Clinical, psychosocial and therapeutic aspects of irritable bowel syndrome : results of cohort studies and aprobiotic intervention trial

This dissertation focusses on irritable bowel syndrome (IBS), a disorder in which symptoms of anxiety and depression play an important role. The dissertation mainly shows the existence of differences between men and women suffering from IBS. A reduction of symptoms was shown in men after being treated with probiotics (Yakult®), whereas remarkably high placebo response rates were shown in women. Furthermore, indications were found of other symptoms and subtypes being prominent and potentially different underlying pathogenetic mechanisms being present in female IBS patients compared to the male population. Differences were found in the serotonin household and the presence of faecal short chain fatty acids. These findings may result from differences in the composition and/or activity of the ‘intestinal flora’. Therefore, Thijssen advocates the focus of IBS care being shifted towards differences between men and women.