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Query: UMLS:C0021831 (enteropathy)
 4,403 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Employing a Hindi adaptation of the Middlesex Hospital Questionnaire (MHQ), neuroticism level was assessed in 133 subjects with irritable bowel syndrome and compared with that in patients with organic bowel disease (33), healthy population (140) and known neurotics (110). Compared with healthy controls and patients with organic bowel disease, significantly higher scores were found among irritable bowel syndrome patients in all the subscales except obsession. The total of scores was midway between those of the normal population and known neurotics. Neurotic disorder was detected in 51% of irritable bowel syndrome patients compared to 24% of organic bowel disease subjects (P less than 0.05) and 7.8% of the healthy population. Cut-off points, calculated as mean + 2 SD of scores in the healthy population, were found to be reliable as shown by clinical interview.
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PMID:Neuroticism in patients with irritable bowel syndrome. 230 99

Because unexplained 'functional symptoms' are a major cause of referral to gastroenterologists, the efficiency of the medical history to lead to a positive diagnosis of irritable bowel syndrome, without resorting to the use of expensive tests, remains a key question. Whilst the six criteria of Manning et al are widely used, data on their validity in discriminating irritable bowel syndrome from healthy controls, irritable bowel syndrome from non-ulcer dyspepsia and especially among irritable bowel syndrome subgroups, are not available. To evaluate this, we studied 361 outpatients who completed a bowel disease questionnaire, which objectively measured Manning's (and other) criteria. The group included 82 patients with irritable bowel syndrome, 33 with non-ulcer dyspepsia, 101 with organic gastrointestinal disease, and 145 healthy controls. Diagnoses were based on a full and independent clinical evaluation, not on responses to the bowel disease questionnaire. Reliability was assessed by a test-retest procedure. All six of the individual Manning criteria were found to be reliable (median kappa = 0.79). Based on a logistic regression analysis of the discriminatory value of Manning's criteria, as the number of positive criteria increased, so did the predicted probability of irritable bowel syndrome. This predictive value was highest in younger patients and in females. The Manning criteria discriminated irritable bowel syndrome from organic gastrointestinal disease and from all non-irritable bowel syndrome gastrointestinal disease with a sensitivity of 58% and 42%, and a specificity of 74% and 85%, respectively. Stools that were often loose and watery provided an additional independent criterion for distinguishing irritable bowel syndrome from non-irritable bowel syndrome. Thus, symptoms can be used to diagnose irritable bowel syndrome positively, but Manning's criteria are not highly sensitive.
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PMID:Diagnostic value of the Manning criteria in irritable bowel syndrome. 231 33

Motility disturbances of the small and large intestines are based on changes in the smooth-muscle potential, whereby the number of amplitudes and configuration of slow waves and of spike potentials as well as pattern, speed of propagation, and duration of the MMC are of crucial importance. Whereas the electromechanical principles of intestinal motility are sufficiently known, changes in the electromechanical activity in clinically manifest motility disturbances have as yet not been given due regard. Only recently, electromechanical measurements in the upper gastrointestinal tract and colon were performed in several gastrointestinal diseases of internal medicine. In the small intestine, changes in slow waves, spike potentials, and the MMC could be disclosed which are typical for hyperthyrosis, hypothyrosis, irritable bowel syndrome, bacterial diarrhea, primary and secondary intestinal pseudo-obstruction, short-bowel syndrome, postoperative bowel atonia, mechanical bowel obstruction, vagotomy, and diabetic enteropathy with disturbed gastric emptying. Regarding the colon, a disturbance in the electromechanical characteristics was found in irritable bowel syndrome, bacterial overgrowth in the small bowel, chronic constipation, and idiopathic intestinal pseudo-obstruction, which is probably identical with the clinical picture of adynamic ileus. Based on a thorough examination of the literature and on own results from electromechanical measurements in children, electromechanical disturbances have been narrowly defined.
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PMID:Electrophysiological principles of motility disturbances in the small and large intestines--review of the literature and personal experience. 251 98

Although functional gastrointestinal symptoms are seen frequently by internists and are the commonest reason for patients to be referred to gastroenterologists, no validated self-report questionnaire is available for their diagnosis. To differentiate among non-ulcer dyspepsia, the irritable bowel syndrome, organic gastrointestinal disease, and health, we developed a self-report questionnaire. Our bowel disease questionnaire, which evaluated 46 symptom-related items was completed prospectively by 361 subjects before their clinical evaluation as outpatients. Of these subjects, 115 were categorized ultimately as having functional bowel disease (non-ulcer dyspepsia or the irritable bowel syndrome), 101 were categorized ultimately as having organic gastrointestinal disease, and 145 were healthy persons having routine periodic examinations for whom no additional diagnoses were made. All diagnoses were based on independent clinical evaluations, not on the patients' responses to the questionnaire. The bowel disease questionnaire was acceptable and easily completed; it elicited symptoms in a highly reliable manner and was shown to be a valid measure of functional bowel complaints. Our questionnaire discriminated non-ulcer dyspepsia from irritable bowel syndrome with a sensitivity of 75% and a specificity of 72%, and it discriminated functional bowel disease from organic disease and health with sensitivities of 85% and 83%, and specificities of 60% and 76%, respectively. We believe that this questionnaire is an additional and useful diagnostic tool for identifying patients with functional gastrointestinal symptoms.
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PMID:A patient questionnaire to identify bowel disease. 267 85

We assessed the nutritional status of 119 patients with chronic gastrointestinal symptoms due to organic disorders (inflammatory bowel disease, IBD; peptic ulcer, PU; malabsorption syndrome, M; and malignant gastrointestinal tumours, T), by standard anthropometry and marker proteins (albumin; retinol-binding protein, RBP; and thyroxine-binding prealbumin, TBPA). We also studied 31 patients with irritable bowel syndrome (IBS) and 75 age-matched healthy controls (C). Compared with healthy controls, patients with organic bowel disease had significant abnormality of two or more anthropometric measurements (P less than 0.05). Plasma albumin was reduced in patients with IBD, M and T (P less than 0.001), but RBP and TBPA measurements were lower in all patient categories (P less than 0.01) including IBS. Stepwise discriminant analysis of the patient data alone, using three to six parameters, correctly separated 65 per cent PU patients, 66 per cent IBD and M, 72 per cent IBS and 88 per cent patients with T from other disease categories. We conclude that patients with chronic gastrointestinal symptoms often have some nutritional disturbances and that simple anthropometric and protein measurements might help us to distinguish patients with functional bowel disease from those with organic bowel disease.
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PMID:Nutritional assessment in patients with chronic gastrointestinal symptoms: comparison of functional and organic disorders. 392 30

Food intolerant symptoms can have various causes, including enzyme deficiencies (of lactase or aldehyde dehydrogenase) and pharmacological effects (e.g., caffeine, salicylates). The irritable bowel syndrome can also be associated with intolerance to specific foods in some cases, but the mechanism is unclear. Immunological causes are less common but may explain the small bowel mucosal changes associated with gluten enteropathy, as well as the childhood enteropathy provoked by cow's milk or, rarely, by other foods. Food allergy of the more immediate and classical type is associated with reactions both within and outside the gastrointestinal tract. Where these include urticaria, asthma and eczema, immunoglobulin E antibodies are often demonstrable by skin or radioallergosorbent tests, but pseudo-allergic reactions can produce a similar clinical picture. Diagnosis of food intolerance depends on withdrawing the food concerned and assessing the response to a blind challenge. Objective ways of detecting subclinical reactions are also useful, including the detection of a mediator response involving prostaglandins, histamine or serotonin.
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PMID:Food intolerance. 392 73

Patients with Crohn's disease (n = 22), ulcerative colitis (n = 5), inactive Whipple's disease (n = 1), irritable bowel syndrome (n = 2), arthritis (n = 1) and Yersinia infections (n = 2) were examined with 111In-oxine labelled "mixed" leukocyte preparations (n = 12) or with 111In-oxine labelled "pure" granulocyte preparations (n = 21). Compared with barium enemas of the gut and colonoscopy, performed within of one week in 31 patients there was a correct location of infiltrated bowel segments in 24 patients (78%). The scan diagnosed more infiltrated segments in 4 patients (13%). In 3 patients it failed to diagnose one inflamed segment. In 24 patients the faecal 111In-excretion was expressed as percentage of the reinjected 111In-activity. All patients with non inflammatory bowel diseases and patients with inactive inflammatory bowel diseases excreted less than 2% of the reinjected 111In-activity. All but one female patient with active bowel disease excreted more than 2%. In 24 patients the correlation of ESR, CDAI and A.I. was available. There was a good correlation between ESR (r = 0.77, P less than 0.001), A.I. (r = 0.61, p less than 0.001) and the %-faecal faecal excretion. The 111In-labelling of white blood cells, especially of granulocytes, seems to be a reliable alternative method to localize infiltrated bowel segments and to assess disease activity in patients with inflammatory bowel diseases, compared to usually performed radiological, endoscopical and clinical methods.
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PMID:[111In-oxine marked leukocytes: a method for diagnosing the location and evaluating the activity of Crohn disease and ulcerative colitis]. 393 91

Autoantibodies reacting with endocrine cells in the gastrointestinal mucosa were found by indirect immunofluorescence in 22 out of 268 sera (8.2%) obtained from patients with coeliac disease, Crohn's disease, ulcerative colitis, irritable bowel syndrome, and from subjects without bowel disease. A double immunofluorescence technique showed that the autoantibodies reacted with cells secreting gastric inhibitory polypeptide (glucose dependent insulinotropic polypeptide, GIP), secretin, somatostatin or enteroglucagon. Most sera contained antibodies against more than one cell type. Neither the presence of a particular antibody nor the pattern of antibody combinations appeared to be specific for any diagnostic category. The mean plasma GIP concentrations, however, both fasting and two hours after a test meal, were significantly lower in subjects with GIP cell autoantibodies. Thus gut hormone cell autoantibodies may be markers of impaired hormone secretion.
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PMID:Autoantibodies to gut hormone secreting cells as markers of peptide deficiency. 634 Nov 78

We have assessed the nutritional status of 31 patients with irritable bowel syndrome (IBS) and 75 control subjects by anthropometry (height, weight, mid-arm circumference, biceps, triceps and subscapular skinfolds) and three plasma proteins: albumin, retinol-binding protein (RBP), and thyroxine-binding pre-albumin (TBPA). There was no significant difference between the patients and controls for any of the anthropometric measurements, but mean (+/- s.d.) plasma concentrations of RBP and TBPA were significantly lower in patients with IBS, 7.21 +/- 2.77 mg/dl (P less than 0.01); and 26.57 +/- 7.33 mg/dl, (P less than 0.001) respectively than in the control group, 8.85 +/- 2.56 mg/dl and 32.71 +/- 6.30 mg/dl. We conclude that patients with IBS may have subclinical protein deficiency in the absence of demonstrable organic bowel disease.
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PMID:Subclinical protein malnutrition in irritable bowel syndrome: assessment by retinol-binding protein (RBP) and thyroxine-binding pre-albumin (TBPA). 640 57

During a 2 year period, 83 patients with gastric motility problems were evaluated using radionuclide imaging. The patients presented with epigastric distress, postprandial fullness, pain, nausea, vomiting, and diarrhea; signs and symptoms suggestive of either gastroparesis or gastric outlet obstruction. Upper gastrointestinal series or endoscopy, or both, demonstrated no mechanical obstruction. After oral administration of a 300 g meal labeled with 600 muCi of technetium-99m sulfur colloid, a gastric emptying study consisting of serial images and data acquisition was performed. Of the patients studied, 52 had had peptic ulcer surgery, 17 were suspected of having gastroesophageal reflux, 8 were diabetic and suspected of having visceral enteropathy, and 6 had a history of irritable bowel syndrome. The normal mean gastric half emptying time was 77 +/- 16 minutes. Of the patients who had had gastric surgery, 90.4 percent had abnormal emptying: 69.2 percent had delayed gastric emptying and 21.2 percent had rapid gastric emptying time; 9.6 percent had normal emptying time. Of the gastroesophageal reflux group, all but two had normal gastric emptying time; 65 percent demonstrated gastroesophageal reflux within 15 minutes. Two of the patients with irritable bowel syndrome had prolonged emptying; the rest had normal emptying. All diabetic patients with gastroparesis had prolonged gastric emptying time, and all responded favorably to metoclopramide. Of the patients who previously had peptic ulcer surgery and had prolonged emptying time, 72 percent also responded favorably to metoclopramide. We conclude that radionuclide gastric imaging is a useful diagnostic test for the measurement of gastric emptying in patients with a variety of gastrointestinal motility disorders and may be helpful in assessing medical therapy and selecting those who may be candidates for surgery.
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PMID:Assessment of gastric motility using meal labeled with technetium-99m sulfur colloid. 665 Jul 70


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