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

Symptoms of functional gastrointestinal disorder were sought by a questionnaire administered to 301 apparently healthy subjects in young, middle-aged, and elderly categories. Abdominal pain, a feeling of incomplete evaculation after defecation, urgency, scybala, runny stools, straining at stool, borborygmi, distension, heartburn, and laxative use were all very common. The typical symptom pattern of the spastic irritable bowel syndrome (IBS) occurred in 13.6% of subjects. Seven percent suffered noncolonic pain that was commonly associated with heartburn. A further 3.7% had painless diarrhea without the features of the spastic IBS. Six percent suffered painless constipation. Constipation seemed to increase with age. Thus four clinically distinct functional bowel syndromes existed in almost one-third of the subjects studied. Most of these had not consulted a doctor. Hospital-based studies of the IBS derive from a selected minority of patients and may not be applicable to all sufferers.
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PMID:Functional bowel disorders in apparently healthy people. 739 31

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with no known pathophysiological etiology. Many individuals with IBS, however, report higher than normal levels of stress and exhibit abnormal personality characteristics. In this article, the author reviews the psychophysiological factors associated with IBS and discusses gastrointestinal neuroendocrinology, the effects of stress on gastrointestinal motility, and the nursing implications related to this syndrome.
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PMID:Psychophysiological factors associated with irritable bowel syndrome. 798 Dec 60

Irritable bowel is a functional gastrointestinal disorder with chronic or relapsing symptoms of abdominal pain and impaired frequency and consistency of the faeces caused by obscure structural or biochemical deviations. The frequency of the condition in civilized countries is estimated to amount to 15-20% of the population and it accounts for 25-50% of all patients in gastroenterological ambulatory departments. From the clinical aspect the type with dominant diarrhoea, typically in the morning and very compelling, and the type with pain and constipation are known but even combinations of the two types are encountered. A psychosomatic disorder of the motility of the large bowel and its tonus is involved associated with enhanced pain perception. Despite great efforts to find aetiopathogenetic factors, knowledge still is at the level of obscure theories. The diagnosis is still established per exclusion after all organic causes are ruled out, i.e. we always have to differentiate between an irritable bowel from an irritated one. In therapy the patient's confidence in his doctor is most important and it is essential to gain the patient's active cooperation. In case of diarrhoea a low-residue diet is used, calcium carbonate, codeine, loperamide, conversely in constipation adequate dietary fibre, intake metoclopramide or cisapride. Pain is relieved by spasmolytics or Ca channel blockers in the smooth musculature of the large bowel. The associated dysbiosis is transformed into eubiosis by Lactobacillus or other bacterial products.
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PMID:[Irritable bowel syndrome]. 818 87

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

The cognitive model of depression assigns a central role to negatively biased information processing in the pathogenesis of the emotional disorder. The relationship between depression and irritable bowel syndrome (IBS) was explored from a cognitive perspective. A word recognition memory task was constructed: subjects had to memorize and subsequently recognise a set of emotionally loaded stimulus words with either positive, neutral, or negative connotations. Four age matched groups participated--30 IBS patients, 28 depressed patients, 28 patients with organic gastrointestinal disease, and 30 healthy volunteers. The depressed patients, as would be expected, showed a significant bias in favour of emotionally negative words (p < 0.05): the IBS patients showed the same negative bias. In addition the IBS patients made significantly more false-positive type errors in recognising emotionally negative words than either the depressed patients (p < 0.05) or the healthy volunteers (p < 0.01). This suggests that the IBS patients have a peculiar confirmatory bias for negative material. This may have clinical relevance in terms of the IBS patients' evaluation of their own abdominal sensory experience.
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PMID:Selective affective biasing in recognition memory in the irritable bowel syndrome. 830 88

We compared 71 patients with irritable bowel syndrome (IBS) and 40 patients with inflammatory bowel disease (IBD) using structured interviews for psychiatric, gastrointestinal and sexual/physical victimization histories, as well as self-reported measures of personality, functional disability and dissociation. IBS patients had significantly higher lifetime prevalence rates of major depression, current panic disorder, and childhood sexual abuse. Despite the absence of organic pathology, IBS patients had significantly higher numbers of medically unexplained physical symptoms and disability ratings equal to, or greater than, those of patients with severe organic gastrointestinal disease.
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PMID:Psychiatric diagnoses, sexual and physical victimization, and disability in patients with irritable bowel syndrome or inflammatory bowel disease. 863 55

Pressure pain over the abdominal aorta is a clinical sign of undetermined significance. Ultrasonographic criteria were used to define and further evaluate this variety of epigastric tenderness. The incidence of aortic pressure pain, aortic characteristics, and gastrointestinal symptoms were scored in 250 consecutive patients. The incidence was approximately 7%. All the patients with aortic pressure pain had gastrointestinal symptoms, with a significantly higher mean symptom score. The occurrence of pressure pain was independent of any of the examined aortic characteristics, age, or body mass index. We further compared the incidence of aortic pressure pain between 25 patients with irritable bowel syndrome and 25 patients without apparent functional gastrointestinal disease. It was present in approximately 50% of the patients with irritable bowel syndrome. We found pressure pain over the abdominal aorta to be associated with significant gastrointestinal discomfort. A causal relationship is possible but not proven. Aortic pressure pain can be provoked in a significant subgroup of patients with the irritable bowel syndrome.
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PMID:Aortic pressure pain: clinical significance. Any relationship to the irritable bowel syndrome? 874 48

Gastrointestinal disorders are common in the general population, with annual prevalence figures ranging from 20% for irritable bowel syndrome to over 40% for dyspepsia. Less than one-third of patients consult general practitioners for these problems, and anxiety about serious disease and cancer are as important in the decision to consult as symptom severity. Gastrointestinal disorders have significant socioeconomic effects in the community, and account for 10% of the work of general practitioners in the UK. The health economics implications of management in primary care relate principally to the costs of investigation and therapy, notably antisecretory drugs, endoscopy, radiology and specialist referral. Although guidelines based on evidence and agreed between primary and secondary care physicians offer an attractive approach to rationalizing the use of resources, there is at present little health service research evidence on which to base important decisions. For example, in dyspepsia, the role of Helicobacter pylori identification and eradication in an overall management strategy in primary care has yet to be defined. An exploration of the clinical economics of gastrointestinal disorders in general practice raises a number of research questions, which will require the attention of both generalists and specialists.
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PMID:Clinical economics review: gastrointestinal disease in primary care. 879 45

Although prior theories about psychiatric disorders causing inflammatory bowel disease (IBD) have largely been discredited, these same disorders have at times been associated with functional gastrointestinal symptoms such as those found in irritable bowel syndrome. Since functional gastrointestinal symptoms can also occur in patients with organic pathology, we hypothesized that a current psychiatric disorder might amplify or produce additional gastrointestinal symptoms in patients with organic gastrointestinal diseases such as IBD, leading to additive functional disability and decreased quality of life. This pilot study evaluated a sequential sample of 40 IBD patients using the NIMH Diagnostic Interview Schedule, structured interviews for functional gastrointestinal symptoms, and prior episodes of emotional, physical, and sexual abuse as well as self-report measures of personality and disability. We compared IBD patients with and without a current psychiatric disorder while controlling for disease severity. Eight patients with major depression were treated with antidepressants. Patients with a current psychiatric disorder had significantly higher 1) mean number of lifetime psychiatric diagnoses, 2) prevalence rates of prior sexual and physical victimization, and, 3) mean numbers of both gastrointestinal and other medically unexplained symptoms despite no differences in severity of IBD. Significant and trend level differences were apparent on several measures of functional disability. A regression analysis showed that number of psychiatric diagnoses, number of functional gastrointestinal symptoms, and dissociation scale scores significantly discriminated the groups. Treatment of current major depression decreased functional disability despite no objective changes in gastrointestinal disease severity. It was concluded that the presence of a current psychiatric disorder appears to alter the perception of disease severity in patients with IBD. Nonrecognition of the psychiatric disorder may lead to unnecessary and aggressive interventions for IBD patients such as medication changes, invasive testing, or surgery. The presence of a current psychiatric illness also appears to be associated with increased functional disability. Psychiatric evaluation and treatment, therefore, have an important role in the ongoing management of IBD patients with distressing gastrointestinal symptoms not directly attributable to their IBD.
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PMID:The relationship of current psychiatric disorder to functional disability and distress in patients with inflammatory bowel disease. 883 53

The role of allergic reactions in the pathogenesis of inflammatory bowel disease and irritable bowel syndrome has been disputed. This study aimed to determine the prevalence of adverse reactions to food in patients with gastrointestinal disease. A total of 375 adult patients of a gastroenterologic outpatient clinic were examined by history, skin tests, measurements of laboratory parameters, and intestinal provocation with food allergens by colonoscopy. Some 32% complained of adverse reactions to food as a cause of their abdominal symptoms. In 14.4%, the diagnosis of intestinal food allergy could be suspected according to several criteria such as elevated total IgE, specific IgE against food antigens, eosinophilia, responsiveness to cromoglycate, and clinical signs of atopic disease. In 3.2%, the diagnosis could be confirmed by endoscopic allergen provocation and/or elimination diet and rechallenge. In conclusion, the data suggest that allergic reactions to food antigens may be a causative factor in a subgroup of patients with inflammatory and functional gastrointestinal disease.
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PMID:Prevalence of adverse reactions to food in patients with gastrointestinal disease. 894 39


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