The recent study by Wouters et al1reported 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.2In 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 symptomfree and when they experience symptomflare.
- irritable bowel syndrome
- Bowel Disease Questionnaire