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

The difficulty of the diagnosis of psychosomatic disorders is known to be lying in the shortage of time, the inadequate training of physicians and in the similarity of psychosomatic symptoms are compared to those of solely organic diseases. The irritable stomach-even with hyperacidity--and the irritable colon with constipation or diarrhea are among the most frequent disorders caused by psychosomatic mechanisms. The duodenal ulcer and the ulcerative colitis belong to the true somatopsychic and psychosomatic diseases. Precise organic (diagnostic) clarification and differentiated drug therapy are necessary in addition to psychotherapeutic measures.
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PMID:[Psychosomatic disorders of the gastrointestinaltract (author's transl)]. 27 Feb 57

The concept of psychophysiologic disorders and the major theories invented to account for such disorders are critically reviewed. The Irritable Bowel Syndrome (IBS) serves to illustrate the application of each theory and provides a vehicle for their appraisal. The tendency to think of 'physical' and 'psychological' as separate entities rather than separate languages has led to attempts to make a categorical distinction between disorders caused by 'psychological' factors and those caused by 'physical' factors. Some of the theories developed to account for psychophysiologic disorders are unscientific and none can adequately account for all the features of IBS. It is concluded that the concept of psychophysiologic or psychosomatic disorder is outmoded.
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PMID:Psychophysiologic disorders: a critical appraisal of concept and theory illustrated with reference to the irritable bowel syndrome (IBS). 42 91

Psychosomatic studies of adolescent patients were conducted at the Kyushu University Hospital. Among many adolescent psychosomatic disorders, the incidence of irritable colon syndrome ranked first. The dynamic mechanisms and therapeutic results of these patients were introduced. Next, an epidemiological study showed that the frequency of constipation and diarrhea rapidly increases over the period from junior high school to senior high school. Through matched pair studies conducted with high school students, significant interrelationships were proven to exist among the occurrence of diarrhea and constipation, awareness of illness and psychological factors.
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PMID:Psychosomatic studies of Japanese youth under social changes. An overview. 74 Aug 49

Among medical clinic patients consulting for IBS, symptoms of psychologic distress are common, and more than half of these patients are found to have a psychiatric diagnosis in addition to bowel dysfunction. Many investigators have therefore concluded that IBS is a psychophysiologic disorder and proposed that patients with IBS be treated with psychologic techniques. However, recent studies suggest that this association may be spurious; persons in the community who have symptoms of IBS but do not consult a doctor have no more psychologic symptoms than persons without bowel symptoms. This indicates that psychologic symptoms do not cause bowel symptoms, but, instead, influence which persons with bowel symptoms will consult a physician. The bowel symptoms and the psychologic symptoms that coexist in most patients with IBS may be best thought of as comorbid conditions. Neither causes the other, but both may be serious enough to warrant treatment. Moreover, in some patients whose bowel symptoms consist of vague complaints of abdominal pain not specifically related to defecation or to changes in the frequency or consistency of bowel habits, the psychologic disorder may be primary. Psychologic stress may exacerbate IBS whether or not the patient has a psychiatric disorder, and psychologic stress may trigger acute episodes of symptoms similar to those of IBS even in persons without IBS. However, the magnitude of this correlation is modest, suggesting that only about 10% of the variation in bowel symptoms is attributable to stress. Psychologically oriented treatments have a role in the management of IBS. Most patients who consult internists about bowel symptoms have significant levels of depression and anxiety, and they tend to notice and to worry about somatic complaints more when they experience these dysphoric affects. Psychologic treatments that reduce the level of their psychologic distress also frequently reduce the frequency and severity of complaints about bowel symptoms. Tricyclic antidepressants may be tried as a first line of treatment; they have been shown to be superior to placebo for the management of abdominal pain and diarrhea but not constipation. In patients who do not show an adequate response to antidepressants, brief psychotherapy focusing on better ways of coping with current problems, hypnosis, or behavior therapy emphasizing methods of controlling reactions to stress are recommended. Controlled trials show these treatment approaches to be superior to medical management alone. It may appear paradoxical that psychologic treatments aimed at the management of emotions are so frequently found to reduce bowel symptoms, because the motility disorder responsible for the bowel symptoms may be unrelated to the psychologic symptoms that influence the patient to seek treatment.+4
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PMID:Psychologic considerations in the irritable bowel syndrome. 206 51

This study reports lifetime prevalence of certain "psychosomatic disorders" in psychiatric patients in India. The "psychosomatic disorders" studied were peptic ulcer, bronchial asthma, rheumatoid arthritis, ischemic heart disease and irritable bowel syndrome. One percent of psychiatric patients had these psychosomatic illnesses. Ten of the fifteen cases had two psychosomatic illnesses. Patients with psychosomatic disorders were significantly more often older in age (p = 0.003) and from an urban background (p = 0.05) as compared to other psychiatric patients. Depression was the commonest diagnosis, and was significantly (p = 0.01) more often diagnosed in the psychosomatic patients. Psychosis was not diagnosed in patients with psychosomatic disorders. This article emphasizes the need for identifying concomitant psychosomatic problems in psychiatric patients for their appropriate management.
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PMID:Psychosomatic patients in a psychiatric clinic. 326 96

The clinical strategy in the treatment of patients having the irritable bowel syndrome is especially important since it is often a psychosomatic disorder. The basis for clinical work with these patients depends very much on the doctor's attitude and the respect for the patients and their symptoms. Some practical guidelines with personal flavour from the work with patients having irritable bowels are discussed.
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PMID:Clinical strategy in the treatment of the irritable bowel syndrome. 347 16

The authors, after having considered the close likeness between the collateral clinical picture described by others in regard to the irritable colon syndrome and the outstanding one pointed out by them in many cases of psychosomatic disorders, have analyzed again a large number of personal cases diagnosed as "psychosomatic" in order to find possible relations between these two unwholesome conditions. At the end of their examination, after having ascertained that the "Irritable colon" has not to be considered an isolated disease but a syndrome caused by many factors, hinged on a predisposing condition likely of constitutional nature, the authors remark how it may nest in the folds of a psychosomatic disorder and sometimes be its outbreaking feature. The authors by this way, don't want to conclude identifying the I.C. with a psychosomatic disorder and suggest that in such cases one may take this syndrome as the main manifestation of a condition marked by an impairment of the digestive tract motility inside a psychosomatic disorder with a somatic expression of this apparatus.
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PMID:[Irritable colon and psychosomatic disease]. 648 46

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

From the case example, it can be seen that when the physician considered the psychosocial aspects of the disease in the treatment of Ms. B, she was able to make a complete recovery, something the medications themselves had been unable to do. Although originally thought to be a purely psychosomatic illness, research in IBD in the past three decades has shown that psychosocial aspects are an important component of IBD, but they are not the cause of the disease. Several studies have indicated that stress can adversely affect the gastrointestinal tract directly, by altering inflammatory mediators and gastrointestinal neurotransmitters. To get a complete clinical assessment of how a patient is functioning with the disease, it is important to incorporate psychosocial information into daily patient care in addition to laboratory measurements of disease severity. How does one obtain the psychosocial information for an individual patient? An understanding of the positive and negative factors that may influence how a patient adapts to chronic illness is important, including the patient's social support system, the self-confidence of the patient, and the presence of any comorbid psychiatric disease. In addition, HRQOL can help the clinician identify areas that may be of concern to large groups of patients with the same disease. By incorporating information obtained through HRQOL and modifying it to the psychosocial situation of the individual patient, the treatment plan becomes a negotiated agreement between the physician and the patient. These steps may lead to increased compliance, decreased likelihood of misunderstanding between the physician and the patient, and improvement in the health status of patients with IBD.
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PMID:Psychosocial factors in inflammatory bowel disease. 880 44

Plasma cortisol, blood glucose, serum lipids and lipoproteins were estimated in diseased human subjects and normal control volunteers. Serum triglyceride (Tg) total cholesterol (Tc) and cholesterol content of very low density lipoprotein (VLDLc), low density lipoprotein (LDLc) and high density lipoprotein (HDLc) were assayed under lipid profile. Clinical investigations were carried out on 115 subjects which involved 30 control, 25 irritable bowel syndrome (IBS), 30 bronchial asthma and 30 rheumatoid arthritis patients. The results of this preliminary study showed a significant change in the levels of all the biochemical parameters in diseased subjects in comparison with controls. Increased levels of atherogenic lipids, Tg, VLDLc and LDLc were found in rheumatoid arthritis subjects. This suggests that arthritis subjects are relatively at higher risk of developing coronary heart disease. Furthermore hypercholesterolemia may aggravate the risk condition in arthritis patients by artereosclerosis. The significant elevation in the levels of plasma cortisol reveals the fact that rheumatoid arthritis is a stabilized and chronic psychosomatic disorder, since, homeostatic competence is disrupted following decline in the tendency of stress-response to return to normalcy.
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PMID:A study on physiological changes in certain psychosomatic disorders with reference to cortisol, blood glucose and lipid profile. 906 10


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