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)

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

Diverticular disease of the colon is, apart from the irritable colon syndrome, by now probably the commonest disorder of the large intestine. The incidence of the disease seems to be increasing, which might be due to fundamental dietary changes during the last 60-80 years. It has been suggested that the condition may be a dietary deficiency disorder caused by an inadequate intake of fiber in the diet. Undiagnosed diverticulosis can suddenly progress to painful diverticular disease or diverticulitis with no warning. Complications are sometimes life-threatening, and they demand immediately surgical intervention. The optimal medical and surgical management of diverticular disease and diverticulitis is not well defined as no controlled clinical trials are available.
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PMID:[Internal aspects of diverticulosis (author's transl)]. 99 60

Nutritional support, whether enteral or parenteral, is an important part of the treatment of IBD. Inadequate oral intake, malabsorption, and increased gastrointestinal losses all contribute to malnutrition. Weight loss, cachexia, abnormal body composition, and multiple micronutrient deficiencies are common. Acute repletion of body weight and correction of specific nutrient deficiencies improve the patients' sense of well-being and decrease morbidity, especially in the perioperative period. If a short period of bowel rest (10 to 14 days) is part of the medical therapy of acute exacerbations of IBD, TPN should be administered to prevent further nutritional deficiencies. Chronic undernutrition, and growth failure in children, usually are best treated by intensive enteral supplementation. Prolonged bowel rest and TPN (4 to 6 weeks) have not been shown to improve outcome but may be appropriate in carefully selected patients. Long-term home TPN may be necessary for patients who have short gut syndrome. The mainstay of treatment for IBD is medical therapy including corticosteroids. Timely and appropriate surgery is equally important and should not be considered a last resort. Careful nutritional management is essential but is adjunctive rather than primary therapy.
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PMID:Nutrition and inflammatory bowel disease. 250 55

IBD is one of the most significant chronic diseases afflicting children and adolescents. As in adults, UC and CD constitute the two major disease entities, with many of the characteristics of these two diseases being similar in adults and children. With technical advances, a complete endoscopic examination of the colon and terminal ileum can be performed in most children without difficulty. There are, however, a number of aspects of the presentation, course, and management of these diseases that are unique to the pediatric population. Because the impact of inadequate nutrition is much greater in the growing child than in adults, growth failure is a common, serious complication of malnutrition in this population. The psychological impact of a chronic illness on both the developing child and the family can also be significant. The management of this population is further complicated by the lack of adequate studies that assess not only the effect of a medical or surgical therapy on disease activity, but also address the issues of growth and pubertal development. It has been a challenge to extrapolate data from adult studies to the pediatric population. The management of children and adolescents requires a critical understanding of the differences between pediatric and adult patients to maximize growth potential and minimize longterm sequelae of treatment. After a long period of limited controlled studies, however, collaborative efforts are underway to investigate most aspects of pediatric IBD, and we look forward to exciting advances toward the optimal management of children and adolescents with IBD.
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PMID:Inflammatory bowel disease in children. 796 10

Although many foods have been suggested to play a role in the cause of IBD, there are not yet definitive data to support diet as a cause of either CD or UC. Malnutrition is a common occurrence in IBD, and this must be considered in the treatment of these diseases. Nutritional support in IBD has limited use as primary therapy (Table 2). Even though parenteral and enteral nutrition have been associated with remission, relapse frequently occurs when normal food intake is resumed. Likewise, fistulae may resolve with aggressive, nutritional therapy, but they frequently recur with reinstitution of food. In short bowel syndrome caused by extensive intestinal resection performed in CD, parenteral nutrition provides an important mode of therapy. In addition, perioperative use of nutritional support may decrease the incidence of postoperative complications in patients who are malnourished. Nutritional support in pediatric patients with CD who have growth failure has been effective in stimulating growth.
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PMID:Nutritional considerations in inflammatory bowel diseases. 880 38

Intestinal bacterial overgrowth (IBD) is very frequent in patients with chronic hepatopathies. Causes of IBO, although not entirely known, principally are: the hepatopathy, the alcoholism and the alterations produced by these two factors, such as achylia (and above all hypochlorhydria), decrease in the secretion of IgA, and malnutrition. On the other hand, the IBO increases the severity of the hepatopathy and frequently produces a bacterial peritonitis. All these data suggest that the IBO play an important role increasing the hepatopathy severity and consequently is a factor to bear in mind.
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PMID:[Intestinal bacteria overgrowth in chronic hepatopathies]. 1042 Sep 29

Weight loss is a major component of the clinical syndrome in patients with acquired immunodeficiency syndrome (AIDS). The impact of malnutrition on the outcome of the disease has been unappreciated in many investigations. The authors evaluated the effects of oral nutritional supplementation on the morphology and immunology of the intestinal mucosa of patients with AIDS. Twelve patients with AIDS without diarrhea or opportunistic infections, with at least 10% of body weight loss over 1 year, were submitted to anthropometric measures, peripheral blood T-lymphocyte counts, and peroral jejunal biopsy before and after oral nutritional supplementation. An industrialized peptide-based formula containing omega-3 fatty acids was given for 6 weeks. Jejunal samples were analyzed by histomorphometry, including villous-to-crypt ratio, lamina propria, and intraepithelial lymphocyte count. Immunologic assessment of the intestinal mucosa was made by indirect immunoperoxidase using monoclonal antibodies against CD3, CD4, and CD8. Seven patients with irritable bowel syndrome and two healthy volunteers were selected as a control group for histologic and immunohistochemical comparisons. After 6 weeks the patient group maintained their body weight and increased their tricipital fold. The number of peripheral blood T cells, albumin, transferrin, and the number of CD3+, CD4+, and CD8+ cells in jejunal mucosa as well as the intestinal morphometry remained stable. Oral supplementation contributed to maintaining body weight and may constitute a reasonable adjuvant therapeutic tool against AIDS progression.
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PMID:Effects of oral nutritional supplementation on the intestinal mucosa of patients with AIDS. 1063 16

Decreased bone mineral density, osteoporosis, is a common disorder in the United States and elsewhere in the world. This disorder is estimated to account for more than 1.5 million bone fractures each year and is estimated to cost over 13 billion dollars annually. Inflammatory Bowel Disease is a relatively common disorder with estimates suggesting that approximately one million Americans are afflicted by these conditions. Osteoporosis is a common extraintestinal complication of inflammatory bowel disease. The importance of the many possible mechanisms contributing to the loss of bone mass in IBD is uncertain. Several of these specific factors, including the use of corticosteroids, calcium deficiency, vitamin D deficiency, chronically active inflammatory bowel disease, and malnutrition. Assessment of the bone mineral density is an important exercise since new therapeutic options exist and new options are available to combat and even prevent this costly complication.
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PMID:Management of bone loss in inflammatory bowel disease. 1172 81

OBJECTIVE: To review the pathophysiology in order to explain the clinical manifestation and treatment of this syndrome, which has not been completely explained yet. METHODS: References were searched on recent review articles, personal files, and Medline. RESULTS: Irritable bowel syndrome in children or chronic nonspecific diarrhea is a very frequent reason for pediatric gastroenterology visits. It is a benign disease and disappears with age, but may cause extreme worry to parents. The pathophysiology is still unclear, and there is not laboratory corroboration. Thus, it is frequently diagnosed incorrectly, although it has proper clinical manifestation (if there is no diet or medicine manipulation). Dietary advice is usually efficient, and is based on pathophysiologic data. The use of drug is still discussed. CONCLUSIONS: Irritable bowel syndrome must be always considered in oligosymptomatic children without signs of malnutrition, with diarrhea, between 6 months and 5 years of age. Drugs are not necessary, and their action is still unclear. Food manipulation based on pathophysiology is enough.
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PMID:[Irritable bowel syndrome] 1467 19

This study shows a broad analysis of gynaecological and obstetrical disturbances in patients with celiac disease in relation to their nutritional status and adherence to a gluten-free diet. Seventy-six adult celiac patients were analyzed according to nutritional status and 18 children/adolescents to gluten-free diet adherence. As controls, 84 adults and 22 adolescents with irritable bowel syndrome were used The significant findings were observed as follow: adult celiac patients, irrespective of the nutritional status, were younger than controls, presented delayed menarche, secondary amenorrhea, a higher percentage of spontaneous abortions, anemia and hypoalbuminemia. No differences were observed regarding the number of pregnancies, age at menopause and duration of the reproductive period. After treatment, patients presented with normal pregnancies and one patient presented spontaneous abortion. The adolescents who were not adherent to gluten-free diet presented delayed menarche and secondary amenorrhea. In conclusion, gluten per se could explain the disturbances and malnutrition would worsen the disease in a consequent vicious cycle. Therefore, celiac disease should be included in the screening of reproductive disorders.
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PMID:Gynecologic and obstetric findings related to nutritional status and adherence to a gluten-free diet in Brazilian patients with celiac disease. 1523 59


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