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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A standardised inventory of stressful life events and a bowel symptom questionnaire were administered at three month intervals for one year to 383 women who were unselected with respect to bowel symptoms. A NEO Personality Inventory was given initially to assess neuroticism. Subjects who satisfied restrictive diagnostic criteria for irritable bowel syndrome were compared with those who complained of abdominal pain plus altered bowel habits but who did not meet restrictive diagnostic criteria (functional bowel disorder) and with controls without bowel dysfunction. The irritable bowel group showed significantly higher levels of stress than the other two groups even when the confounding effects of neuroticism were statistically controlled for. Time lagged correlations showed that stress in one three month interval was significantly correlated with bowel symptoms in the subsequent three month interval for all groups. The slope of the regression line relating stress to bowel symptoms was significantly steeper for the irritable bowel group than for the other two groups at three and six months, suggesting that subjects with irritable bowel syndrome show a greater reactivity to stress. Stress scores were also significantly correlated with the number of disability days and the number of medical clinic visits for bowel symptoms.
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PMID:Effects of stressful life events on bowel symptoms: subjects with irritable bowel syndrome compared with subjects without bowel dysfunction. 162 67

Because infants with colic appear to have abdominal pain similar to that of adults with irritable bowel syndrome, who may benefit from the addition of fiber to their diet, we tested whether fiber added to infant formula would alleviate colic. Twenty-seven normal, term infants (aged 2 to 8 weeks; 14 girls) with colic, defined as crying plus fussing for more than 3 hours a day for at least 3 days of a 6-day baseline period, were enrolled. Infants were randomly assigned in 9-day periods to a sequence of placebo (Isomil formula) followed by fiber-supplemented formula (Isomil plus soy polysaccharide) (n = 12) or the reverse (n = 15). Daily diaries of crying, fussing, sleeping, formula, intake, and stooling were kept. Twenty-two infants completed three lactulose breath hydrogen tests at the end of the baseline period and after each study period. The crossover trial was followed by 30 to 35 days of use of the study formula chosen by the parents as most beneficial but unknown to the investigators. Growth was monitored throughout. Serum cholesterol, calcium, phosphate, albumin, iron, and zinc concentrations were measured at the conclusion. There were no significant differences in average daily time spent by the infants in fussing and crying during ingestion of the fiber-supplemented formula. However, parents of 18 of 27 infants chose fiber-supplemented formula as most beneficial in ameliorating symptoms of colic. While the infants were consuming fiber-supplemented formula, stool frequency increased, and breath hydrogen excretion increased significantly, in response to lactulose. Growth and serum biochemical measurements were normal in all infants. Supplementation of infant formula with the level of soy polysaccharide used in this study may have reduced crying and fussing in some infants but did not affect colicky behavior in the majority of infants, who continued to cry and fuss excessively.
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PMID:Evaluation of the effect of a fiber-enriched formula on infant colic. 165 81

The major aims of medical therapy in irritable bowel syndrome (IBS) are: a) to ameliorate symptoms (pain, bowel movement abnormalities, bloating) and b) to improve psychological problems of the patients. The first step of IBS therapy is the diet. In fact some forms of IBS can be ascribed to food intolerance. When abdominal pain, meteorism and constipation are the main symptoms, treatment with high-fiber diet, antispastic and antimuscarinic drugs is indicated. Sometimes amitriptyline, an antidepressant which also shows anticholinergic and analgesic properties, can be helpful. When diarrhoea is prevalent, the most effective drug is represented by loperamide. If diarrhoea is related to meal ingestion, antispastic or antimuscarinic drugs can be successfully used. In the case of diarrhoea related to documented cholorrhoea, cholestyramine can be of benefit. Furthermore, there are some resistant cases, secondary to striking psychological problems that require sedatives and antidepressant drugs and sometimes, psycho and/or hypnotherapy.
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PMID:Therapeutic strategy for the irritable bowel syndrome. 166 28

We studied 114 patients affected by irritable bowel syndrome (IBS) (group A = 53 patients, group B = 61). Group A received diet with high content of roughage (20 g of fibers) and 10 g of bran, group B received otilonium bromide (OB) 40mg tid and normal diet (10-15 g of fibers). Abdominal pain, abdominal distension, bowel movements were evaluated before treatment (T0) at the end (T24) and after 12 months (T12). In group B otilonium bromide induced a significant improvement (p less than 0.01) of abdominal pain and distension when comparing T0 with T24. In group A diet produced an improvement, albeit not significant, of the aforementioned parameters at T24. On the basis of our data OB seems to be more effective than a high-fiber diet in the treatment of IBS.
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PMID:Aleatory clinical study comparing otilonium bromide with a fiber-rich diet in the treatment of irritable bowel syndrome. 166 30

To investigate whether the clinical history and basic laboratory test results can differentiate between an organic or functional cause of chronic diarrhea and thus avoid unnecessary hospital admissions and invasive procedures, we reviewed the charts of 58 adult patients admitted during 6 years because of chronic diarrhea who had normal stool and colonic examinations. The final diagnoses were irritable bowel syndrome in 34 patients, organic diarrhea in 21, and unknown cause in three. The following clinical data did not help in the differential diagnosis: age, sex, duration of diarrhea, presence of continuous diarrhea, abdominal pain, stool frequency or volume, and presence of stool mucus. Significant weight loss, nocturnal diarrhea, and the absence of tenesmus were associated with an organic cause. One or more laboratory alterations (increased erythrocyte sedimentation rate, anemia, hypokalemia, and low serum albumin level) were found in 62% of patients with organic diarrhea but in only 3% of those with functional disease; p less than 0.001. In 20 of 21 patients with organic diarrhea, an syndromic diagnosis (fat malabsorption, n = 13; inflammatory bowel disease, n = 4; and secretory diarrhea, n = 3) could be obtained with three simple tests (stool fat, rectal biopsy, and fecal water osmolality and electrolyte determination, respectively). Our study confirms that a detailed history and a few simple laboratory data can help to distinguish between functional and organic diarrhea and so avoid extensive investigation. The syndromic diagnosis of organic diarrhea can also be approximated with relatively easy tests.
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PMID:Chronic diarrhea with normal stool and colonic examinations: organic or functional? 174 88

Irritable bowel syndrome (IBS) is defined as chronic-recurrent abdominal pain in absence of organic lesions. The crucial pathogenetic point is to establish whether pain is related to enhanced sensitivity of the patient or to an abnormal peripheral stimulus originating from the bowel. We can subdivide the patients with abdominal pain into two main groups: the first comprehends those patients with an abnormal response to a normal stimulus (i.e. an enhanced motor response to a meal) (irritable bowel syndrome) and second those patients who have a normal response to an abnormal stimulus (i.e. alimentary factors, laxatives, bile acids) (irritated bowel syndrome). On the basis of our knowledge we can say that the pathogenesis of IBS is complex and not yet completely defined. The crucial point is represented by our capability to discriminate between the "irritable" and "irritated" colon.
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PMID:Pathogenesis of irritable bowel syndrome. 175 80

The irritable bowel syndrome (IBS) is characterized by abdominal pain, abdominal distension and altered bowel habits. The diagnosis is usually made by excluding other diseases. The diagnosis of IBS must be based on a) medical history (i.e. symptoms, bowel habits, normal physical examination, absence of intestinal infections or parasites) b) physiopathological evaluation (hyperactivity of the distal colon, hypersensitivity to stimuli, stress), and c) physiological evaluation of the patient. The diagnosis of IBS can be supposed in patients with typical symptoms in the absence of other diseases that were excluded by complementary examinations.
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PMID:The irritable bowel syndrome: diagnostic strategies. 175 82

The pathogenetic factors involved in the genesis of the irritable bowel syndrome (IBS) has not been fully explained yet. The abnormalities observed in these patients are a hypersensitivity to distension and an amplification of painful sensations. The motor activity of sigmoid colon shows an increased motility index in IBS patients with constipation and a low motility index in those with diarrhea. An hypercaloric meal induces a hypermotility in these patients. In our experience rectal distension evokes abdominal pain in 78% of cases at volumes of 100ml (less than than controls and constipated patients). The perfusion of rectum induces continuous abdominal pain in 89% of IBS patients. We can say that the motility of the whole colon over prolonged periods of time may represent an important progress in understanding the motor function in these patients.
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PMID:Colonic sensitive-motor alterations in the irritable bowel syndrome. 175 83

Seventy-two patients complaining of abdominal pain were studied in a double blind trial with otilonium bromide (OB) (40 mg tid or placebo). In our patients we performed, before and after the treatment, a clinical evaluation (symptom variations) and functional studies (sigmoid manometry during bowel distension). As regards clinical parameters, otilonium bromide significantly reduced abdominal pain and bloating and significantly increased (p less than 0.02) the pain threshold. However the comparison with the placebo group did not show any difference between the two groups. Sigmoid motility during distension was significantly reduced (p less than 0.05) in OB group, whereas it did not change in the placebo group. We can conclude that, in irritable bowel syndrome (IBS) patients, OB is able to improve symptoms and to reduce stimulated motor activity of the sigmoid.
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PMID:Clinical and functional evaluation of the efficacy of otilonium bromide: a multicenter study in Italy. 175 85

Abdominal migraine is well recognised in children, but in spite of anecdotal reports migraine is not well established as a cause of abdominal pain in adults. Functional abdominal pain is usually classified as either irritable bowel syndrome or nonulcer dyspepsia, but some patients have intermittent abdominal pain associated with headache or other migraine accompaniments and, in these, a diagnosis of abdominal migraine should be considered. It is possible that some patients with functional abdominal pain have migraine presenting with few or even no migraine accompaniments. There is no nonclinical objective standard for diagnosing migraine, and research in this area is therefore very difficult. Nevertheless, some patients with functional abdominal pain may respond to antimigraine medication and, if their symptoms are suggestive, a trial of therapy may be desirable.
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PMID:Abdominal migraine: does it exist? 176 32


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