Posted 8/9/2010 10:29 AM (GMT -6)
Just somethings to point out here, they have found many problems in IBS both in the gut brain and the brain and this is a part of IBS research. They have known about intestinal permeabilty for a long time, especially in Post infectious IBS.
I ask Dr Drossman about this study.
My disclaimer is that basic science research is not my area of expertise so I can’t comment on the methodological rigor, only the results and I only glanced at the article. We do know that intestinal permeability may play a role in the clinical expression of IBS. That is actually the basis for transmigration of bacterial products which sets the stage for submucosal inflammation and visceral sensitization. This is where all the work on bacterial flora and probiotics come in: to destabilize or stabilize the gut mucosal barrier. These authors have demonstrated an association in IBS patients who have increased intestinal membrane permeability with a genetic marker for glutamine synthetase expression. So there may a genetic linkage for a metabolic mechanism that leads to intestinal permeability which in turn may predispose to IBS development.
Dr Doug Drossman
Douglas A. Drossman, MD
Professor of Medicine and Psychiatry
Dr. Drossman is Professor of Medicine and Psychiatry (UNC School of Medicine, Division of Gastroenterology & Hepatology) and Co-Director of the UNC Center for Functional GI & Motility Disorders. He has had a long-standing interest in the research and evaluation of difficult to diagnose and treat GI disorders. He established a program of research in functional GI disorders at UNC more than 25 years ago and has published more than 400 books, articles and abstracts relating to epidemiology, psychosocial and quality of life assessment, design of treatment trials, and outcomes of research in GI disorders. He has also published two books, a GI procedures manual, and a textbook on Functional GI Disorders (Rome I, Rome II and Rome III). In addition, he serves on six editorial boards in medicine, gastroenterology and psychosomatic medicine, was associate editor of Gastroenterology and GI section editor of the Merck manual, and is currently editor of Digestive Health Matters published by IFFGD as well as the newsletter of the Functional Brain-Gut Research Group.
Dr. Drossman received his MD degree from Albert Einstein College of Medicine in 1970, and completed his medical residency at the University of North Carolina School of Medicine and New York University-Bellevue Medical Center. After his residency, he sub-specialized in psychosocial (psychosomatic) medicine at the University of Rochester School of Medicine under the mentorship of Dr. George Engel from 1975 to 1976 and in gastroenterology at the University of North Carolina in from1976 to 1978.
Dr. Drossman has been involved in several national and international activities which include President of the Rome Foundation and Scientific Director and member of the Board of the International Foundation for Functional GI Disorders (IFFGD). He is a past president of the American Psychosomatic Society, immediate past Chair of the AGA Council on Motility and Nerve-Gut Interactions, and Founder/Past President of the Functional Brain-Gut Research Group of AGA. He is an AGA Fellow and serves on the AGA Media Committee, AGA Nominating Committee, and the AGA Research Awards Panel. Dr. Drossman is a Fellow of the American College of Physicians and a Master of the American College of Gastroenterology. He is a member of the Institute of Medicine of the National Academy of Sciences Committee on Gulf War and Health: Physiologic, Psychologic and Psychosocial Effects of Deployment Related Stress. He has been an Ad Hoc Advisory Board member of the NIH National Center for Complementary and Alternative Medicine (NCCAM), and is currently serving on the NIH (NIDDK) Functional GI and Motility Disorders Working Group.
As Medical Director of the UNC Center for Functional GI & Motility Disorders, Dr. Drossman sees patients in the Functional GI Clinic. He also precepts GI fellows and visiting gastroenterologists to develop their clinical skills in patient care and communication. He facilitates the learning of medical faculty and fellows, psychiatry residents and medical students with regard to the biopsychosocial care of patients with functional GI disorders. In 2004, Dr. Drossman received the AGA Distinguished Educator Award, recognizing an individual for achievements as an outstanding educator over a lifelong career.
Dr. Drossman’s educational and clinical interests in the psychosocial/behavioral aspects of patient care have led to the development of a series of videotapes to teach physicians and other healthcare professionals how to conduct an effective patient interview, carry out a psychosocial assessment, and enhance patient-doctor communication. He has taught numerous US and international workshops on this topic and was chair of the ACG Physician-Patient Relations Committee from 1994-1996. He is also a charter fellow of the American Academy on Physicians and Patients, a consortium of doctors teaching these skills to medical school faculty. In 2007, he will receive the AGA Mentors Research Scholar Award.
Dr. Drossman has an active research program that relates to the clinical, epidemiological, psychosocial, and treatment aspects of irritable bowel syndrome and the functional GI disorders. He has held several NIH grants totaling $10 million, including a recent multi-center treatment trial of functional bowel disorders with cognitive behavioral therapy and antidepressants in addition to several pharmaceutical trials of new investigative agents for IBS. He has developed and validated several assessment and quality of life measures that are used worldwide for clinical research. Recently, he is studying brain imaging (fMRI) in functional bowel disorders to determine if reported changes in the brain are associated with pain and stress, and are responsive to treatment. He also consults with pharmaceutical companies and government agencies regarding treatment trials. In 1999, Dr. Drossman received the Janssen Award for Clinical Research in Digestive Diseases. In 2003, he received the Research Scientist Award for Clinical Research presented by the Functional Brain-Gut Research Group (FBG) during Digestive Diseases Week. That year, he also received the American Psychosomatic Society’s President’s Award. In 2005, Dr. Drossman received the AGA/Miles and Shirley Fiterman Foundation Joseph B. Kirsner Award in Clinical Research in Gastroenterology.
In addition to his clinical care, research and teaching responsibilities associated with the UNC School of Medicine and the Center for Functional GI & Motility Disorders, Dr. Drossman has numerous involvements with leading national and international organizations:
Chair of the Executive Committee (since 1989) and President (since 2003) of the Rome Foundation
Editor of Rome III: The Functional Gastrointestinal Disorders, 3rd edition, published in 2006
Member of the Board of Directors, Chair of the Scientific Advisory Board, and Chair of the Awards Committee of the International Foundation for Functional GI Disorders (IFFGD)
Co-Chair and Chair of the Motility and Nerve-Gut Interactions Section of the AGA Council from 2001 to 2005
Founder and past chair of the Functional Brain-Gut Research Group (FBG) special interest section within the American Gastroenterological Association (AGA)
Chair of the Digestive Health Initiative on Functional GI Disorders sponsored by the American Digestive Health Foundation in 1999-2000
Past-president of the American Psychosomatic Society
Functional Brain-Gut Research Group Research Scientist Award -- 2001
Fellow of the American College of Physicians (ACP)
Master of the American College of Gastroenterology (MACG)
Charter fellow of the American Academy of Physician and Patient
Janssen Award for Clinical Research in Digestive Diseases -- 1999
Associate Editor of Gastroenterology, the official journal of the AGA, from 2001 to 2006
Author of the AGA Clinical Teaching Project on IBS (1997) and the AGA Gastroenterology Teaching Project (2003) on IBS (2nd edition, 2003)
Editor of the Manual of GI Procedures (now in its fourth edition)
On the board of the medical website Medscape Gastroenterology
Gastroenterology Section editor of the Merck Manual 1990-2005
Member of the Institute of Medicine Committee on Gulf War and Health: Physiologic, Psychologic and Psychosocial Effects of Deployment Related Stress
Member of the NIDDK (NIH) National Commission on Digestive Diseases Subcommittee on Functional GI & Motility Disorders
Dr. Drossman is considered a world authority in the field of functional GI disorders and physician-patient communication. He presents at numerous national and international meetings throughout the year.