic disease or diseased organ?" @default.
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• W2000244974 doi "https://doi.org/10.1111/apt.12379" @default.
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