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

The prevalences of bowel diseases (hemorrhoids, appendicitis, polyps, ulcerative colitis, irritable bowel syndrome, diverticular disease, and colon cancer) are similar in South African whites and in populations of prosperous western countries. Among rural South African blacks with a traditional life style, these diseases are very uncommon or almost unknown. Among the urban South African blacks with a partially westernized life style, the diseases remain uncommon. Frequencies of appendectomies and colon cancer in urban blacks have increased little during the last three decades, although an increase undoubtedly has occurred in the frequency of diverticular disease. Frequencies of bowel diseases in South African Indian and colored (Eurafrican, Malay) populations are intermediate. Because the diseases are almost entirely of environmental causation (due to principally to changes in diet), prevalences almost certainly will increase in blacks, Indians and coloreds, as their way of life becomes further westernized.
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PMID:Epidemiology of noninfective intestinal diseases in various ethnic groups in South Africa. 44 96

Psychopathology and alexithymia were investigated in a consecutive series of 60 patients suffering from large bowel disorders (ulcerative colitis, irritable bowel syndrome and appendicitis). Patients with irritable bowel syndrome reported the highest percentage of psychiatric illness and the lowest alexithymic score. Conversely, patients with ulcerative colitis showed very pronounced alexithymic traits with limited psychopathology. Implications for psychosomatic research and treatment are discussed.
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PMID:Large bowel disorders. II. Psychopathology and alexithymia. 105 91

Stressful life events preceding disease onset were investigated in a consecutive series of 60 patients with large bowel disorders (ulcerative colitis, irritable bowel syndrome and appendicitis), using Paykel's methodology. Ulcerative colitis and irritable bowel syndrome were frequently preceded by events generally regarded as undesirable and involving losses or exits from the social field, which would be specific of a depressed population, while appendicitis seemed to reflect more generic psychosocial difficulties.
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PMID:Large bowel disorders. I. Illness configuration and life events. 105 95

Changes in diet from ancient times until the present are described. Previously relatively low in energy and animal products yet high in fibre-containing foods, diets are now high in energy and animal products (particularly fat), yet contain less fibre. The changing incidences of bowel disorders and diseases are described, with assessments of the role of diet. Clearly, diet is implicated as regards predisposition to constipation, appendicitis, colorectal cancer and diverticular disease; however, a meaningful dietary role in irritable bowel syndrome, ulcerative colitis and Crohn's disease is doubtful. In South Africa the rarity of bowel diseases in rural blacks compared with whites affords valuable aetiological information about some bowel diseases. The low occurrence thereof (except inflammatory bowel disease) in Indian and coloured populations is not readily explicable. While dietary changes in whites are being widely urged in order to combat degenerative diseases, the magnitude of changes made is unlikely to reduce the occurrence of bowel diseases. The progressive westernization of the diets and lifestyles of less-privileged populations is likely to be associated with increases in the incidences of these diseases.
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PMID:Diet and bowel diseases--past history and future prospects. 299 4

By 1986 the central analysis team of this on-going multinational survey had received a total of 10,682 cases for analysis and had accepted 10,320. In all, some 26 centres in 17 countries, involving over 200 doctors, had participated in this survey. A common protocol was used for data collection; around 98% of all possible data was recorded (using precirculated definitions) and analysed via a computer-aided system in Leeds, England. The construction and format of a series of computer-aided decision-support and teaching programs has been described in an earlier (1982) report. These programs are currently available/in use in 10 countries. The present report concentrates upon an update of current material collated for the survey, some demographic trends, and special subreports (as with IBD survey) concerning acute abdominal pain in children and elderly patients, together with some preliminary data on the value of leucocyte count in patients with suspected appendicitis.
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PMID:The OMGE acute abdominal pain survey. Progress report, 1986. 304 46

Diseases affecting the female reproductive organs often raise differential-diagnostic problems in the field of gastroenterology. Diagnostic pelviscopy represents the most reliable means for the diagnostic clarification of alterations of the adnexa, appendicitis irritable colon, genital endometriosis etc. Today, 10 years after its development this technique, which usefully supplements the x-ray and ultrasonic examination, has advanced so far that immediately after the diagnostic procedure, surgical therapy follows in a high percentage of cases during the same procedure. Thus in Kiel surgical pelviscopy replaces today till 50% of the classic laparotomies (e.g. adhaesiolysis, adnexectomy, myoma-enucleation, coagulation of endometriotic spots, appendectomy, fimbrioplasty, salpingostomy etc.). As a result not only is the duration of ectopic diseases considerably shortened but also the hospitalization time and in particular the time of convalescence is also reduced to a minimum.
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PMID:[Endoscopic methods in gastroenterology and gynecology. Completion of diagnostic pelviscopy by endoscopic abdominal surgery]. 637 2

There is no clear scientific evidence for a clinically relevant chronic form of appendicitis in the absence of acute flares. Lacking typical symptoms of acute appendicitis or corresponding imaging findings, no indication is given for appendectomy from the internal medicine point of view. By contrast, chronic or recurrent right lower quadrant pain is often of functional origin and may be part of the Irritable Bowel Syndrome or the Functional Abdominal Pain Syndrome. These syndromes are linked to a higher rate of appendectomies in the medical history. The Irritable Bowel Syndrome may be diagnosed based on clinical symptoms alone. But in doubt and in considering malignancy, the indication for diagnostic imaging is given, after ultrasound particularly by colonoscopy. For positively diagnosing these functional syndromes, the typical clinical presentation, extraintestinal pain syndromes, and psychic factors should be evaluated. The visceral hypersensitivity is the predominant pathophysiologic finding and measured by rectal distention stimuli. Medical treatment comprises relaxatives of smooth muscle and low dose antidepressants as modulators of visceral perception. These are supplemented by the psychosocial management.
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PMID:[Chronic appendicitis. Recurrent abdominal pain in the right lower quadrant from the viewpoint of the internist]. 1067 96

Endometriosis of the intestinal tract may mimic a number of diseases both clinically and pathologically. The authors evaluated 44 cases of intestinal endometriosis in which endometriosis was the primary pathologic diagnosis, and evaluated them for a variety of gross and histologic changes. Cases with preneoplastic or neoplastic changes were excluded specifically because they were the subject of a previous study. The patients ranged in age from 28 to 56 years (mean age, 44 years), and presenting complaints included abdominal pain (n = 15), an abdominal mass (n = 12), obstruction (n = 8), rectal bleeding (n = 2), infertility (n = 3), diarrhea (n = 2), and increasing urinary frequency (n = 1). The clinical differential diagnoses included diverticulitis, appendicitis, Crohn's disease, tubo-ovarian abscess, irritable bowel syndrome, carcinoma, and lymphoma. Forty-two patients underwent resection of the diseased intestine and two patients underwent endoscopic biopsies. In 13 patients there were predominantly mural masses, which were multiple in two patients (mean size, 2.6 cm). In addition, 11 cases had luminal stenosis or strictures, six had mucosal polyps, four had submucosal masses that ulcerated the mucosa (sometimes simulating carcinoma), three had serosal adhesions, one had deep fissures in the mucosa, and one was associated with appendiceal intussusception. Involvement of the lamina propria or submucosa was identified in 29 cases (66%) and, of these, 19 had features of chronic injury including architectural distortion (n = 19), dense lymphoplasmacytic infiltrates (n = 7), pyloric metaplasia of the ileum (n = 1), and fissures (n = 1). Three cases had features of mucosal prolapse (7%), ischemic changes were seen in four (9%), and segmental acute colitis and ulceration were seen in four and six cases (9% and 13%) respectively. In 14 patients, endometriosis formed irregular congeries of glands involving the intestinal surface epithelium, mimicking adenomatous changes. Mural changes included marked concentric smooth muscle hyperplasia and hypertrophy, neuronal hypertrophy and hyperplasia, and fibrosis of the muscularis propria with serositis. Follow-up of 20 patients (range, 1-30 years; mean, 7.8 years) revealed that only two patients had recurrent symptoms. None of the patients developed inflammatory bowel disease. Endometriosis can involve the intestinal tract extensively, causing a variety of clinical symptoms, and can result in a spectrum of mucosal alterations. Because the endometriotic foci may be inaccessible to endoscopic biopsy or may not be sampled because of their focality, clinicians and pathologists should be aware of the potential of this condition to mimic other intestinal diseases.
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PMID:Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. 1125 18

Eosinophilic gastroenteritis is a rare gastrointestinal (GI) disorder of undetermined cause characterized by infiltration of eosinophils in the GI tract. Eosinophils accumulate in tissues and may release highly cytotoxic granular proteins, which cause severe tissue damage characteristic of eosinophilic gastroenteritis. Eotaxin may play a role in the recruitment of eosinophils into tissue in combination with chemoattractants and cytokines, including interleukin 3 and 5 and granulocyte-macrophage colony-stimulating factor. Food allergy, especially in children, can be a triggering factor, and an amino acid-based diet may be helpful. Accumulation of eosinophils in the gut is a common feature in food-induced GI disorders that can be regulated through a complex molecular network involving Th2 cells, various cytokines, and chemokines. Eosinophilic gastroenteritis has a wide spectrum of clinical presentation depending on the site of involvement. It may be confused with irritable bowel syndrome or dyspepsia and, rarely, mimics pancreatitis or appendicitis. Diagnosis is important and is usually made by a pathologist. Eosinophilic gastroenteritis is a treatable disease; patients generally respond to steroid therapy, although relapse is common. Non-enteric-coated budesonide, a locally acting corticosteroid with little risk of adrenal suppression, may be substituted, although more experience is needed. Promising new drugs for eosinophilic gastroenteritis include montelukast, a selective leukotriene receptor antagonist, and suplaplast tosilate, a selective Th2 cytokine inhibitor with inhibitory effects on allergy-induced eosinophilic infiltration and IgE production. Although it is likely a separate disease, more experience has accumulated, and an elimination or specific amino acid-based diet appears to be helpful in treatment.
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PMID:Eosinophilic gastroenteritis. 1222 38

To assist the radiologist in differentiating the colitis in children, this review proposes a systematic US approach to the disease, presents the US aspect of the normal colon and describes three distinctive US patterns reflecting the intramural extension of the histopathological changes. Each pattern corresponds to one or several diseases producing alterations in the same layer(s). Stratified thickening suggests an inflammatory mucosal process resulting from infection (as in advanced appendicitis or in infectious colitis) or to inflammation (as in IBD). Nonstratified thickening with loss of the haustral folds reflects a marked submucosal infiltrate. Color Doppler is required to distinguish between an inflammatory disease (as advanced CD or neutropenic colitis) and an ischemic colitis (HUS in children). Nonstratified thickening with preservation of the length of the haustral folds is the sign of an intraluminal deposit due to PMC. Correlating the sonographic pattern and the anatomic distribution of the disease with the clinical and laboratory findings often permits to propose a specific diagnosis.
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PMID:Sonographic diagnosis of colitis in children. 1523 10


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