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There was a study done in 2008 that looked at the reasoning behind many IBD patients developing functional IBS during remission. This is actually the case for me, so I am curious to know how many others does this affect?
My daughter was diagnosed with IBS when she continued to have symptoms even though her colonoscopy/pillcam was clear. They've mostly gone away since then, but I'm interested in hearing more about this, it seems quite common!
I'm somewhat skeptical but maybe that's just me. After about 2 lovely years in remission, I started getting mild symptoms again (this happened right around the time that they stopped making regular Asacol in the US - Asacol HD didn't work for me and I started getting symptoms at that time as I struggled to find a maintenance med that would work for me). My symptoms stayed on the mild end of things and I presumed it was a mild flare - I managed to maintain my weight during that time and I never got super sickly, never got terribly pale, etc. But still, I was having some symptoms and wanted answers and/or treatment. I had to beg and plead to my GI to put me back on Entocort - his presumption was, because I had maintained my weight and things hadn't gotten bad, that perhaps I just had IBS and that was the cause of my symptoms, rather than a mild ongoing flare. I rejected that theory - I don't respond well to IBS meds, and I had been passing blood during the mild flare, so IBS didn't make a lot of sense to me. After much pleading, he finally did put me back on Entocort, and it's working - so it seems as though it was indeed a mild flare and not IBS in my case.
Part of me wonders if this so called "functional IBS during remission" isn't just our IBD. Perhaps it is just not bad enough to show up on any tests, yet it's still lingering and causing phantom-like symptoms....seems to be true in my case.
I wondered about that too - especially in my daughter's case, since she no longer has "IBS" symptoms. It took a few months after her pillcam and colonoscopy showed that there was no inflammation for all her GI symptoms to go away. I wonder if there was inflammation that we couldn't see or something, that has now gone away?
It may not be common, but certainly its not unheard of. Here is a quote from a scientific article.
Curr Opin Gastroenterol. 2014 May 7. [Epub ahead of print] Inflammatory bowel disease and irritable bowel syndrome: similarities and differences.
PURPOSE OF REVIEW:
Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are classically viewed as dichotomous conditions. The former is perceived as a typical organic disease, and the latter is regarded as a disorder of gut function driven by mood. Recent research identified some shared contributing factors, which will be discussed here.
Mounting evidence shows the importance in both IBD and IBS of genetic, microbiological, epithelial, and immunological factors. In some instances, these factors overlap in the two conditions as shown by: involvement of brain-gut axis dysfunction in IBD, implication of TNFSF gene in Crohn's disease and IBS, evidence of abnormal microbiota and its impact on host functions, identification of low-grade inflammation in subsets of IBS patients, and development of IBS symptoms in patients with IBD in remission.
IBD and IBS remain separate conditions although there are some overlapping mechanisms. Both research and clinical management would benefit from considering a functional approach for certain manifestations of IBD and accepting an organic view in subsets of IBS patients.