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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 enteric nervous system (ENS) can be thought of as the third component of the autonomic nervous system. It is a vast network of neurons widely dispersed throughout the gut. The ENS is a dominant regulator of gut function through the action of peptide and non-peptide neurotransmitters. The most intensively studied roles of the ENS have been the regulation of secretory processes, such as gastric acid secretion, and motility. It is clear, however, that the ENS plays a broader role in the regulation of other gut functions, including mucosal defense, the gut immune response, and sphincter function. Alterations in the regulation of gut function by the ENS are likely or suspected in a number of conditions, including achalasia, Hirschsprung's disease, inflammatory bowel disease, Chagas' disease, chronic intestinal pseudoobstruction, biliary dyskinesia, tachygastria, and irritable bowel syndrome. Improved knowledge of the pathophysiology of these troublesome conditions makes effective therapy more likely in the future.
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PMID:Neuroendocrine design of the gut. 167 22

The clinicofunctional and morphological status of the stomach, biliferous system, pancreas, large and small intestine was studied in 83 patients with Sjogren's syndrome and disease (SS and SD). Chronic gastritis with secretory insufficiency was shown to develop in SD. Morphological changes of the gastric mucosa were represented by chronic gastritis with glandular involvement and chronic atrophic gastritis of immune genesis. Pathology of the extrahepatic system of bilification was detected in 87% of patients. The most common pathologies diagnosed in these patients were chronic cholecystitis (51%) and biliary dyskinesia (25%). Changes of the chemical composition of the bile (arise of its lythogenic properties) were observed. Various disorders of pancreatic function were detected in 85% of SS and SD patients. X-ray and endoscopic investigations revealed duodenal, intestinal and colon hypokinesia, less frequently signs of enteritis and colitis in one-third of the patients. The irritable colon syndrome was found in 40%. On the whole, involvement of different parts of the intestine was observed in 92%. Morphological changes in the duodenal and sigmoid colon mucosa were typical of chronic diffuse duodenitis and sigmoiditis in a subacute SD course, and chronic atrophic duodenitis and sigmoiditis in a chronic SD and SS course.
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PMID:[Lesions of the digestive organs in Sjogren's disease]. 339 95

Biliary pain resulting from motility disorders is common and may be overlooked due to the difficulty of diagnosing the presence of these disorders. A sound, logical approach to the evaluation and treatment of these specific groups of disorders is essential. In patients who have a gallbladder, we initially exclude the presence of gallstones by use of transcutaneous ultrasonography. If a patient's symptoms are atypical, we initiate therapy (eg, antispasmodics) for irritable bowel syndrome. Subsequently, we perform a quantitative cholescintigraphy with a low-dose infusion of cholecystokinin in patients with typical symptoms and in those with persistent atypical symptoms. Those patients who have abnormally low gallbladder ejection fractions are subsequently referred for laparoscopic cholecystectomy. In postcholecystectomy patients, a standard approach should include obtaining serum liver associated laboratory chemistries, amylase and lipase levels, and a transcutaneous ultrasound to measure bile duct size. Endoscopic retrograde cholangiopancreatography (ERCP) is done to measure bile duct size, assess biliary duct emptying, and exclude other etiologies for pain. In patients with more than two abnormal findings on these tests (type I sphincter of Oddi dyskinesia), we recommend performing an empiric endoscopic biliary sphincterotomy. In patients with no objective abnormalities (type III sphincter of Oddi dyskinesia), it is appropriate to begin medical therapy with antispasmodics and calcium-channel antagonists. In individuals who have one or two abnormalities (type II sphincter of Oddi dyskinesia) we prefer endoscopic biliary sphincterotomy; however, these individuals are offered the opportunity to have endoscopic biliary manometry performed in order to establish a clear diagnosis. If patients refuse this procedure, after careful explanation of risks, alternatives, and possible benefits of the procedure, empiric endoscopic biliary sphincterotomy is performed.
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PMID:Biliary Tract Dysmotility. 1109 61

Fibromyalgia (FM) is a common and complex condition, defined as long lasting, widespread musculoskeletal pain, in the presence of tender points (TPs) at specific anatomical sites. Dysautonomic and functional symptoms, such as orthostatic hypotension, tachycardia, effort intolerance, marked fatigue, sleep disorders, cognitive disturbances, psychological distress, paresthesias, headache, genitourinary manifestations, irritable bowel syndrome and bladder dyskinesia, frequently occur. The etiopathogenesis of FM is presently unknown, but nociceptor, autonomic and neuro-endocrine system dysfunctions have been found in patients. Since specific serological or instrumental markers of the syndrome are not yet identifiable, TP search is the only useful diagnostic hallmark. The development of an effective therapy of FM has hitherto been hampered by the incomplete knowledge of its pathogenic mechanisms. In this paper, the most recent information on FM is reviewed.
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PMID:Fibromyalgia: state of the art. 1504 25

The appropriateness of further wide prevalence of diagnostics of gastroesophageal reflux disease, functional non-ulcer dyspepsia and irritable bowel syndrome is discussed. All these diseases are believed to be found in 30-50% of adults. It is very difficult to find a healthy person taking into account such an approach to the problem. As a matter of fact, gastroesophageal disease was invented by merging two different diseases: esophagitis and reflux esophagitis plus such a prevalent symptom as heartburn. All this leads to the hyperdiagnosis of this disease. The irritable bowel syndrome also includes two conditions: that of the irritable large intestine and dyskinesia of the small one. They are very different. The application of the diagnosis of functional dyspepsia leads to the practical disappearance of the diagnosis of chronic gastritis. At that symptoms of the dyskinetic form of functional dyspepsia coincide with minor symptoms of gastric carcinoma, which can lead to late diagnostics of this oncological disease. In this connection, it is necessary to narrow the limits of these diseases because their actual prevalence is much lower than that found in medical literature.
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PMID:[Modern myths of clinical gastroenterology]. 1556 Apr 7

The authors point out the therapeutic properties of sulphate-bicarbonate mineral waters. After summarizing the general mechanism of action of mineral waters, the main indications of such waters in thermal treatment are examined including: biliary sand, biliary dyskinesia, functional dyspepsia, irritable colon, chronic primitive constipation. The dysfunctions of biliary and digestive tracts are growing, mainly in the affluent world, because of the increase for stress, dietary habits, modern life style. Now they affect from 2,4% of general population to 7% of men and 20% of women, according to different studies. Mineral waters can improve symptoms and care some physiopathological underlying mechanisms. Authors stress the efficacy of sulphate-bicarbonate mineral waters in the therapy of biliary dyskinesias, namely gallbladder hypokinesia and Oddi's sphincter spasm, caused by their content in SO4 = anion and Mg++ cation and related effects on paracrine-endocrine gastrointestinal system. In addition, they report the effects of sulphate-bicarbonate mineral waters in the lithogenic bile (sand bile), because of their diluting and washing activity. Among the sulphate-bicarbonate mineral waters, the Authors outline the well-documented therapeutic activity of Acqua Santa and Fucoli of Chianciano Terme. Acqua Santa has stimulating effect on cholecystis's motility, as proved by controlled clinical trials. Finally, the therapeutic use of sulphate-bicarbonate mineral water is discussed in functional dyspepsia, chronic primitive constipation and irritable bowel syndrome.
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PMID:Sulphate-bicarbonate mineral waters in the treatment of biliary and digestive tract diseases. 2049 33

The investigations conducted in the past decade have offered better insight into the basic mechanisms of chronic constipation (CC), among other things, its association with large bowel (LB) transit and anorectal function. Intestinal dyskinesia, slow transit of the intestinal contents (inert LB), and impaired defecation due to pelvic floor dyssynergia play a leading role in the pathogenesis of primary constipation. Its treatment should be similar to that for CC. Motility regulators correcting LB dyskinesia are given to treat functional constipation and constipation-predominant irritable bowel syndrome. Enteral pro-kinetic agents are effective in treating the inert LB. The possibilities of biofeedback therapy should be used to treat dyssynergic defecation.
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PMID:[Pathogenetic treatment for chronic constipation]. 2299 81

Patients with functional gastrointestinal disorders (FGIDs) often experience distress, reduced quality of life, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework is implemented with the consideration of important factors that impact FGIDs, such as gender, age, society, and the patient's perspective. Although the majority of FGIDs, including globus, rumination syndrome, IBS, bloating, constipation, functional abdominal pain, sphincter of Oddi dyskinesia, pelvic floor dysfunction, and extra-intestinal manifestations, are more prevalent in women than men, functional chest pain, dyspepsia, vomiting, and anorectal pain do not appear to vary by gender. Studies suggest sex differences in somatic but not visceral pain perception, motility, and central processing of visceral pain; although further research is required in autonomic nervous system dysfunction, genetics and immunologic/microbiome. Gender differences in response to psychological treatments, antidepressants, fiber, probiotics, and anticholinergics have not been adequately studied. However, a greater clinical response to 5-HT3 antagonists but not 5-HT4 agonists has been reported in women compared with men.
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PMID:Age, Gender and Women's Health and the Patient. 2714 22