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The pathophysiology of the IBS is hardly understood, whereas several possible mechanisms, such as visceral hypersensitivity, irregular gut motility, abnormal brain\u2013gut relations, and the role of infectious agents, are implicated in initiation and development of this syndrome. Different studies demonstrated an alteration in B\u2010lymphocytes, mast cells (MC), T\u2010lymphocytes, and cytokine concentrations in intestinal mucosa or systemic circulation that are likely to contribute to the formation of the IBS. Therefore, IBS could be developed in those with genetic predisposition. Infections\u2019 role in initiation and exacerbation of IBS has been investigated by quite several clinical studies; moreover, the possible role of some pathogens in development and exacerbation of this disease has been described. It appears that the main obligatory pathogens correspond with the IBS disease, <jats:italic>Clostridium difficile<\/jats:italic>, <jats:italic>Escherichia coli<\/jats:italic>, <jats:italic>Mycobacterium avium<\/jats:italic> subspecies paratuberculosis, <jats:italic>Campylobacter concisus<\/jats:italic>, <jats:italic>Campylobacter jejuni<\/jats:italic>, <jats:italic>Chlamydia trachomatis<\/jats:italic>, <jats:italic>Helicobacter pylori<\/jats:italic>, <jats:italic>Pseudomonas aeruginosa<\/jats:italic>, <jats:italic>Salmonella spp<\/jats:italic>, <jats:italic>Shigella spp<\/jats:italic>, and viruses, particularly <jats:italic>noroviruses<\/jats:italic>. A number of pathogenic parasites (<jats:italic>Blastocystis, Dientamoeba fragilis<\/jats:italic>, and <jats:italic>Giardia lamblia<\/jats:italic>) may also be involved in the progression and exacerbation of the disease. Based on the current knowledge, the current study concludes that the most common bacterial, viral, and parasitic pathogens may be involved in the development and progression of IBS.<\/jats:p>","DOI":"10.1002\/jcp.27828","type":"journal-article","created":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T16:08:48Z","timestamp":1543334928000},"page":"8550-8569","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["The possible role of bacteria, viruses, and parasites in initiation and exacerbation of irritable bowel syndrome"],"prefix":"10.1002","volume":"234","author":[{"given":"Aref","family":"Shariati","sequence":"first","affiliation":[{"name":"Department of Microbiology School of Medicine, Iran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fateme","family":"Fallah","sequence":"additional","affiliation":[{"name":"Department of Microbiology School of 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