Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2016; 22(4): 1331-1334
Published online Jan 28, 2016. doi: 10.3748/wjg.v22.i4.1331
Is irritable bowel syndrome an infectious disease?
John Richard Thompson
John Richard Thompson, Department of Pharmacy Practice, Lipscomb University College of Pharmacy, One University Park Drive, Nashville, TN 37204, United States
Author contributions: Thompson JR contributed solely to the literature analysis and writing of the manuscript.
Conflict-of-interest statement: Dr. Thompson serves on the Speakers’ Bureau for GlaxoSmithKline and Salix Pharmaceuticals.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: John Richard Thompson, PharmD, MBA, Professor, Chair, Department of Pharmacy Practice, Lipscomb University College of Pharmacy, One University Park Drive, Nashville, TN 37204, United States. richard.thompson@lipscomb.edu
Telephone: +1-615- 9667172 Fax: +1-615-9667163
Received: April 29, 2015
Peer-review started: May 12, 2015
First decision: August 26, 2015
Revised: October 6, 2015
Accepted: November 24, 2015
Article in press: November 24, 2015
Published online: January 28, 2016
Processing time: 266 Days and 14.5 Hours
Core Tip

Core tip: Recent evidence from both basic and clinical science supports the hypothesis of infectious disease as an etiological agent in irritable bowel syndrome (IBS). The presence of small intestinal bowel overgrowth and its treatment as reflected in reductions of lactulose hydrogen breath tests correlates with improvement in IBS symptoms. Clinical trials with both probiotics and antibiotics also appear to relieve symptoms of IBS and have a sustained effect post-treatment. Recurrences of symptoms post-treatment appear to respond similarly with no loss of effect. An infectious disease etiology of IBS may explain the heterogeneous symptoms of the disease and varying responses seen with different symptom phenotypes.