Volume 79 - 2016 - Fasc.1 - Case series
Irritable bowel syndrome and visceral hypersensitivity : risk factors and pathophysiological mechanisms
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, characterized by abdominal pain and altered intestinal motility. Visceral hypersensitivity is an important hallmark feature of IBS and is believed to underlie abdominal pain in patients with IBS. The two main risk factors associated with the development of IBS are gastrointestinal inflammation and psychological distress.
On a peripheral level, visceral sensitivity seems to be modulated by several mechanisms. Immune cells in the mucosal wall, such as mast cells, and enterochromaffin cells may sensitize afferent nerves by release of their mediators. Furthermore, increased mucosal permeability, altered intestinal microflora and dietary habits may contribute to this feature. On a central level, an increased prevalence of psychiatric comorbidities is demonstrated in IBS patients, alongside alterations in the hormonal braingut axis, increased vigilance towards intestinal stimuli and functional and structural changes in the brain.
Risk factors for complications and mortality related to endoscopic procedures in adults
Background / study aims : The objective of this study is to iden- tify and describe risk factors and complications in
Methods : This review presents the complications and the accom- panying risk factors that were described in the selected full-text articles. The relevant full-text articles were found in Pubmed, ISI Web of Science and the CINAHL database.
Results : The search resulted in 238 abstracts, 50 of which were finally selected for full-text analysis.
The different types of endoscopic procedures each have specific complications, but bleeding and perforation occur in all proce- dures. It was found that bleeding, perforation, cardiovascular and respiratory complications were common complications.
Furthermore, morbidity and mortality have been associated with risk factors such as older age, high ASA class and sedation.
Conclusion : Endoscopy is not without risk, although the preva- lence of complications is low. Most complications seen in this analy- sis, are linked to known risk factors. Some complications might be preventable or avoidable, given a more systematic and compre- hensive approach pre-, per- and postprocedural. The creation and implementation of an endoscopic safety checklist could be an important supportive tool in lowering complications. (Acta gastro-enterol. belg., 2016, 79, 39-46).