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Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Behavioral research in gastroenterology has grown exponentially over the last decade. Controlled studies demonstrate that psychotherapy, stress management, and hypnosis are effective for irritable bowel syndrome; and behavioral treatments are preferred over medical management for some types of fecal incontinence and vomiting. For peptic ulcer disease, interest in behavioral treatments has declined. However, a new syndrome, functional dyspepsia, is now recognized, in which ulcerlike symptoms occur without ulcer and frequently in association with psychological symptoms. For inflammatory bowel disease, stress management training has produced inconsistent outcomes. Newly recognized disorders for which behavioral treatments are needed include constipation associated with inability to relax the pelvic floor muscles during defecation, functional rectal pain (proctalgia), noncardiac chest pain, and aerophagia (excessive air swallowing).
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PMID:Behavioral medicine approaches to gastrointestinal disorders. 150 8

Gastrointestinal bloating is a common complaint met within the general practitioner's office. The most important cause of this symptom is an increase in the volume of gas in the gastrointestinal tract. Differential diagnoses include aerophagia, ingestion of gas-producing foods, gastric hypersecretion, bacterial overgrowth in the small intestine, disordered gastrointestinal transit, malabsorption or maldigestion of carbohydrates. In addition, nonulcer dyspepsia and the irritable bowel syndrome must be excluded. The diagnosis is based on a history of eructation, heart burn, flatulence and diarrhea, dietary habits, physical examination, laboratory analysis and apparative diagnostic measures. Therapy depends on the underlying cause of the disease.
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PMID:[Meteorism]. 191 70

The aim of this study was to describe the clinical features of patients with chronic unexplained dyspepsia and compare the symptoms with peptic ulcer and biliary pain, and determine the prevalence of symptoms that may indicate psychoneurotic traits and measure chronic illness behaviour (days lost from work and doctor visits). Studied were: 113 patients with essential dyspepsia, defined as endoscopically confirmed non-ulcer dyspepsia where gallstones, the irritable bowel syndrome and gastro-esophageal reflux have been excluded and there is no ascertainable cause for the dyspepsia; 55 patients with dyspepsia and peptic ulceration at endoscopy; and 53 patients with diagnosed biliary pain and cholelithiasis, proven at cholecystectomy. All patients completed a detailed structured history questionnaire in the presence of one investigator. More patients with peptic ulcer than with essential dyspepsia experienced night pain, pain relieved by food, and vomiting, while more patients with essential dyspepsia than with cholelithiasis experienced epigastric pain, lack of radiation of pain, continuous pain, mild to moderate pain, pain before meals, pain relieved by food and antacids, pain aggravated by food and alcohol, and an absence of vomiting (all p less than 0.01). Symptoms suggesting psychoneurosis, aerophagy symptoms, and chronic illness behaviour were similar in all groups. We conclude that certain symptoms may be of value in diagnosing the underlying cause of dyspepsia.
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PMID:Comparison of the clinical features and illness behaviour of patients presenting with dyspepsia of unknown cause (essential dyspepsia) and organic disease. 346 12

Non-ulcer dyspepsia (NUD) is defined as dyspepsia in which investigation shows no evidence of focal gastroduodenal disease or oesophagitis. The aim of the present study was to determine the proportion of NUD patients with other identifiable diseases. We interviewed 327 consecutive patients who had at least 1 month of dyspepsia before a panendoscopy that showed no evidence of oesophagitis, malignancy, or peptic ulcer. Symptoms were assessed by a structured history questionnaire. The existence of gallstones was excluded radiologically. Of the subjects studied, 75 (23%) had irritable bowel syndrome and 71 (22%) gastro-oesophageal reflux, whereas 63 (19%) had both, 25 (8%) had aerophagy, and 14 (4%) had gallstones. Of the remaining 79 patients (24%) 6 had duodenitis and 10 gastritis, whereas 1 had both. Sixty-two subjects (19%) had entirely normal endoscopic results and no ascertainable cause of their dyspepsia (termed provisionally essential dyspepsia). It is concluded that, whereas three-quarters of NUD patients have diseases that fall into other diagnostic categories, nearly one-quarter have essential dyspepsia.
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PMID:The association between non-ulcer dyspepsia and other gastrointestinal disorders. 404 40

One third to one half of cases of dyspepsia remain unexplained. The cause of nonulcer dyspepsia is unknown, but aerophagia, esophageal dysfunction, pyloroduodenal dysmotility and the irritable bowel syndrome may be important factors in some patients. The symptoms are often affected by diet and emotion. History-taking and endoscopy are the most discriminating diagnostic tests. Unexplained dyspepsia tends to be a lifelong disease with few, if any, sequelae. Nevertheless, reassurance and treatment with a placebo, such as an antacid or simethicone, provide effective and safe relief for many patients.
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PMID:Nonulcer dyspepsia. 636 98

The subject of aged people and stress was discussed from both clinical and basic points of view, mainly by introducing our research results, beginning with our immunoneuroendocrine studies on aging and stress. Stress stimulates the secretion of two adrenal hormones, cortisol and dehydroepiandrosterone-sulfate (DHEA-S). Both hormones are metabolized and excreted from the kidney, respectively converting to 17-OHCS and 17-KS-S in the urine. We have found that the two adrenal steroids reflect the physiology and pathophysiology of stress and aging, thereby suggesting that the simultaneous analysis of these parameters could be utilized as new biological markers for stress and aging. It was speculated that a disturbed balance between cortisol and DHEA-S would result in various aging- and stress-related disorders. Furthermore, clinical problems in aged people with stress-related diseases such as psychosomatic diseases, neurosis and depression were illustrated by some interesting cases. In particular, much data about peptic ulcer disease in the aged, a typical psychosomatic disease, were presented. In addition, clinical characteristics of old people with irritable bowel syndrome, aerophagia, neurogenic abdominal distention and depression were described. Data of our research to determine why pancreatic cancer is accompanied with depression so frequently were also presented. Finally, it was emphasized that a holistic approach, paying to sufficient attention to psychosomatic aspects, is very important for the management of stress diseases in the aged.
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PMID:[Aged people and stress]. 802 98

Our objective was to obtain national data of the estimated prevalence, sociodemographic relationships, and health impact of persons with functional gastrointestinal disorders. We surveyed a stratified probability random sample of U.S. householders selected from a data base of a national market firm (National Family Opinion, Inc.). Questions were asked about bowel symptoms, sociodemographic associations, work absenteeism, and physician visits. The sampling frame was constructed to be demographically similar to the U.S. householder population based on geographic region, age of householder, population density, household income, and household size. Of 8250 mailings, 5430 were returned suitable for analysis (66% response). The survey assessed the prevalence of 20 functional gastrointestinal syndromes based on fulfillment of multinational diagnostic (Rome) criteria. Additional variables studied included: demographic status, work absenteeism, health care use, employment status, family income, geographic area of residence, population density, and number of persons in household. For this sample, 69% reported having at least one of 20 functional gastrointestinal syndromes in the previous three months. The symptoms were attributed to four major anatomic regions: esophageal (42%), gastroduodenal (26%), bowel (44%), and anorectal (26%), with considerable overlap. Females reported greater frequencies of globus, functional dysphagia, irritable bowel syndrome, functional constipation, functional abdominal pain, functional biliary pain and dyschezia; males reported greater frequencies of aerophagia and functional bloating. Symptom reporting, except for incontinence, declines with age, and low income is associated with greater symptom reporting. The rate of work/school absenteeism and physician visits is increased for those having a functional gastrointestinal disorder. Furthermore, the greatest rates are associated with those having gross fecal incontinence and certain more painful functional gastrointestinal disorders such as chronic abdominal pain, biliary pain, functional dyspepsia and IBS. Preliminary information on the prevalence, socio-demographic features and health impact is provided for persons who fulfill diagnostic criteria for functional gastrointestinal disorders.
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PMID:U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. 835 66

This is the first attempt at defining criteria for functional gastrointestinal disorders (FGIDs) in infancy, childhood, and adolescence. The decision-making process was as for adults and consisted of arriving at consensus, based on clinical experience. This paper is intended to be a quick reference. The classification system selected differs from the one used in the adult population in that it is organized according to main complaints instead of being organ-targeted. Because the child is still developing, some disorders such as toddler's diarrhea (or functional diarrhea) are linked to certain physiologic stages; others may result from behavioral responses to sphincter function acquisition such as fecal retention; others will only be recognizable after the child is cognitively mature enough to report the symptoms (e.g., dyspepsia). Infant regurgitation, rumination, and cyclic vomiting constitute the vomiting disorders. Abdominal pain disorders are classified as: functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain, abdominal migraine, and aerophagia. Disorders of defecation include: infant dyschezia, functional constipation, functional fecal retention, and functional non-retentive fecal soiling. Some disorders, such as IBS and dyspepsia and functional abdominal pain, are exact replications of the adult criteria because there are enough data to confirm that they represent specific and similar disorders in pediatrics. Other disorders not included in the pediatric classification, such as functional biliary disorders, do occur in children; however, existing data are insufficient to warrant including them at the present time. For these disorders, it is suggested that, for the time being, clinicians refer to the criteria established for the adult population.
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PMID:Childhood functional gastrointestinal disorders. 1045 47

Aerophagia refers to a rather rare disorder that may occur in both children and adults that features repetitive air swallowing and belching and that may result in abdominal distention. There are few, if any, controlled studies to guide therapy, which remains largely supportive but may include behavioral therapy and psychotherapy. Bloating, distention, and other gas-related symptoms are common in functional gastrointestinal disorders, including the irritable bowel syndrome; their pathophysiology remains, for the most part, poorly understood. Two separate phenomena need to be distinguished in these disorders: gas production and gas perception. Thus, whereas gas production, which relates most closely to flatus emissions, is probably within the normal range in most patients with irritable bowel syndrome, gas transport or transit through the gut may be impaired and may lead to the retention of gas within segments of the gut. Visceral hypersensitivity, a common phenomenon in all functional disorders, may exacerbate the sensation of distention and contribute to other "gas-related" symptoms. Few controlled studies have addressed any of these issues. Although, on an empiric basis, dietary therapy may be partially effective in some situations, there is at present no data to support the use of any form of pharmacologic, endoscopic, or surgical therapy for any of these symptoms.
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PMID:Aerophagia and Intestinal Gas. 1209 73

Chronic abdominal pain occurs in 17% of children aged 0-14 years with a peak of 33% at the age of 7 years. According to the Rome II criteria abdominal pain disorders can be classified as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia. This new classification will hopefully lead to a more careful diagnosis of functional abdominal pain syndromes and to better treatment strategies. A thorough history taking and physical examination are the cornerstone of diagnostic workup in children with chronic abdominal pain. An extensive explanation and reassurance are the basis of an adequate treatment and in the majority of cases this is successful.
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PMID:[Functional childhood gastrointestinal disorders. I. Chronic abdominal pain]. 1286 62


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