Gastro Flash Vol-9, No-3, 2023

Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder (FGID) characterized by altered bowel habits associated with abdominal discomfort or pain without apparent structural and biochemical abnormalities. Studies report that FGID have a prevalence of about 40% worldwide, with a higher occurrence in women than in men.In India, prevalence of IBS varies from 0.4% to 4.2%. Exact etiology behind IBS is still unknown. However, various factors contribute in its development. Altered gastrointestinal motility,visceral hypersensitivity, post infectious reactivity, brain-gut interactions, alteration in fecal micro flora, bacterial overgrowth, food sensitivity, carbohydrate malabsorption, and intestinal inflammation all have been implicated in the pathogenesis of IBS.1-4 According to the WHO DMS-IV code classification, IBS can be classified as either diarrhea -predominant (IBS-D), constipation- predominant (IBS-C), or with alternating stool pattern (IBS-A) or pain-predominant. There is no specific test that can diagnose IBS. However, the diagnosis is based on specific symptoms known as the “Rome criteria.” Rome IV is one of the accepted criteria for the diagnosis of IBS worldwide. However, in Indian population ROME-III criteria could be preferred over the ROME-IV criteria as it has higher sensitivity for IBS compared to the ROME-IV criteria for diagnosis of IBS.

Liver cirrhosis is a condition marked by extensive disruption of the normal liver structure due to fibrosis, resulting from chronic progressive liver diseases such as alcohol-related steatotic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Cirrhosis is characterized by severe liver scarring, loss of organ function, and complications associated with portal hypertension. The prevalence and mortality rates of liver cirrhosis are on the rise. Traditionally viewed as a singular entity with a continuum of severity, recent paradigms acknowledge liver cirrhosis as a heterogeneous condition with varying prognoses at different stages.