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The recent study by Wouters et al1 reported that psychological status inversely correlates with immune profile in the development of postinfectious IBS. While there is increasing evidence of chronic low-grade immune activation in IBS, this field is mired in controversy.2 In our opinion, this contention is related to two major methodological issues: the tendency to group all patients with IBS together rather than stratifying according to bowel habit,3 and the overwhelming predominance of cross-sectional studies. We addressed these issues by performing a longitudinal study of patients with IBS comparing immune function within patients when symptom free and when they experience symptom flare.
Eleven subjects with long-standing IBS (initially characterised by ROME II criteria: 5 IBS-D, 4 IBS-A, 2 IBS-C; 10 female; 59±3 years (mean±SEM)) were enrolled sequentially from tertiary centres in Adelaide, Australia. Subjects completed a valid self-report Bowel Disease Questionnaire3 and …
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