The Irritable Bowel Syndrome (IBS), skin connection and why it matters for your treatment

When our Board-Certified Gastroenterologist, Dr. Alexander Shapsis of Atlantic Gastroenterology in Brooklyn, New York, gets your Irritable Bowel Syndrome (IBS) and other GI diseases under control, you may also notice an improvement in the condition of your skin! A recent Practical Dermatology article analyzed the ever-growing medical literature that connects the dots between IBS and inflammatory skin conditions such as urticaria (hives), Atopic Dermatitis (allergic eczema), and rosacea.

These studies matter; the more we understand about the connection between the gut and the skin, the more therapeutic options can emerge for multi-disciplinary teams to effectively target these linked conditions.

The connection

The links between the health of the skin and the health of the Gastrointestinal (GI) system were first proposed more than 90 years ago. At the time, Drs John Stokes and Donald Pillsbury suggested that the gut and skin are both influenced by the brain (our emotional states). While these links remain elusive, there is an increasing body of research designed to explain the brain-gut-skin connection. Notably, researchers are looking at IBS and its role in skin conditions.

Said to affect up to 20% of the world’s population, IBS is characterized by chronic constipation, diarrhea, and GI upset. It has been implicated in everything from fibromyalgia (chronic pain) to persistent pruritis (itching). Now, of special interest to Drs Shapsis and his team, studies found associations between this common GI condition and common dermatological conditions.

Notably, analysis of more than 30,000 medical records in the U.K. found that those patients with atopic (allergic) skin conditions were considerably more likely to have IBS than healthy control subjects. Research implicates both increases in the level of a particular antibody, immunoglobulin E (IgE), and mast cells that release histamines and trigger asthma attacks and allergic reactions in the development, frequency, and severity of IBS. It’s reasoned that the associated hypersensitivity and hyperreactivity triggers GI symptoms. A process that Practical Dermatology characterized as an “allergic-mediated chemical cascade.”

So, what does all of this mean?

Well, this research holds great promise for the development of new, highly-targeted therapies to relieve or manage these interconnected conditions. Consider this: patients with mastocytosis (allergic diseases) are already experiencing a substantial improvement in the severity and frequency of GI distress and diarrhea with antihistamines and cromolyn sodium, a nasal spray or inhalant designed to prevent asthma attacks and symptoms of allergic rhinitis (hay fever).

Another asthma medication, omalizumab (sold under the brand name Xolair), has demonstrated positive improvements among asthmatic patients with chronic hives and diarrhea. In summary, at least one of the “paths” to IBS is similar to the path to inflammatory skin diseases. The connection between IBS and hives and AD, in particular, supports this notion. With a continued increase in our knowledge of these pathways, there are sure to be more options on the horizon to treat the symptoms of these linked conditions, including more specialized medications that build upon the successes seen with medications to address the effect of IgE and mast cells.

In the meantime, know that Atlantic Gastroenterology takes a comprehensive approach to manage and treat many GI conditions. We stay on the leading edge of science and technology, and our considerable and current knowledge informs your treatment options. You deserve to look, feel, and “be” better. Contact us today to schedule your appointment with Dr. Shapsis.