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

A wide range of secretory (salivation, gastric acid and bile secretion) and motor functions (rumination, esophageal and anal sphincter contraction, gastric and colonic motility) have been successfully modified using operant conditioning procedures or biofeedback training. The clinical syndromes to which these studies have been addressed include rumination, reflux esophagitis, hypersecretion of acid associated with peptic ulcer, irritable bowel syndrome, and fecal incontinence. The available evidence strongly suggests that biofeedback is effective and is the treatment of choice for some types of fecal incontinence, and the evidence supports the effectiveness of operant conditioning for the treatment of intractable rumination in infants or retarded individuals. There is suggestive evidence that a nonspecific biofeedback technique, EMG biofeedback for skeletal muscle relaxation, may contribute to the healing of peptic ulcers, but the data are so far inconclusive. Biofeedback approaches to the treatment of other clinical syndromes are at the investigational stage only, and no predictions can be made regarding their efficacy.
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PMID:Biofeedback in the treatment of gastrointestinal disorders. 75 83

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

The prevalence of chronic gastrointestinal symptoms and the irritable bowel syndrome (IBS) in the elderly, and their impact on health, is largely unknown. The prevalence of symptoms compatible with IBS was estimated in a representative sample of elderly community residents, and the impact of these symptoms was determined on presentation for health care. An age- and sex-stratified random sample of noninstitutionalized Olmsted County, Minnesota, residents aged 65-93 years were mailed a valid questionnaire; 77% responded (n = 328). The age- and sex-adjusted prevalence (per 100 persons) of frequent abdominal pain was 24.3 [95% confidence interval (CI), 19.3-29.2]. Chronic constipation and chronic diarrhea had prevalences of 24.1 (95% CI, 19.1-29.0) and 14.2 (95% CI, 10.1-18.2), respectively. Fecal incontinence more than once a week was reported in 3.7 per 100 (95% CI, 1.6-5.9). The prevalence of symptoms compatible with IBS (greater than or equal to 3 Manning criteria with frequent abdominal pain) was 10.9 per 100 (95% CI, 7.2-14.6). Among the subjects sampled who had abdominal pain, chronic constipation, and/or chronic diarrhea (n = 152), only 23% had seen a physician for pain or disturbed defecation in the prior year, and this behavior was poorly explained by the symptoms. It is concluded that complaints consistent with functional gastrointestinal disorders are common in the elderly, but symptoms are a poor predictor of presentation for medical care.
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PMID:Prevalence of gastrointestinal symptoms in the elderly: a population-based study. 153 25

One hundred and nine distance runners participated in a questionnaire survey of bowel function related to running. Thirteen (12%) had had fecal incontinence while running. Sixty-eight (62%) had stopped to have a bowel movement while training. Forty-seven (43%) had "nervous" diarrhea before competition and 13 (12%) had stopped during competition for a bowel movement. Fifty-one (47%) had experienced diarrhea after racing or hard runs and 17 (16%) had seen blood in their stool in the same situations. Runners who had nervous diarrhea before competition were more likely to have symptoms of milk intolerance and irregular bowel function when not exercising, and runners who had symptoms of the irritable bowel syndrome often had to stop for a bowel movement during training. Runners with diarrhea after racing or hard runs frequently experienced severe abdominal cramps, nausea and vomiting, and occasionally, rectal bleeding at the same time. Any form of "runners' diarrhea" was unrelated to age, previous intestinal infection or food poisoning, food allergies, or dietary fiber.
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PMID:Runners' diarrhea. Different patterns and associated factors. 155 21

Almost all functions of the gastrointestinal tract have been shown to be under central nervous control and to respond to environmental factors such as stress. It is, therefore, not surprising that disturbed gastrointestinal functions may be altered through psychological therapy approaches. For motor dysfunctions of the esophagus and functional dyspepsia, there is a lack of behavioral therapy studies, while controlled studies utilizing relaxation techniques, stress management strategies and anxiety treatment have been shown to improve symptoms and prevent recurrence in reflux esophagitis and peptic ulcer disease despite the wide use of effective medication. Most studies have treated patients with symptoms of the irritable bowel syndrome: This approach usually combined conventional medical treatment with psychotherapy. Psychological management usually consisted of relaxation training, stress management and patient information. Additional behavioral modification, e.g. of eating and defecation behavior, is superior to pharmacological and dietary management alone. The role of biofeedback therapy in these patients remains to be clarified in the future. It is, however, therapy of choice in some patients with constipation due to spastic pelvic floor syndrome and in fecal incontinence, if the external anal sphincter is insufficient to maintain continence. There ist a systematic lack of treatment opportunities as compared to the number of patients seeking health care for functional bowel disorders.
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PMID:[Behavior therapy in gastrointestinal functional disorders]. 155 23

Biofeedback has had a greater impact on gastroenterology than on any other medical subspecialty. Biofeedback is the treatment of choice for many of the most common types of fecal incontinence, and preliminary studies suggest that it is likely to become a preferred method for treating patients with constipation related to inability to relax the striated pelvic floor muscles during defecation. This dysfunction may account for up to 50% of patients with chronic constipation. Thermal biofeedback forms part of a multicomponent behavioral treatment for irritable bowel syndrome that is reported to be effective, and other promising applications of biofeedback for gastrointestinal disorders are under investigation.
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PMID:Biofeedback treatment of gastrointestinal disorders. 156 25

Although biofeedback has been applied to many gastrointestinal disorders, including reflux esophagitis, peptic ulcer disease, and irritable bowel syndrome, the limited number of reports precludes conclusions concerning its safety or efficacy in these disorders. Most studies have used biofeedback in the treatment of fecal incontinence. Uncontrolled trials have shown this procedure can reduce substantially the frequency of incontinence in 70% to 83% of patients at up to 1 to 2 years of follow-up. Biofeedback has been most successful in patients with a surgical cause for fecal incontinence, but recent data suggest the procedure may also be useful in diabetics. The few number of sessions required, its apparent safety, physiological appeal, and apparent success suggest biofeedback is a promising therapy for this disorder, but it remains inadequately tested.
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PMID:Biofeedback for gastrointestinal disorders: a review of the literature. 389 57

To assess the value of history in evaluating abdominal pain, 45 outpatients (25 women and 20 men) aged 16-76 completed a questionnaire. The affirmative replies of the patients with organic disease were compared with those of patients with irritable bowel syndrome (IBS) by the chi 2 test. 17 patients had organic diseases while 28 had IBS. The features indicating an organic lesion (p less than 0.0005) were age over 50, history of short duration, bloody stools, bowel incontinence and urgency, pain at night, pain lasting minutes, colicly pain, and onset of pain 1-2 h after meals. Typical features of IBS (p less than 0.0005) were age below 50, frequent bowel movements of normal consistency, increased pain with emotional stress, a rigid personality and an exceptionally well-groomed appearance. From these findings the following conclusions are drawn: 1. Patients with organic disease always present with two symptoms indicative of an organic origin and with one highly significant symptom of IBS at most. 2. IBS is characterized by a broad range of various highly significant symptoms simultaneously. There is a larger number of significant symptoms against IBS (n = 10) than for it (n = 4). History serves rather to rule out IBS than to prove it.
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PMID:[Irritable colon--yes or no? Does the anamnesis help in the decision?]. 707 92

Twenty-five patients (ages 10 to 79 years; average, 48 years) with fecal incontinence underwent anorectal manometry with a three-balloon system connected to a physiograph. On a basis of manometric criteria showing the presence of rectal sensation, 17 patients underwent biofeedback conditioning. Underlying disorders included irritable bowel syndrome, diabetes mellitus, anal sphincter damage from surgery or disease, and neurogenic anal dysfunction. Twelve of the 17 patients who received biofeedback training had significant improvement in bowel soiling. Follow-up periods ranged from 2 to 38 months (mean, 15 months). There were no significant differences in threshold of rectal sensation, relaxation of the internal anal sphincter, and pre- and postbiofeedback thresholds of external anal sphincter contraction between responders and nonresponders. Minimal criteria for successful treatment appeared to be ability to sense rectal distension, good motivation, and absence of significant psychological dysfunction. Biofeedback conditioning is a simple and effective technique in the treatment of selected patients with fecal incontinence.
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PMID:Biofeedback therapy for fecal incontinence. 725 62

Quantitative studies of the afferent pathways from hollow viscera have been limited by the lack of an easily controlled, reproducible visceral stimulus. We adapted a slow distention device to allow for rapid distention to study the afferent pathways from the rectum. The device produced a pressure increase of 10 mm Hg in 42 msec and of 20 mm Hg in 60 msec. We recorded cerebral evoked potentials (EPs) after rectal balloon distention in 17 healthy subjects. Several averages of 25 to 50 rectal distentions at 0.17-Hz frequency were recorded. The responses consisted of multiple peaks within 200 msec after stimulation. The mean latency of the initial positive peak was 44 msec, suggesting that a myelinated pathway was stimulated with mechanical rectal distention. Our device produced reliable and repeatable EPs that were independent of balloon characteristics or rectal pressures. EP recording after rectal stimulation may become a useful technique for the physiologic investigation of disorders such as fecal incontinence, constipation, irritable bowel syndrome, and chronic intestinal pseudo-obstruction.
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PMID:Study of the afferent pathways from the rectum with a new distention control device. 764 50


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