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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

In order to develop a simple and accurate screening test for steatorrhea, the authors compared quantitative stool fat excretion with breath excretion of 14CO2 after the ingestion of 14C-labeled trioctanoin, tripalmitin, or triolein. The study group included 24 nonobese subjects without steatorrhea but with diarrhea secondary to irritable bowel syndrome and 40 subjects with steatorrhea. The triolein breath test provided the most reliable discrimination, with 100% sensitivity and 96% specificity. The trioctanoin and tripalmitin breath tests were sensitive, but lacked specificity (69% and 58% false-positive results, respectively). Three of the 12 obese patients with irritable bowel syndrome had false-positive triolein breath results. In detecting steatorrhea, the triolein breath test was moderately superior to the measurement of serum carotene and to qualitative stool fat. Thus, the triolein breath test appears to be a sensitive, specific, noninvasive, and relatively simple screening test for the detection of steatorrhea.
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PMID:Triolein breath test: a sensitive and specific test for fat malabsorption. 75 49

Although the irritable bowel syndrome has been characterized as an abnormality in colonic motor activity occurring in response to certain stimuli, the etiology of this abnormality is unclear. The purpose of this study was to compare colonic myoelectric and motor activity in normal subjects and in patients with the irritable bowel syndrome. Myoelectric activity was recorded using a bipolar electrode clipped to the mucosa of the rectal and rectosigmoid areas. Basic electrical rhythm (BER), spike potential activity, and intraluminal pressure were recorded in both groups. Two types of BER were observed. The major component of the BER had a frequency of approximately 6 cycles per min, whereas the minor component had a frequency of approximately 3 cycles per min. Although both types of BER were recorded in the two groups, thitable bowel syndrome. The 3 cycles per min activity was present as 44.1 +/- 1.3% of the total BER in the irritable bowel syndrome, as compared with 10.0 +/- 1.6% in the normal group (P less than 0.001). Basal spike potential and motor activity were similiar in both groups. Because it had been demonstrated previously that colonic responsiveness to certain stimuli was increased during the slower frequency BER, it is suggested that the abnormalities in colonic motor response reported in the irritable bowel syndrome may be related to this difference in colonic BER.
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PMID:Colonic myoelectric activity in the irritable bowel syndrome. 76 83

Colonic diverticula result from herniation of the mucosa through weak spots in the muscular wall. Clinically manifested diverticulitis has been thought to have its pathologic basis in an abscessed diverticulum obstructed by a fecalith, but studies of resected sigmoids have failed to produce evidence to support this view. Instead, the outstanding lesion was found to be a perforation in the fundus of a diverticulum, with surrounding peridiverticular or pericolic inflammation. Another surprising finding in pathologic studies was that one out of three sigmoids resected for "diverticulitis" showed no inflammation in or around the diverticula, but the wall of the sigmoid was impressively thickened. This type of diverticulosis, which is frequently symptomatic, has been referred to as painful diverticular disease or spastic colon diverticulosis. Diverticula without muscle thickening are usually asymptomatic, and the condition is referred to as diverticulosis or simple massed diverticulosis. It is uncertain whether the two types have a similar pathogenesis. High intrasigmoid pressures, abnormalities of sigmoid musculature, low-fiber diet, and psychologic stress are thought to be important factors in the formation of diverticula.
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PMID:Pathogenesis of colonic diverticulitis and diverticulosis. 79 42

This paper reviews the current status of knowledge with relation to the effects of natural fiber on intestinal physiology. The one clear feature that emerges from literature is that most types of natural fiber increase the bulk of the stool. It is probable also that transit time is affected. Transit time appears to be decreased in persons with initially a slow time when they use certain forms of natural fiber and it may be that persons with rapid transit have a decrease in the rate of passage as fiber is added to the diet. Data on colonic intraluminal pressures are scanty, but those that exist seem to indicate that the addition of bran to the diet results in a decrease in overall colonic pressures. Much has been written and speculated about the role of natural fiber in the prevention or therapy of irritable colon and diverticular disease. Clinical studies, while enthusiastic, are preliminary and there are no hard data to indicate that the use of these materials are, in fact, helpful. Such clinical trials that have been published are, in general, small, poorly controlled and overall equivocal in their conclusions. A great deal of further work requires to be done to justify the claims that have been made on the role of fiber in altering normal or abnormal bowel habit.
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PMID:Natural fiber and bowel dysfunction. 82 51

A comparison has been made of the fecal characteristics in controls and patients with the irritable bowel syndrome and diverticular disease. No detectable difference was found in the fecal wet weight, dry weight, or total bile acid excretion in the four groups. A significant increase in the percentage of the water content of the stool was seen in the idiopathic diarrhea group with irritable bowel syndrome. Significantly less magnesium, potassium, and calcium was found in the stools of patients with diverticular disease and a similar trend was noted in patients with the spastic colon. These changes did not relate to the age of the patients. This suggests a common etiology for these disorders. The presence of increased water and primary bile acids in the feces of patients with idiopathic diarrhea suggests that this is a separate entity.
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PMID:Fecal characteristics contrasted in the irritable bowel syndrome and diverticular disease. 82 53

Although the irritable bowel syndrome is characterized as an abnormality in colonic motor activity occurring in response to certain stimuli, the etiology of this disorder is unclear. The purpose of this study is to determine the relationship of altered slow wave activity and the abnormal motility of the distal colon seen in patients with the irritable bowel syndrome. Myoelectrical activity was recorded using a bipolar electrode clipped to the distal colonic mucosa and motor activity was measured by perfused catheters. Colonic slow waves and contractions were present at two frequencies, 6 and 3 cycles per min. The slow wave frequency seemed to determine the frequency of colonic motor activity. Patients with the irritable bowel syndrome had increased 3-cycle per min slow wave activity in the basal state (P less than 0.001). However, no difference in basal 3-cycle per min motor activity was present between the two groups (P greater than 0.05). When colonic motor activity was increased with cholecystokinin or pentagastrin, patients with irritable bowel syndrome showed a marked increase in 3-cycle per min contractile activity, occurring simultaneously with 3-cycle per min slow wave activity. These studies suggest that increased colonic 3-cycle per min slow wave activity in patients with the irritable bowel syndrome may be the basic abnormality that leads to colonic motor dysfunction in response to various physiological stimuli.
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PMID:Evidence that abnormal myoelectrical activity produces colonic motor dysfunction in the irritable bowel syndrome. 83 84

The irritable colon syndrome comprises two predominant symptom patterns -- "spastic colon" with pain and constipation, and painless "nervous diarrhea". The two patterns frequently overlap. Low intake of dietary fibre is common to patients in both groups. Diagnosis of the irritable colon as a cause of diarrhea requires the characteristic symptom pattern and exclusion of organic disease. Management is based on common sense, careful reassurance of the patient, detailed explanation of the symptom pattern and explicit dietary advice. Increasing fibre in the diet is of prime importance in most patients.
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PMID:Symposium on diarrhea. 4. Diarrhea in the irritable colon syndrome. 84 55

Sixty-three unselected cases of giardiasis, with no evidence of other systemic disease, were screened for evidence of steatorrhoea. No patient had any evidence of protein-energy malnutrition. Seventeen (27%) of the cases had steatorrhoea; three (17-8%) of the 17 patients having steatorrhoea also had D-xylose malabsorption. Vitamin B12 absorption was normal in all. Bacterial culture and qualitative analysis of bile salt in jejunal fluid was carried out in all the 17 cases having steatorrhoea as well as 13 cases with normal absorptive parameters (eight cases of irritable bowel syndrome and five cases of giardia infection) who served as controls. All the patients showing bacterial overgrowth had free bile acids in their duodenal aspirate. Free bile acids could also be detected in jejunal aspirates of five of the seven patients having no bacterial overgrowth. Two control cases of giardia infection with normal small bowel function and sterile duodenal aspirate showed evidence of bile salt deconjugation. The significance of these findings is discussed in relation to the pathogenesis of steatorrhoea in patients with giardiasis. The possible role of giardia in bile salt deconjugation is suggested.
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PMID:Mechanism of malabsorption in giardiasis: a study of bacterial flora and bile salt deconjugation in upper jejunum. 85 75

Serum seromucoid estimation was carried out in 60 normal controls and 100 patients. (1) The serum seromucoid values in normal subjects ranged between 37-5-127 mg.% (69-35 +/- 17-84). (2) Serum seromucoid levels were found to be increased in patients of abdominal tuberculosis (210-95 +/- 86-49). These values corresponded directly to the severity of the disease. (3) Seromucoid levels came down to normal after three months of antitubercular treatment. (4) There was an inverse relationship between serum albumin and seromucoids. (5) Serum seromucoids were also found to be increased in patients of amoebiasis (157-54 +/- 37-61), with associated active colonic or hepatic disease. Asymptomatic cyst passers had normal levels of serum seromucoids. (6) Serum seromucoid values were within normal limits in patients with tropical sprue and irritable colon syndrome.
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PMID:Seromucoids in chronic bowel disorders of tropics. 86 5


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