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)

Dyspepsia is a frequent presenting symptom amongst patients attending medical clinics worldwide. However their aetiologies differ geographically. The present study was conducted to identify the aetiologies of dyspepsia of our centre and to determine their clinical characteristics. Five hundred consecutive patients presenting with dyspepsia were studied at our Institute. All patients underwent detailed structured questionnaire, stool examination, upper gastrointestinal endoscopy, ultrasound scan of upper abdomen and sigmoidoscopy when necessary. Among 500 patients, 34% suffered from essential dyspepsia, 28% had peptic ulcer, 19.2% had cholelithiasis, 10.8% had irritable bowel syndrome and 6% had gastro-oesophageal reflux. Significantly more patients with peptic ulcer experienced night paints, pain relief with food, milk, antacids or H2 receptor antagonists and periodic pain. In patients with essential dyspepsia, pain was continuous, mild to moderate in intensity, aggravated by food or alcohol, without relief with milk, antacids or H2 receptor antagonists and night pains were absent in them.
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PMID:Aetiology and dynamics of dyspepsia in Shimla: a study of 500 patients. 761 3

Placebo, defined as any therapeutic procedure, without any specific activity, given deliberately to have an effect on a patient, symptom, syndrome or disease, has a great impact in the evaluation of drug response. The possible pathways via which the possible effect brings about clinical and physiological changes remain unknown, but a humoral mechanism seems to be implicated in some placebo effects (e.g. placebo-induced analgesia). The placebo effect depends on many factors, including the type of patient, the personality of the physician, the doctor-patient relationship and the type and even the colour of the drug preparation. Placebo control is important particularly when the disease is characterized by frequent spontaneous periods of acute exacerbation and remission. Functional (such as dyspepsia and irritable bowel syndrome) and organic (such as peptic ulcer and inflammatory bowel disease) gastrointestinal diseases have got great benefit from placebo-controlled clinical trials. In such trials the more effective the placebo is, the more difficult it will be to demonstrate the efficacy of active drug in statistical terms. Nevertheless, provided the use of placebo be ethical for a given condition, placebo-controlled trials are the only objective way of assessing correctly drug response in patients.
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PMID:Placebo and placebo effect: their impact on the evaluation of drug response in patients. 771 18

Irritable bowel syndrome and (or) non complicated diverticulosis, associated with fever, could simulate diverticulitis. Cancer of the sigmoid colon appears the main differential diagnosis, when diverticulitis is associated with an atypical or complete colonic stenosis on opaque enema, with a vesicoenteric fistula or with a peritonitis due to a colonic perforation. Even at laparotomy, a pseudotumoral diverticulitis cannot easily be differentiated from a colonic carcinoma. Acute diverticulitis of the caecum or ascending colon is usually mistaken for acute appendicitis. When massive and life-threatening bleeding occurs, the diverticular origin is difficult to assess. Bleeding due to peptic ulcer disease and thermometric ulceration being precluded, arteriography performed on emergency is necessary to differentiate between diverticular bleeding and angiodysplasia.
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PMID:[Diagnostic pitfalls of complicated colonic diverticulosis]. 776 84

To study the prevalence of peptic ulcer, non-ulcer dyspepsia and irritable bowel syndrome (IBS) in the Dutch and Japanese working population, a structured history using a questionnaire on gastrointestinal symptoms during the preceding 3 months was obtained from persons undergoing a periodic medical examination. Principal components factor analysis of questionnaire responses was conducted to examine interrelationships of symptoms. In Holland, 427 men and 73 women participated (mean age 48.0 years), while in Japan 196 men and 35 women took part (mean age 48.8 years). In both the Japanese and the Dutch population, factor analysis yielded clusters of symptoms consistent with previously defined clinical syndromes: dyspepsia, diarrhoea-predominant IBS and constipation-predominant IBS. The prevalences of verified peptic ulcer history were 19% and 17% (95% confidence intervals (CI): 14-26% and 7-34%) in Japanese men and women in contrast to 5% and 0% (95% CI: 3-8% and 0-5%) in Dutch men and women respectively. The ratio of duodenal to gastric ulcer was 4.5: 1 in Holland and 1.5:1 in Japan. The 3-month period prevalence of non-ulcer dyspepsia was 13% in both the Japanese and the Dutch population and was twice as high in women as in men (p < 0.01). There was considerable overlap between dyspepsia subgroups. IBS was present in 25% of the Japanese and in 9% of the Dutch (p < 0.001) and occurred twice as often in women as in men (p < 0.01). In conclusion, factor analysis supported the existence of dyspepsia and IBS as distinct syndromes in both countries.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Peptic ulcer, non-ulcer dyspepsia and irritable bowel syndrome in The Netherlands and Japan. 801 69

The subject of aged people and stress was discussed from both clinical and basic points of view, mainly by introducing our research results, beginning with our immunoneuroendocrine studies on aging and stress. Stress stimulates the secretion of two adrenal hormones, cortisol and dehydroepiandrosterone-sulfate (DHEA-S). Both hormones are metabolized and excreted from the kidney, respectively converting to 17-OHCS and 17-KS-S in the urine. We have found that the two adrenal steroids reflect the physiology and pathophysiology of stress and aging, thereby suggesting that the simultaneous analysis of these parameters could be utilized as new biological markers for stress and aging. It was speculated that a disturbed balance between cortisol and DHEA-S would result in various aging- and stress-related disorders. Furthermore, clinical problems in aged people with stress-related diseases such as psychosomatic diseases, neurosis and depression were illustrated by some interesting cases. In particular, much data about peptic ulcer disease in the aged, a typical psychosomatic disease, were presented. In addition, clinical characteristics of old people with irritable bowel syndrome, aerophagia, neurogenic abdominal distention and depression were described. Data of our research to determine why pancreatic cancer is accompanied with depression so frequently were also presented. Finally, it was emphasized that a holistic approach, paying to sufficient attention to psychosomatic aspects, is very important for the management of stress diseases in the aged.
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PMID:[Aged people and stress]. 802 98

A cross-sectional home survey on drug use, mental health, somatic illnesses and psychosocial issues was carried out with a nation-wide multi-stage probability sample of 4,292 persons aged 12-17, 18-24 and 25-64. This article aims at investigating the relationship of specific categories of somatic illnesses with a psychological component to the use of licit and illicit drugs. For the purpose of analysis the total sample was divided into three mutually exclusive groups: group A included respondents who have reported illicit drug use 1-3 or more times in their lives; group B comprised respondents who have reported the use of licit psychotropic drugs 3 or more times in their lives; group C included non-user respondents. A higher proportion of respondents of groups A and B of both sexes in all three age strata reported the presence of a specific somatic illness such as bronchial asthma, essential hypertension, peptic ulcer, irritable bowel syndrome, rheumatoid arthritis, dermatitis or eczema, in comparison to group C (non-user) respondents. This difference was greater in the adolescent group 12-17 years of age. Possible explanations of the association between somatic illness with a psychological component and drug use are discussed.
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PMID:Drug use and somatic illnesses with psychological component: a nation-wide survey among adolescents and adults in Greece. 827 76

To determine the current indications and referral patterns for routine gastrointestinal radiology examinations, 1000 consecutive patients were prospectively analyzed. The following specialties were the largest sources of referral: general internal medicine (38%), gastroenterology (21%), and general and colorectal surgery (17%). Referrals from gastroenterologists were weighted toward areas not well evaluated by endoscopy, such as suspected small bowel disease. The major indications for upper gastrointestinal (GI) examinations were dysphagia and swallowing disorders (32%), hiatus hernia/reflux (14%), and ulcer (14%). Small bowel series were predominantly performed for inflammatory bowel disease (37%), obstruction (25%), and occult blood loss (18%). The majority of combined upper GI/small bowel studies were performed for indications primarily relating to the small bowel. Forty percent of barium enemas were performed for detection of neoplasms and polyps, with pain/irritable colon (14%) and exclusion of leak (14%) the next most common indications. Traditional indications, such as peptic ulcer disease and neoplastic disease, continue to be sources of referral for gastrointestinal radiology. However, more specialized applications, particularly in areas not well suited to endoscopy, such as swallowing disorders, inflammatory disease of the small bowel, and evaluation of surgical anastomoses, are also being commonly used. The changing indications, along with the previously documented decreased volume of gastrointestinal radiologic procedures, should be kept in mind when planning a radiology resident educational curriculum.
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PMID:Gastrointestinal radiology: current indications and referral patterns. 843 86

Cisapride is a substituted benzamide compound that stimulates motor activity in all segments of the gastrointestinal tract by enhancing the release of acetylcholine from the enteric nervous system. Cisapride is administered orally in the treatment of gastro-oesophageal reflux disease, functional dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction syndromes and chronic constipation. In gastro-oesophageal reflux disease in both adults and children, cisapride provides symptomatic improvement and mucosal healing. Long term treatment with cisapride is effective in the prevention of relapse of oesophagitis. Cisapride improves gastric emptying rates and improves symptoms in patients with gastroparesis of various origins. Unlike domperidone and metoclopramide, long term administration of cisapride seems to result in persistently enhanced gastric emptying. Cisapride is also effective in improving symptoms in patients with functional dyspepsia. In comparative studies in patients with functional dyspepsia, cisapride was at least as effective as metoclopramide, domperidone, clebopride, ranitidine and cimetidine. Cisapride increases stool frequency and reduces laxative consumption in patients with idiopathic constipation. Severe cases of slow transit constipation seem refractory to cisapride. Clinical studies also indicate that cisapride might be effective in the treatment of chronic intestinal pseudo-obstruction, postoperative ileus, peptic ulcer and irritable bowel syndrome. Further clinical studies are warranted to define the role of cisapride in these conditions. The dosage of cisapride ranges from 5mg 3 times daily to 20mg twice daily. Cisapride is generally well tolerated, both during short and long term treatment. In children, cisapride is also well tolerated in doses of 0.2 to 0.3 mg/kg, 3 to 4 times daily.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A risk-benefit assessment of cisapride in the treatment of gastrointestinal disorders. 852 13

This article outlines the clinical management of common gastrointestinal disorders encountered in the primary care setting. The general assessment of a woman presenting with a gastrointestinal concern is reviewed. Diagnosis and management of acute and chronic diarrhea, constipation, irritable bowel syndrome, and anorectal disorders are covered with emphasis on client education. Gastroesophageal reflux disease and peptic ulcer disease is discussed with the latest treatment recommendations for Helicobacter pylori infection outlined. Diagnosis of gallbladder disease and gallstones with alternative treatment options is reviewed. Finally, the diagnosis and management of viral hepatitis is outlined. A case study is given to illustrate the basic principles needed by the nurse-midwife in the assessment, diagnosis, and management of a woman with a gastrointestinal concern.
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PMID:Primary care for women. Management and treatment of gastrointestinal disorders. 869 Dec 76

Hindi adaptation of the Middlesex Hospital Questionnaire (MHQ), Brief Psychiatric Rating Scale and Presumptive Stressful Life Events Scale were used to measure neuroticism, psychiatric morbidity and stressful life events in 35 patients with non-ulcer dyspepsia (NUD), 22 cass of peptic ulcer disease (PUD), 65 irritable bowel syndrome (IBS) and 45 age and sex matched healthy controls. NUD subjects had significantly higher total MHQ scores (28.8 +/- 11.3; p < 0.001) and scores in subscales of somatization (7.8 +/- 3.4; p < 0.001) and hysterical personality traits (5.5 +/- 2.8; p < 0.01) compared to healthy controls. MHQ scores in IBS subjects was significantly higher than in NUD, but in PUD subjects it was in-between NUD and healthy controls. Psychiatric morbidity, as assessed by Brief Psychiatric Rating Scale, was significantly higher in patients with NUD and IBS than in normal controls. Stressful Life event score was statistically similar in all the groups.
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PMID:Neuroticism and stressful life events in patients with non-ulcer dyspepsia. 928 68


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