Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Feb 6, 2016; 7(1): 78-90
Published online Feb 6, 2016. doi: 10.4292/wjgpt.v7.i1.78
Diagnosis and management of functional symptoms in inflammatory bowel disease in remission
Carlos Teruel, Elena Garrido, Francisco Mesonero
Carlos Teruel, Elena Garrido, Francisco Mesonero, Gastroenterology Department, Hospital Ramón y Cajal, 28034 Madrid, Spain
Author contributions: All authors contributed equally to this work.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carlos Teruel, MD, Gastroenterology Department, Hospital Ramón y Cajal, Ctra. Colmenar Viejo; km. 9100, 28034 Madrid, Spain. cteruelvegazo@yahoo.es
Telephone: +34-91-3368354 Fax: +34-91-3368354
Received: April 28, 2015
Peer-review started: May 6, 2015
First decision: July 17, 2015
Revised: September 3, 2015
Accepted: October 20, 2015
Article in press: October 27, 2015
Published online: February 6, 2016
Abstract

Inflammatory bowel disease (IBD) patients in remission may suffer from gastrointestinal symptoms that resemble irritable bowel syndrome (IBS). Knowledge on this issue has increased considerably in the last decade, and it is our intention to review and summarize it in the present work. We describe a problematic that comprises physiopathological uncertainties, diagnostic difficulties, as IBS-like symptoms are very similar to those produced by an inflammatory flare, and the necessity of appropriate management of these patients, who, although in remission, have impaired quality of life. Ultimately, from almost a philosophical point of view, the presence of IBS-like symptoms in IBD patients in remission supposes a challenge to the traditional functional-organic dichotomy, suggesting the need for a change of paradigm.

Keywords: Inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, Irritable bowel syndrome, Functional gastrointestinal disease

Core tip: Many inflammatory bowel disease patients in remission suffer from ongoing gastrointestinal symptoms that resemble those of irritable bowel syndrome and that hinder their quality of life. We review the pathogenesis of these symptoms, their prevalence and the best management strategies.