Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

Gonadotropin-releasing hormone agonists are a relatively new class of drugs, which, when chronically administered, result in marked reductions in blood levels of testosterone and estrogen. These drugs include leuprolide acetate (Lupron); the first GnRH agonist to be approved in the United States, nafarelin acetate (Synarel); and goserelin acetate (Zoladex). Approved indications for these drugs, depending on the specific agent, include advanced prostate cancer, endometriosis, and precocious puberty. These and other investigational GnRH agonists are also being evaluated in many other diseases, including uterine fibroids, polycystic ovarian disease, breast cancer, fibrocystic breast disease, benign prostatic hypertrophy, and irritable bowel syndrome. Because of their therapeutic potential in many endocrinologic disorders, the GnRH agonists represent one of the most important advances in hormonal therapy in the past few decades. Thus, it appears likely that in the 1990s a greater number of patients will be receiving these agents. This article summarizes the application of GnRH agonist drugs in clinical practice, their side effects, and important information for patient use.
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PMID:Uses of GnRH agonists. 799 7

This systematic review presents both the physiological and symptom-based studies which have explored gastrointestinal variation across the menstrual cycle. Understanding this variation may be helpful in identifying the origin of pelvic pain, particularly as the symptoms associated with causes, such as endometriosis, also vary across the cycle. One-third of otherwise asymptomatic women may experience gastrointestinal symptoms at the time of menstruation, and almost 50% of women with irritable bowel syndrome report a perimenstrual increase in symptoms.
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PMID:Do gastrointestinal symptoms vary with the menstrual cycle? 1060 32

Background: Pelvic pain is a common complaint encountered in pediatric and adolescent gynecology. Etiologies are similar to those found in adult women, but the incidence and presentations vary with age. The purpose of this study is to review musculoskeletal (MS) pelvic pain in a pediatric and adolescent gynecology setting. Methods: A retrospective review of charts of 63 patients presenting to a private practice pediatric and adolescent gynecologist between 7/1/97 and 6/30/99 was performed. To be included in analysis, patients had a diagnosis of pelvic pain which could not be explained by standard gynecologic history, physical exam, laboratory, and ultrasound evaluation or did not respond to standard treatments for known endometriosis. A history of laparoscopy was not required, but when it was performed it could be used to exclude patients from analysis if a reason for the pain was identified. All patients who fulfilled these criteria had been screened for MS etiologies of pelvic pain using the leg lift (Carnett test) and/or head lift. Results: Sixty-three patients aged 9-23 (mean 15.21, SD 2.71) fulfilled the criteria for evaluation. Diagnoses included irritable bowel syndrome (N = 4, 6.35%), interstitial cystitis (N = 1, 1.56%), unexplained (N = 7, 11.11%), endometriosis not responding to ablation & GnRH agonists (N = 2, 3.17%), endometriosis not responding to ablation & GnRH agonists & MS pain (N = 7, 11.11%), and MS pain (N = 42, 66.67%). Mean age of those with MS pain was 15. 27 (SD 2.94), and mean duration of symptoms prior to diagnosis was 17.97 mo (SD 20.90, range 1 week-7 yr). On physical exam, trigger points were identified as causative factors in 5 (10.20%), and 40 (81.63%) had a + Carnett test. Of those with a final diagnosis of MS pain, only 5/31 (16.31%) responded to nonsteroidal anti-inflammatory agents, 6/30 (20.0%) responded to OCPs, and 3/11 (27.27%) responded to DMPA-2/3 also had a diagnosis of endometriosis. Nineteen (38.78%) had been surgically explored for the pain in the past, 1 by laparotomy & 18 by laparoscopy. Only 3 (15.79%) had symptomatic improvement after surgery. Physical therapy resulted in resolution of symptoms in 20/21 (95.24%) who completed treatment. Four of 5 (80%) who underwent trigger point injections responded.Conclusions: MS etiologies of pelvic pain are common in the adolescent age group and respond well to physical therapy. Physical therapy might be employed as an early intervention prior to surgery in adolescent girls with unexplained pelvic pain.
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PMID:Musculoskeletal pelvic pain in a pediatric and adolescent gynecology practice 1086 76

Chronic pelvic pain (CPP) is a common and debilitating condition, and yet remarkably little is known about what causes the pain. In this chapter we present a model of CPP which emphasizes the multifactorial nature of the problem. A range of physical causes are discussed, including endometriosis, pelvic inflammatory disease (PID), adhesions, irritable bowel syndrome, interstitial cystitis, musculo-skeletal factors and nerve-related pain. The role of the nervous system in the genesis and moderation of pain is explored. The importance of psychological factors is discussed, both as a primary cause of pain and as a factor which affects the pain experience. As with other chronic syndromes, the biopsychosocial model offers a way of integrating physical causes of pain with psychological and social factors.
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PMID:Causes of chronic pelvic pain. 1096 33

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

Some chronic diseases have a favourable course and are cured spontaneously. Allergic diseases such as eczema, hay fever and asthma have a good outcome in more than 75% of cases within 7 to 25 years, depending on the kind of allergy. Migraines have also a good evolution in children and after menopause. Many symptoms due to menstruation such as dysmenorrhea, premenstrual syndrome or anemia, disappear after menopause as well as diseases due to estrogens such as uterine leiomyoma, endometriosis and prolactinoma. The risk of epilepsy relapse after a first seizure is about 40% after 2 years. The risk is lower in children. Attention deficit disorder affects 3 to 5% of children but is present in only 30% of them in adult age. The prevalence of depression decreases in women between 30 and 60 years of age. Functional somatic syndromes such as fibromyalgia, irritable bowel syndrome or dyspepsia decrease in 2/3 of cases within 5 to 10 years if there is no history of anxio-depressive symptoms. However, prognosis is reserved when initial symptoms are severe or if they are connected to sexual abuse, domestic violence or depression. Other diseases have a spontaneous favourable course such as myopia, idiopathic infertility, polycystic ovary disease or ventricular arrhythmia. The knowledge of a good prognosis enables to avoid unnecessary treatments and to reassure many patients.
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PMID:[The benefits of aging. I. Patience and cure: spontaneous beneficial course of certain diseases]. 1172 11

The Authors report a case of sigmoid obstruction due to endometriosis and review the literature about. Unusual localisation and difficult preoperative differential diagnosis with IBD and bowel carcinoma are stressed. A 45-years old woman with previous history of oophorectomy was admitted at the hospital with symptomatic bowel obstruction. A barium enema showed a sigmoid stenosis thought to a carcinoma of bowel. A laparoscopic approach confirmed the diagnosis and a laparotomy was performed with a subsequent anterior resection (end-to-end anastomosis with stapler) plus myomectomy. The Authors do believed, during surgery, to be treating a carcinoma which disappeared with opening the specimen. The mucosa were intact and muscular layers so think to form a strong ring to be able to invaginate the upper colon for 3-4 cm. A stromal tumor was supposed and the definite diagnosis of endometriosis was very surprisingly. Intestinal resection to be necessary, with associated salpingo-oophorectomy and hysterectomy in older patients and treatment with oral contraceptive in younger female. Laparoscopy may be helpful in the diagnosis showing pelvic endometriosis with bowel wall involvement. Laparoscopic treatment in our opinion must be confirmed to particular situation and to well experience of surgeons.
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PMID:[Sigmoid occlusion due to endometriosis. A case report]. 1181 43

Chronic pelvic pain is a common and significant disorder of women. It is estimated to have a prevalence of 3.8% in women. Often the etiology of chronic pelvic pain is not clear, as there are many disorders of the reproductive tract, gastrointestinal system, urological organs, musculoskeletal system, and psychoneurological system that may be associated with chronic pelvic pain. The history and physical examination are crucial in evaluating a woman with chronic pelvic pain and must address all of the possible systems potentially involved in chronic pelvic pain, not just the reproductive system. Laboratory and imaging studies should be selectively utilized, as should laparoscopy. Conscious laparoscopic pain mapping has been proposed as a way to improve information derived from laparoscopic evaluations. Treatment of chronic pelvic pain may consist of two approaches. One is to treat chronic pain itself as a diagnosis, and the other is to treat diseases or disorders that might be a cause of or a contributor to chronic pelvic pain. These two approaches are not mutually exclusive, and in many patients effective therapy is best achieved by using both approaches. Treatment of chronic pain as well as treatment of four of the more common disorders associated with chronic pelvic pain (endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis) are discussed in this review.
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PMID:Chronic pelvic pain. 1296 62

Both irritable bowel syndrome and endometriosis are common conditions, although symptomatic gastrointestinal endometriosis is extremely rare. We report the case of a patient initially thought to have irritable bowel syndrome, in whom the diagnosis of endometriosis only became clear following a laparotomy for small bowel obstruction. This case highlights the need to question the diagnosis in patients with irritable bowel syndrome when there is any uncertainty, and also to appreciate that other pathology can arise, even when the diagnosis is secure.
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PMID:Irritable bowel syndrome or endometriosis, or both? 1450 24


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