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

Irritable bowel syndrome (IBS) is characterized by abdominal pain and alteration of bowel habits. Manning et al. have reported that certain symptoms distinguished IBS from organic gastrointestinal disease (OGD); these were pain relieved by defecation, looser or more frequent stools at the onset of pain, abdominal distention, mucus, and a feeling of incomplete evacuation. Another simple scoring system for discriminating IBS from OGD that incorporated historical data, physical examination findings, and basic investigations was first devised by Kruis et al. In differential diagnosis of IBS from OGD, to evaluate the reliability of Manning's criteria and Kruis scoring system when used apart or combined; we studied 347 out-patients who completed a bowel disease questionnaire which objectively measured Manning's criteria and scoring system of Kruis. The group included 165 patients with IBS and 182 patients with OGD. The Manning's criteria discriminated IBS from OGD with a sensitivity of 90% and a specificity of 87% if three or more items were regarded as positive. Also the Kruis scoring system discriminated IBS from OGD with a sensitivity of 81% and a specificity of 91%. When used together, these systems discriminated IBS from OGD with a sensitivity of 80% and a specificity of 97%. Manning's criteria and Kruis scoring system had a strong correlation when compared in IBS, but not in OGD.
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PMID:Kruis scoring system and Manning's criteria in diagnosis of irritable bowel syndrome: is it better to use combined? 908 21

Eicosanoids are produced throughout the gastrointestinal tract and are significant mediators of physiologic and pathophysiologic processes. Understanding the precise role(s) of specific eicosanoid metabolites remains a significant challenge, but has led to the development of new pharmacologic strategies for treating NSAID-induced gastroenteropathy and IBD. Given the complex array of arachidonic acid metabolites, the development of more specific and potent inhibitors of these cyclooxygenase isoforms is important for future studies and possible therapeutic applications. Mice have been prepared that lack expression of COX-1 or COX-2. Once these animals have been carefully evaluated, understanding of the role of various pathways of eicosanoid formation in gastrointestinal function, development, and epithelial growth regulation might be improved. Considerable progress has been made in the understanding of arachidonic acid metabolism and in eicosanoid receptor biology. The identification and characterization of an inducible cyclooxygenase isoform has led to important studies evaluating the role of this enzyme in inflammation, neoplasia, and NSAID-induced gastrointestinal injury. The demonstration that COX-2 overexpression in intestinal epithelial cells leads to specific phenotypic changes, such as increased adhesion and inhibition of apoptosis, indicates that this enzyme may alter the tumorigenic potential of epithelial cells and offers hope for the future development of improved chemopreventive agents.
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PMID:Introduction to eicosanoids and the gastroenteric tract. 922 72

IBS is one of the most common of the gastrointestinal disease, but it can be a diagnostic challenge because of the many symptoms that overlap with other such diseases. Most common among the symptoms are abdominal pain, a feeling of intestinal distention or bloating, and either diarrhea or constipation. Patients may be found to have an exacerbation of symptoms with stress, and they may have an increased sensitivity to bowel distention. History and physical examination findings often can be relied on to make the diagnosis, avoiding overuse of laboratory testing. Treatment consists of patient education and support, lifestyle and dietary changes, and use of several pharmacologic agents for symptom relief. Antidepressants are being investigated as a possible additional form of treatment.
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PMID:Irritable bowel syndrome. Streamlining the diagnosis. 930 28

Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder, defined as a variable combination of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities. It is attributable to the intestine with symptoms of abdominal pain, altered bowel habits and bloating. The diagnosis is primarily based on typical symptoms and prudent use of investigations to exclude organic disorders. The initial positive diagnosis is accurate and on a longterm follow-up its revision rarely required. A change in its clinical manifestation may imply the superimposition of another disorder. Treatment primarily rely on the confidence in the diagnosis and a strong physician-patient relationship. High fiber diets and bulking agents may be effective in alleviating symptoms. Though antispasmodic, antidiarrheal and psychotropic drugs are repeatedly used in patients with moderate to severe symptoms their effects remain uncertain. Psychotherapy, hypnosis and biofeedback may relief symptoms and may be considered for motivated patients with moderate to severe symptoms.
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PMID:[Irritable colon]. 945 69

Gastrointestinal disorders are among the most common disorders for which women seek medical attention. Most gastrointestinal diseases in women are not inherently different from those that occur in men. There are several disorders, however, that occur more frequently or manifest themselves differently in women. This article reviews common gastrointestinal disorders affecting women. The pathophysiology, clinical manifestations, management, and gender-specific issues of gastroesophageal reflux disease, peptic ulcer disease, irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD) are discussed.
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PMID:Gastrointestinal diseases in women. 945 50

An association between panic disorder and functional gastrointestinal disease has emerged since the introduction of reliable diagnostic criteria, first for psychiatric disorders and more recently for functional gastrointestinal disorders. At the same time, a more rigorous review of methodology of older reports linking structural gastrointestinal diseases such as peptic ulcer and inflammatory bowel disease to psychiatric illness has cast doubt on the validity of their association. In this review original articles reporting an association between panic disorder and globus, functional chest pain of presumed esophageal origin, functional dyspepsia, and irritable bowel syndrome are critically reviewed and it is concluded that panic disorder is overrepresented in noncardiac chest pain and irritable bowel syndrome. Original reports of the prevalence of panic disorder in structural gastrointestinal disease are reviewed and it is concluded that they do not support an association with panic. Hypotheses explaining the statistical link of panic disorder and functional gastrointestinal disease are discussed.
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PMID:Panic disorder associated with gastrointestinal disease: review and hypotheses. 948 67

Oxidative stress appears to play a role in the pathogenesis of a number of gastrointestinal disease states, including pancreatitis; gastric and duodenal ulcer disease; IBD; gastric, esophageal, and colon cancers; and hepatic injury secondary to alcohol, metal storage disorders, hepatitis, and ischemia/reperfusion injury. The nutritional antioxidants are attractive potential therapeutic and chemopreventive agents because they are inexpensive and have a relatively low toxicity profile. A word of caution should be noted: Some antioxidants, such as vitamin C, can be prooxidant under certain conditions, and systemically altering the redox state may have untoward effects on the inflammatory response in certain disease states. Thus, at the current time, antioxidant therapy should be restricted to randomized, controlled clinical trials, in which treatment effects can be closely monitored, and therapeutic efficacy can be determined with scientific accuracy.
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PMID:Nutrient antioxidants in gastrointestinal diseases. 965 24

Constipation, diarrhea, and irritable bowel syndrome are commonly encountered in the primary care practice. Most episodes of constipation and diarrhea are benign and self-limited. Patients with chronic constipation should undergo a screening evaluation to exclude organic disease, after which most can be managed successfully with dietary modification and fiber supplementation. The cause of chronic diarrhea usually can be discerned clinically, with irritable bowel syndrome, inflammatory bowel disease, and lactose intolerance being diagnosed most frequently. Irritable bowel syndrome is a functional gastrointestinal disorder characterized by abdominal pain and disordered defecation, which is successfully managed with a strong physician-patient relationship and periodic pharmacologic intervention.
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PMID:Constipation, diarrhea, and irritable bowel syndrome. 992 98

Generic questionnaire such as SF36 and functional gastrointestinal disorder (FGD)-specific questionnaires (i.e. IBSQOL or FGDQL) are now available for the evaluation of new drugs for the treatment of irritable bowel syndrome or functional dyspepsia. For regulatory issues it is necessary to describe in detail the scale of the QOL questionnaire, its psychometric properties and reason for its choice, as well as validation studies, populations concerned, means of administration and methods for analysis. Preselection of few dimensions of the QOL questionnaire, if necessary, has to be explained. QOL results have to be compared with symptom scores. Trials have to be double-blind placebo- controlled studies with a sample size calculation taking account of the high placebo-response. No official guidelines are available in FGD and more validation studies are needed to help in the choice of the specific QOL questionnaire, in the metrologic analysis and in the interpretation of QOL changes during FGD treatment. Then QOL questionnaires could become a primary end point in clinical trials if efficient drugs for FGD treatment are developed.
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PMID:The role of quality of life in functional gastrointestinal disorders: regulatory issues. 1002 80

IBS is a functional gastrointestinal disorder in which the patient has chronic or recurrent gastrointestinal symptoms (diarrhea, constipation or abdominal pain and bloating) that are unexplained by any structural or biochemical abnormalities. Research has demonstrated no causal relationship between psychosocial factors and the development of IBS. IBS cannot be diagnosed through radiologic, endoscopic or laboratory studies because the symptoms are not explained by structural or chemical abnormalities. One of the most important components of treatment is the development of an effective provider patient relationship. Behavioral treatments may be helpful in select patients. Dietary management can also reduce symptoms if the patient can identify foods that trigger them.
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PMID:Managing irritable bowel syndrome. 1003 Jan 69


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