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

About five per cent of the adult population each year will see their doctor with complaints that are finally characterised as irritable bowel syndrome (IBS). The complaints are constipation (perhaps alternating with diarrhoea), abdominal pain (dull or colicky), abdominal distension, abdominal rumbling and flatulence. The diagnosis of IBS implies that a relevant examination has precluded any organic disease. The etiology is unknown and the syndrome probably does not represent a disease entity. It is therefore difficult, if not impossible, to produce a definite rationale of treatment. However, several aspects of the pathogenesis of the individual symptoms of IBS are well known: 1) chronic constipation is most likely due to fibre-depleted diet, psychological factors, local organic disorders (e.g., anal fissures, hemorrhoids, diverticulosis) and disturbance of the body fluid balance (e.g., high consumption of diuretic compounds such as coffee and tea); 2) pain is related to spasms and motility disturbances causing increased intraluminal pressure; 3) meteorism is not due to an increased amount of intestinal gas, but "air traps" and segmental accumulation of gas seem to occur. Furthermore, psychopathological factors and perhaps also food intolerance may play an etiological role. At present the rationale of treatment in IBS is: 1) management of constipation, 2) ease of spasms, 3) reduction of surface tension of intestinal contents, 4) ease of mental stress.
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PMID:Irritable bowel syndrome: current concepts and future trends. 389 85

We assessed the nutritional status of 119 patients with chronic gastrointestinal symptoms due to organic disorders (inflammatory bowel disease, IBD; peptic ulcer, PU; malabsorption syndrome, M; and malignant gastrointestinal tumours, T), by standard anthropometry and marker proteins (albumin; retinol-binding protein, RBP; and thyroxine-binding prealbumin, TBPA). We also studied 31 patients with irritable bowel syndrome (IBS) and 75 age-matched healthy controls (C). Compared with healthy controls, patients with organic bowel disease had significant abnormality of two or more anthropometric measurements (P less than 0.05). Plasma albumin was reduced in patients with IBD, M and T (P less than 0.001), but RBP and TBPA measurements were lower in all patient categories (P less than 0.01) including IBS. Stepwise discriminant analysis of the patient data alone, using three to six parameters, correctly separated 65 per cent PU patients, 66 per cent IBD and M, 72 per cent IBS and 88 per cent patients with T from other disease categories. We conclude that patients with chronic gastrointestinal symptoms often have some nutritional disturbances and that simple anthropometric and protein measurements might help us to distinguish patients with functional bowel disease from those with organic bowel disease.
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PMID:Nutritional assessment in patients with chronic gastrointestinal symptoms: comparison of functional and organic disorders. 392 30

Gastrointestinal and mental symptoms were assessed in 101 outpatients with the irritable bowel syndrome (IBS). A normal female population was used for comparison of mental symptoms. By definition all patients had abdominal pains and/or change of bowel habits (constipation or diarrhoea, or both) but no demonstrable organic disease. Upper gastrointestinal symptoms without peptic ulcer disease were reported by 87% of the patients. Mental symptoms were reported by almost all patients. Symptoms of anxiety, fatiguability, hostile feelings, sadness, and sleep disturbances were seen significantly more often among IBS women than in the controls. We conclude that patients with IBS frequently have upper gastrointestinal and mental symptoms that should be taken into account in the therapeutic management and evaluation of new modes of treatment.
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PMID:Upper gastrointestinal and mental symptoms in the irritable bowel syndrome. 402 24

The clinical features of 150 consecutive patients with irritable bowel syndrome are reported. All patients were referred to a private practice. There was a marked female preponderance and a wide range of ages. Diarrhoea was predominant in 61,3%. The common symptoms were altered bowel habit, abdominal pain, emotional disturbance, flatulence and distension. Fatigue, weight loss, upper gastrointestinal symptoms, backache and urinary symptoms were frequent. The rectum showed nonspecific loss of vascular pattern, oedema and congestion in 11,4% of patients, but this was readily distinguished from inflammatory bowel disease on histological examination. The incidence of non-smokers in the group was 78,1%. The overall appendicectomy rate was 34%, and 65% of the 92 women had had gynaecological operations. A positive diagnosis was made on a typical history and simple basic investigations. More extensive investigations were required for those patients with markers of organic disease, but these yielded few associated lesions.
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PMID:The irritable bowel syndrome--a study from private practice. 403 10

The effect of a new tranquillizer, mepiprazole, in the treatment of the irritable bowel syndrome has been studied in a double-blind cross-over trial in 19 patients. After examination to exclude organic disease the patients were followed up over two treatment periods of four weeks each under either placebo or the active principle, each patient being his own control. The results indicated that the drug had a beneficial effect (P < 0.05) provided that it was given for a period of at least three weeks.
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PMID:Controlled clinical trial of mepiprazole in irritable bowel syndrome. 460 45

To examine whether Entamoeba histolytica is the cause of a variety of intestinal disorders, as often implicated, a two-part study was conducted. In part 1, 184 patients attending a gastroenterology clinic and needing a sigmoidoscopy had a rectal biopsy specimen and a stool sample cultured for E histolytica. Part of the biopsy specimen was examined histologically. In addition, serum was tested for antibody to E histolytica. 34 (18.7%) patients were culture positive. There was no correlation between the culture results and patients' symptoms except for diarrhoea, which was more common in the culture-negative group, or with histological or serological findings. In the second part of the study, 15 culture-positive patients were followed up untreated for a mean (+/- SD) of 8.6 (+/- 4.9) months, range 1-18. In all 15 patients spontaneous eradication of the parasite occurred, and in none did symptoms of invasive amoebiasis develop. Thus E histolytica seems not to be responsible for many of the bowel complaints commonly attributed to it. In these cyst passers the cysts are probably incidental to an irritable bowel syndrome or some other organic disease. There seems to be little justification for treating cyst passers since eradication of the parasite occurs spontaneously and the danger of invasive amoebiasis is negligible. Such a practice would result in an enormous saving on the cost of drugs.
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PMID:Entamoeba histolytica cyst passers: clinical features and outcome in untreated subjects. 614 59

77 hospitalized patients with chronic unspecific abdominal complaints, in whom any other organic disease had been previously excluded, were investigated for lactose malabsorption; they were subdivided into two groups: 46 patients complaining primarily of colicky abdominal pain and/or intermittent diarrhoea (group 1) and 31 patients presenting with dyspepsia as the predominant symptom (group 2). To establish the exact prevalence of isolated lactase deficiency in the healthy adult population served by our hospital, 40 Italian adult healthy subjects were also studied. The prevalence of lactose malabsorption was significantly higher (p less than 0.005) in patients of the 1st group than in patients of the 2nd group, and in the healthy adult population seen at our hospital (74% vs 35.5% and 37.5%, respectively). Furthermore a high prevalence of lactose intolerance, determined by means of a three-week diet trial (lactose free-diet versus normal diet), was documented among lactose malabsorbers of the 1st group. We concluded therefore that lactose intolerance is a factor in some Italian adult patients who suffer from long-standing aspecific abdominal discomfort, and it should be always considered in these patients, especially when colicky abdominal pain and diarrhoea are present, before the diagnosis of irritable bowel syndrome is made.
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PMID:Lactose intolerance in adults with chronic unspecific abdominal complaints. 667 46

Irritable bowel syndrome is a very common clinical problem for which there are no established diagnostic criteria. The two aims of the present study were first, to create a scoring system for the diagnosis of irritable bowel syndrome incorporating features from the case history, physical examination, and some basic investigations including erythrocyte sedimentation rate and blood count; and second, to estimate the diagnostic accuracy of this scoring system in terms of its sensitivity and specificity, and of its predictive value in patients diagnosed as having irritable bowel syndrome by conventional methods. A group of 479 consecutive outpatients referred to a gastrointestinal clinic was studied by the usual extensive routine workup practiced at the clinic, including numerous laboratory tests, endoscopy of upper and lower gastrointestinal tract, and ultrasound. In 209 patients, symptoms were related to an underlying organic disease and in 108 patients irritable bowel syndrome was diagnosed without any recognizable organic disease. As a separate exercise, a scoring system including the answers of a questionnaire and the results of eight basic investigations was established. After completion of the study, the score was weighted by means of a logistic regression analysis. Using the weighted score, at a sensitivity of 64%, the specificity for the diagnosis of irritable bowel syndrome was 99%, and at a sensitivity of 83%, the specificity was 97%. Patients with organic diseases such as malignant tumor or inflammatory bowel disease were well discriminated by the score. It is concluded that a detailed history, physical examination, and basic laboratory tests are sufficient in most patients for the positive diagnosis of irritable bowel syndrome and the exclusion of any underlying organic diseases.
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PMID:A diagnostic score for the irritable bowel syndrome. Its value in the exclusion of organic disease. 672 51

In a consecutive study of 101 patients with IBS and at least one year of complaints, the presence of somatic and mental symptoms were measured. By definition all patients had abdominal pain and/or disturbed bowel function in the absence of organic disease. The most prominent symptom of indigestion was abdominal distension. Many patients also had complaints of food intolerance and avoided bulk forming agents such as fruits and vegetables. Symptoms associated with the upper gastrointestinal tract such as burning sensations in the epigastrium nausea and acid regurgitation were seen in a majority of the patients. Mental symptoms were seen in almost all patients. A majority had complaints of inner tension, worrying over trifles, autonomic disturbances and muscular tension. Symptoms referred to the neurasthenic syndrome were also frequently seen, such as fatiguability and irritable and hostile feelings. Common depression symptoms were sadness and feelings of helplessness. Other mental symptoms of importance were phobias, sleep disturbances, reduced sexual interest, loss of appetite and obsessive-compulsive symptoms. Our conclusion is that patients with IBS frequently have upper gastrointestinal and mental symptoms which should be taken into account searching for more rational methods of treatment.
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PMID:Symptoms in irritable bowel syndrome. 696 23

To assess the value of history in evaluating abdominal pain, 45 outpatients (25 women and 20 men) aged 16-76 completed a questionnaire. The affirmative replies of the patients with organic disease were compared with those of patients with irritable bowel syndrome (IBS) by the chi 2 test. 17 patients had organic diseases while 28 had IBS. The features indicating an organic lesion (p less than 0.0005) were age over 50, history of short duration, bloody stools, bowel incontinence and urgency, pain at night, pain lasting minutes, colicly pain, and onset of pain 1-2 h after meals. Typical features of IBS (p less than 0.0005) were age below 50, frequent bowel movements of normal consistency, increased pain with emotional stress, a rigid personality and an exceptionally well-groomed appearance. From these findings the following conclusions are drawn: 1. Patients with organic disease always present with two symptoms indicative of an organic origin and with one highly significant symptom of IBS at most. 2. IBS is characterized by a broad range of various highly significant symptoms simultaneously. There is a larger number of significant symptoms against IBS (n = 10) than for it (n = 4). History serves rather to rule out IBS than to prove it.
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PMID:[Irritable colon--yes or no? Does the anamnesis help in the decision?]. 707 92


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