The role of inflammation and anti-inflammatory therapy in irritable bowel syndrome (review and results of own research)
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 1
Abstract
The paper presents relevant data on the pathogenetic role of intestinal mucous inflammation at irritable bowel syndrome (IBS). It has been shown that with some IBS subtypes, especially post-infectious IBS, the inflammation may be of key significance in the developing of low-intensity inflammatory reaction and symptoms emergence. Mast cells, intestinal barrier dysfunction, intestinal pathogens and genetic predisposition are of great importance in the development of such inflammation. In IBS patients the inflammation may be a part of disease pathogenesis, which requires further study. Thus, IBS pathogenetic treatment may include anti-inflammatory agents, such as Mesalazine, Ketotifen and Sodium Cromoglycate, steroids, Omalizumab. The results of own investigation demonstrated that Montelukast in combination with Quifenadine as an adjunctive of the standard baseline therapy increased the treatment efficacy in IBS patients with concomitant allergic diseases, especially IBS-D subtype. In particular, both allergic and gastroenterological manifestations were reduced, pain intensity and diarrhea syndrome significantly attenuated, the overall health, vitality and physical condition of patients improved. These changes took place owing to following effects of combined therapy: blocking of the inflammatory mediators in mast cells, anti-spasmodic and desensitizing effects with additional relief of the constrictive and spasmogenic histamine effects on smooth muscles of the intestine. Moreover, Quifenadine has a moderate anti-serotonin effect which, plays an important role in IBS, taking into account its pathophysiological mechanisms. Thus, the combination of anti-leukotriene and antihistamines, along with the baseline therapy in patients with IBS and associated allergic diseases, provides a positive clinical and laboratory outcome, but requires further study.
Authors and Affiliations
A. R. Levchenko
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