A Clinical Case of Lyme Disease and Irritable Bowel Syndrome Comorbidity

Borreliosis (or Lyme disease) is an infectious disease that develops after being bitten by ixodes ticks, which are carriers of Borrelia burgdorferi spirochaetes, and affects several body systems, including the skin, joints, heart, and nervous system. Neurological manifestations of the disease, known as neuroborreliosis, can include meningitis, cranial nerve damage, and peripheral neuropathy. A poorly studied and complex problem is the effect of chronic Borrelia burgdorferi infection on the function of the gastrointestinal tract, which can manifest in the form of gastroparesis, motor disorders, and visceral hypersensitivity. The most difficult to diagnose is the simultaneous lesion of the gastrointestinal tract as a result of borreliosis and irritable bowel syndrome. Irritable bowel syndrome is considered a multifactorial disease based on disorders of the gut-brain axis, dysregulation of the enteric nervous system, and increased visceral sensitivity. Damage to these systems in borreliosis, especially under neuroborreliosis, can induce or modulate similar processes, leading to functional symptoms characteristic of irritable bowel syndrome. The article presents a long-term clinical observation of the comorbidity of these two diseases, the difficulties of diagnosis and treatment, as well as a call for discussion and research of this problem due to the fact that the effectiveness of the management of the described patient cannot be considered satisfactory.