Visceral hypersensitivity, low grade inflammation and increased intestinal permeability are three main pathophysiological mechanisms involved in irritable bowel syndrome. The connexion between these abnormalities is not known. We hypothesis there is a link between them in IBS with diarrhoea.
Irritable bowel syndrome (IBS) is a common functional disorder which affect around 10% of the general population. Abdominal pain and discomfort are associated with transit disorders (diarrhea, constipation, alternating). IBS is defined by Rome III criteria. For clinicians, IBS remains difficult to treat while its pathophysiology remains not completely understood. Visceral hypersensitivity, low grade inflammation and increased intestinal permeability are three abnormalities found in IBS patients. Visceral hypersensitivity is present in 60% of the patients, while intestinal permeability is increased in a subgroup of IBS with diarrhea. Low grade inflammation could be identify with faecal calprotectin dosage. The link between this three abnormalities is not clear. The goal of our study is to describe the prevalence of these three abnormalities in IBS-Diarrhea population and to look for a correlation between low grade inflammation, visceral hypersensitivity, increased intestinal permeability and clinical phenotypes.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SCREENING
Masking
NONE
Enrollment
34
Eleven colonic biopsies are taken in the left colon during colonoscopy. Intestinal permeability is assessed by western blot, qPCR and immunofluorescence for claudin, occludin and ZO-1.
Rouen University Hospital
Rouen, France
Occludin level expression in left colonic biopsies
Occludin expression is measured using western blot (for proteins), Quantitative Real Time Polymerase Chain Reaction (q RT-PCR) (RNA) and IF (for localization)
Time frame: day 1
Faecal calprotectin level
Level is assessed on stool sample by ELISA kit in µg/g
Time frame: day 1
Claudin level expression in left colonic biopsies
Claudin expression is measured using western blot (for proteins), q RT-PCR (for RNA) and IF (for localization)
Time frame: day 1
Zonula Occludens (ZO)-1 level expression
ZO-1 expression is measured using western blot (for proteins), q RT-PCR (for RNA) and IF (for localization)
Time frame: day 1
Pression pain threshold by rectal barostat
Pression pain threshold is measured in mmHg during rectal barostat.
Time frame: day 1
Quality of life by GIQLI
Evaluation of quality of life using the validated score : french version of the Gastrointestinal Quality of Life Index (GIQLI)
Time frame: day 1
Abdominal symptoms
Abdominal symptoms of IBS are assessed with IBS symptom severity scale.
Time frame: day 1
Anxiety and depression level
Anxiety and depression are assessed with the Hospital anxiety and depression scale.
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Time frame: day 1