Refractory irritable bowel syndrome in adults: psychological characteristics, morphometric aspects of the diffuse endocrine system


DOI: https://dx.doi.org/10.18565/therapy.2019.3.26-31

Kozlova I.V., Tikhonova T.A., Krylova Yu.S.

1) V.I. Razumovsky Saratov State medical University of the Ministry of Healthcare of the Russia; 2) D.O. Ott Research Institute of obstetrics, gynecology and reproductology, St. Petersburg, Russia
Objective: to study the features of refractory irritable bowel syndrome in adult (IBS), given the the functional comorbidity, psychological characteristics of patients, morphometric features of the diffuse endocrine system (DES).
Material and methods. 101 patients with IBS were examined. 35 healthy volunteers – the control. All groups completed clinical and psychometric tests, colonoscopy with biopsy, general morphological, immunohistochemical and morphometric studies.
Results and conclusion. Patients with refractory, reported a higher degree, of distress, depression, anxiety, somatization then the non-refractory IBS group. IBS-C, IBS-D groups (IBS with constipation, IBS with diarrhea) both show the signs of chronic nonspecific inflammation with minimal activity in the mucous membrane of the colon ; refractory IBS-D group, shows signs of minimal inflammation accompanied by focal atrophy of the large intestine. For different variants of IBS, morphological and functional changes in intestinal permeability are related to changes in optical density and expression area of colonocytes immunopositive to motilin and sirtuin-1.
Keywords: minimal chronic inflammation, psychological factors, refractoriness to treatment, diffuse endocrine system, irritable bowel syndrome
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About the Autors

Irina V. Kozlova, MD, professor, Head of the chair of Therapy, gastroenterology and pulmonology of V.I. Razumovsky Saratov State medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bol’shaya Kazach’ya Str. Tel.: +7 (927) 277-0901. E-mail: kozlova@inbox.ru
Tatyana A. Tikhonova, postgraduate of the chair of Therapy, gastroenterology and pulmonology of V.I. Razumovsky Saratov State medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, Bol’shaya Kazach’ya street, 112. Tel.: +7 (927) 157-52-71. E-mail: jdipisma@mail.ru
Yulia S. Krylova, PhD, Senior research fellow of the Department of pathomorphology of D.O. Ott Research Institute of obstetrics, gynecology and reproductology/ Address:199034, St. Petersburg, 3 Mendeleevskaya line. Tel.: +7 (921) 302-95-70. E-mail: emerald2008@mail.ru


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