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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 investigation of colonic motility is a difficult task. Little is known on the myoelectrical activity of the human colon or on physiologic manometric findings. Scintigraphic studies have been performed to investigate the movement of colonic contents and have revealed that the ascending colon mainly acts as a storage area. Because physiologic data are rare, the interpretation of findings in patients with distinct bowel symptoms may be very difficult to interpret. Only a part of the patients who present with chronic obstipation have colonic inertia which is characterized by a slow transit through the entire colon. Other patients may have anismus, i.e. a disturbance of the highly complex activity of defecation. Elderly patients may have diminished rectal sensitivity to dilation and thus do not feel the urge the defecate. Patients with irritable bowel syndrome have been extensively investigated for underlying motility disorders. In spite of ample data the exact pathogenesis remains unknown. Furthermore, it has become clear that patients with the irritable bowel syndrome not only have irritable guts but also an irritable personality. Treatment of chronic constipation is difficult. Bulking agents and osmotically active laxatives often fail to give a satisfactory result. Patients with irritable bowel syndrome may benefit from both bulking agents, but tranquilizers may be helpful as well.
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PMID:[Motility of the large intestine: from irritable colon to obstipation]. 192 9

A group of outpatients with chronic non-organic upper abdominal pain was followed up 5-7 years after the index investigation, to evaluate the predictive value of several variables on the basis of a questionnaire and a laboratory pain study. Fifty-four per cent had symptoms of irritable bowel syndrome. A low pain tolerance measured with an ischemic pain technique significantly predicted a poor course of the disease (P = 0.03). So did a high score indicating psychic vulnerability (P = 0.02) and two social factors: poor school and vocational education (P less than 0.01). Without significant predictive value were level of abdominal pain rated on a visual analogue scale, length of dyspepsia history, bowel habits, relation of pain to meals and to life events, heartburn, headache, back pain, dysmenorrhea, paresthesias in fingers or feet, present occupation, sex, marital status, days absent from work because of the disease, and consumption of tranquilizers, cigarettes, and alcohol. The findings indicate that psychologic factors and a low pain tolerance may be elements in this poorly understood syndrome. This is supported by earlier findings of a decreased pain tolerance and an elevated psychologic score in this group compared with controls.
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PMID:Predictors for the course of chronic non-organic upper abdominal pain. 278 Dec 39

One hundred fifty-four of 184 consecutive patients diagnosed as having the irritable bowel syndrome were followed for an average of 29 months. Diagnosis was based on history, physical examination, and sigmoidoscopy. Seventy-eight percent of the patients had some form of gastrointestinal radiologic investigation, the majority ordered by the referring physicians. Treatment was restricted to reassurance, explanation, and a high-fiber diet. Twenty-five patients continued to take or had prescribed by their family physicians antispasmodics, minor tranquilizers, or laxatives. Eleven patients required psychiatric referral or major psychotropic medication. At follow-up, 79% felt their symptoms were better, much better, or gone completely. Outcome was not affected by identified psychiatric problems. During follow-up, an organic cause for symptoms was identified in six patients. The change in diagnosis was the result of clinical suspicion plus failure to respond to conservative therapy.
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PMID:Management of the irritable bowel syndrome: a personal view. 666 41

The therapeutic objectives for irritable bowel syndrome (IBS) patients are to improve their functioning in society. Accordingly, recommended management is to develop a logical strategy including a positive diagnosis, consideration of the patient's agenda and emotional state, critical appraisal of the efficacies of various drugs and a graded therapeutic response. Unfortunately, none of the currently available drugs (e.g. antispasmodics, antidiarrheals, osmotics, cathartics, bulking agents, tranquilizers, sedatives) are globally effective in treating all IBS symptoms, and the advanced receptor-targeted drugs are not always successfully and safely marketed. Consequently, more than half of patients may seek complementary and alternative medicine (CAM) to treat the annoying bowel symptoms. Physicians have considered these CAM measures to have an "enhanced placebo effect". For example, many herbal medicine and plant products are globally used to treat IBS, whereas their efficacies are often inconclusive because of small sample sizes, inadequate data analyses and lack of standardized preparations. Meta-analyses do not establish their true efficacy. Acupuncture has long been employed by patients themselves to treat functional gastrointestinal disorders with satisfactory response, but its effect on IBS does not seem to be promising. Peppermint oil, melatonin and clay-like materials are effective in treating some IBS symptoms, while their true pharmacology remains enigmatic. In conclusion, IBS treatment is usually tailored to the individual's manifestations, ranging from reassurance to psychotherapy. Apart from conventional medications, CAM may be considered individually as a supplement or alternative to treat IBS patients that is at least equal in effect to placebo if patients do not exhibit any intolerable or serious side effects.
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PMID:Treatment of irritable bowel syndrome using complementary and alternative medicine. 1954 64