Recognizing and Managing Irritable Bowel Syndrome in Quiescent Inflammatory Bowel Disease

Patients with inflammatory bowel disease (IBD) commonly experience new or persistent gastrointestinal symptoms despite quiescent disease. These symptoms may be attributed to a wide range of etiologies, including IBD-associated complications, concomitant gastrointestinal or extra-intestinal pathologies, and medications side effects. Disorders of gut-brain interaction (DGBIs) - formerly termed functional gastrointestinal disorders (FGIDs) - can be seen in up to two thirds of patients with IBD, the most common being irritable bowel syndrome (IBS). DGBIs in IBD are often under-recognized and are associated with worse quality of life, impaired mental health, and greater healthcare utilization. In this article, we provide a systemic approach to assessing GI symptoms in quiescent IBD, and focus on the overlap and interplay between IBD and DGBIs, in particular IBS, and review management options for IBS in patients with IBD.