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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 comparative study was conducted on the psychological features of chronic pancreatitis, peptic ulcer, ulcerative colitis and the irritable colon syndrome by means of psychological tests and interviews. The patients with irritable colon syndrome were found to be the most neurotic of all, whereas those with the definite type of chronic pancreatitis and ulcerative colitis presented prominent alexithymic characteristics. About one half of the patients having peptic ulcer showed alexithymic features. Despite their neurotic tendencies shown on the psychological tests, the patients with the suspicious type of chronic pancreatitis were socially better adjusted than those with irritable colon syndrome. It was also noted that the concept of alexithymia needs to be elucidated by including such factors as over-adaptation to the environment, certain distorted life habits and lack of bodily sensations.
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PMID:Alexithymic feature in digestive diseases. 55 Jan 72

Significant changes on a standard barium follow-through examination in celiac disease have been determined by comparison with functional changes (irritable bowel syndrome), malabsorption without a villous lesion (chronic pancreatitis), and a villous abnormality without malabsorption (dermatitis herpetiformis). Patients with iron deficiency anemia formed the control group. Slight jejunal dilatation (26-30 mm) was found in 15% of the celiacs and 17% of the irritable bowel patients. Dilatation in excess of 30 mm and/or effacement of jejunal fold pattern occurred only with an abnormal jejunal biopsy, in 54% of the celiacs and 33% of the dermatitis herpetiformis patients. Patients with malabsorption by itself and 46% of the celiacs could not be distinguished from those with irritable bowel syndrome. The concept of a malabsorption pattern is considered invalid, and the diagnosis of celiac disease can be reliably established only by peroral jejunal biopsy.
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PMID:Relevance of the barium follow-through examination in the diagnosis of adult celiac disease. 55 35

Although recent work has suggested that an abnormality of the 0.05 Hz (3 c/m) slow wave electrical activity exists in the distal colon of patients with the irritable colon syndrome, it is not established whether this is related to altered bowel habit alone, or whether it is specific to the irritable colon syndrome. We have therefore studied 10 patients referred with this disorder and compared their colonic myoelectrical pattern with 10 patients suffering from assorted disorders with similar symptoms--for example, chronic pancreatitis, diverticular disease, ulcerative colitis, etc. Transit time, stool weights, percentage motility, and slow wave electrical activity were measured in each patient. The two groups were well matched for age and patients with similar symptoms in the two groups had similar values for transit time and percentage motility. There was a statistically significant increase in the 3 c/m electrical activity in patients with the irritable colon syndrome unrelated to the degree of diarrhoea or constipation. It would appear, therefore, that the abnormally high incidence of 3 c/m electrical activity in the colon is specific to the irritable colon syndrome and not merely a feature of altered bowel habit.
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PMID:Is there a myoelectrical abnormality in the irritable colon syndrome? 65 69

The 14C-glycocholate breath test was performed in 15 normal subjects and 134 patients clinically suspected of bacterial overgrowth in the proximal small intestine, with functional impairment of the ileum and chologenic diarrohea as well as other forms of diarrhoea. In addition, faecal weight, faecal fat excretion and faecal bile-acid excretion were measured. Early and highest 14CO2 expiration peaks were found as an expression of increased deconjugation of bile acids in patients with fistulae between proximal small intestine and colon, and in 13 of 24 patients with Billroth II gastric resection or duodenopancreatectomy. Bile-acid deconjugation was not increased in sprue, chronic pancreatitis with steatorrhoea, ulcerative colitis, irritable colon, Whipple's disease, Salmonella enteritis, non-specific enteritis, or laxative abuse. In six of twelve patients with Crohn's disease of the ileum there was an increase in deconjugation of bile acids.
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PMID:[Clinical significance of the 14C-glycocholate breath test in the diagnosis of gastro-enterological diseases (author's transl)]. 124 74

Breath hydrogen (H2) exhalation after xylose administration reflects the malabsorbed portion of the pentose and thus might facilitate the application of the D-xylose test. Therefore, as a complementary parameter, breath H2-exhalation in response to 25 g D-xylose was assessed in control subjects, in patients with coeliac disease, with chronic pancreatitis and with the irritable bowel syndrome. Patients with coeliac disease showed significantly higher breath H2 concentrations than the controls. Specificity and the positive predictive value of peak H2-increments greater than 56 ppm (i.e. greater than mean + 2 SD of controls) were 100%, but sensitivity was only 40%. In all patients with a positive H2 breath test, urinary D-xylose excretion and serum D-xylose increments were also abnormal. Apart from great overlap between controls and patients with coeliac disease, the failure to produce H2 in response to D-xylose in 12% of the 57 investigated subjects was the major factor limiting diagnostic efficiency of the test. Non H2 production could be shown to reflect a specific metabolic disability of the colonic flora and did not prove complete absorption of the substrate. It is concluded, that the 25 g D-xylose H2 breath test is of no clinical relevance for the diagnosis of celiac sprue but exaggerated breath H2 increases (greater than 56 ppm) with normal urinary and D-xylose tests were indicative for the irritable bowel syndrome in 5 out of 10 patients. The diagnostic impact of this constellation thus merits further investigation.
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PMID:Clinical evaluation of a 25 g D-xylose hydrogen (H2) breath test. 227 52

Insulin-like growth factor II is secreted primarily by the liver and is reported to be transcribed in many primary hepatocellular carcinoma (PHC) cell lines. We have studied diagnostic significance of serum IGF-II in chronic liver diseases using specific enzyme immunoassay. Serum IGF-II levels (mean +/- SE) were decreased in chronic hepatitis (538 +/- 51 ng/ml; N = 29), liver cirrhosis (427 +/- 45; 50) and PHC (260 +/- 41; 17) compared to controls (830 +/- 49; 57). Serum IGF-II was not different from controls in any of nonhepatic diseases such as diabetes (1032 +/- 97; 19) pancreatic cancer (1413 +/- 282; 8), chronic pancreatitis (999 +/- 126; 17), peptic ulcer (1186 +/- 43; 11), irritable bowel syndrome (1002 +/- 109; 12), gastrointestinal tract cancer (1250 +/- 216; 21) and chronic renal failure (733 +/- 135; 14). In liver diseases serum IGF-II showed a significant correlation with liver function test (negative with retention of indocyanine green and total bile acids; positive with albumin, thrombo-test, and cholinesterase). These results suggest that serum IGF-II reflects a reduced production of IGF-II in the liver and that it can be an index for the residual capacity of liver function.
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PMID:Serum insulin-like growth factor II in chronic liver disease. 253 15

Among the numerous differential diagnoses of chronic diarrhea, chologenic diarrhea is rarely taken into account. However, diseases or postoperative syndromes leading to bile acid malabsorption and thus resulting in chologenic diarrhea such as Crohn's disease or ileal resections have increased considerably. Further, malabsorption of bile acids might be incriminated in the pathogenesis or sequels of other digestive diseases (e.g. irritable bowel syndrome or chronic pancreatitis) and also can be the only characteristic in the rare "idiopathic" bile acid malabsorption. Etiologies, pathophysiology and the clinical sequels of impaired bile acid absorption have been elucidated in recent years, but in clinical medicine several questions remained unresolved since valid and generally acceptable analytical methods for the detection of bile acid malabsorption have not been developed until recently. In this field, radioisotope methods have considerably expanded our diagnostic facilities.
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PMID:[Causes and clinical diagnosis of chologenic diarrhea]. 266 63

Tumor-associated trypsin inhibitor (TATI) is a 6 K dalton protease inhibitor, that was isolated from urine of a patient with ovarian cancer. In our experience, mean serum level of TATI in healthy subjects (n. 120), is 13 micrograms/l (range 5.1-42 micrograms/l). The cut-off point is established in 32 micrograms/l (mean +/- 3 SD). We have examined 357 patients with gastrointestinal diseases: 98 gastric cancer, 50 colon cancers, 52 pancreatic cancers, 32 chronic pancreatitis, 38 IBD, 28 colon polyps, 40 gastric ulcers and 25 non-neoplastic biliary tree diseases. TATI may be a good tumor marker only in gastric cancer. Elevated levels of TATI also occur in obstructive hepatobiliary disease and active pancreatitis or IBD.
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PMID:[Determination of tumor-associated trypsin inhibitor (TATI) in subjects with gastrointestinal diseases. Preliminary data]. 271 42

Dyspepsia, defined as chronic or recurrent upper abdominal pain or nausea, is a common occurrence. Dyspepsia without an ulcer (non-ulcer dyspepsia) is diagnosed in patients at least twice as often as peptic ulceration. Diseases that may present with similar symptoms include gastroesophageal reflux, biliary tract disease, chronic pancreatitis, and irritable bowel syndrome. A careful history and physical examination, supplemented by selected tests, usually lead to a correct diagnosis. The pathogenesis of non-ulcer dyspepsia remains unknown. Gastric acid secretion, duodenogastric reflux, psychological factors, environmental exposures, and heredity probably do not play a major role. Some patients may have motility disturbances, but whether these disturbances cause dyspepsia is unknown. Campylobacter pylori infection and associated gastritis are common in non-ulcer dyspepsia, but their etiologic role is controversial, as is the importance of chronic duodenitis. By recognizing the heterogeneity of patients who present with non-ulcer dyspepsia, more rational management may be possible. Although an empiric trial of antacids or H2 blockers has been recommended to treat dyspepsia, most controlled trials show that although these substances reduce severity of symptoms, they are no more effective than placebos in non-ulcer dyspepsia.
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PMID:Non-ulcer dyspepsia: potential causes and pathophysiology. 328 48

Nonucler dyspepsia lacks a clear definition, and probably conceals several entities under this heading. It seems appropriate to deal separately with symptoms likely to be elicited from the upper digestive tract. Therefore, we propose "epigastric distress syndrome" (EDS) as a designation for chronic or recurrent epigastric pain without any anatomical antecedents and without concomitant symptoms consistent with established criteria of the irritable bowel syndrome. In this study 185 dyspeptic patients with a tentative diagnosis of EDS, based on symptoms and negative upper endoscopy, underwent laboratory screening, peroral cholecystograms, ultrasound scanning of the liver, biliary tract, and pancreas, biopsies from the distal part of the duodenum, and acid secretory tests. There were very few pathological findings. Five patients had gallstones. No single case of chronic pancreatitis or celiac disease was disclosed. Thus, EDS seems to be a "safe" diagnosis, and it is not unreasonable to assume that it could represent a disease entity. Although many patients had symptoms closely similar to those in duodenal ulcer, the mean basal and maximal acid output in this patient category did not differ from that observed among healthy subjects.
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PMID:The "epigastric distress syndrome". A possible disease entity identified by history and endoscopy in patients with nonulcer dyspepsia. 361 84


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