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

Many women report that bowel symptoms are associated with menstruation, but neither the prevalence of these complaints nor their physiological basis is known. This study aimed to estimate prevalence, to determine whether patients with irritable bowel syndrome are more likely to make such complaints, and to determine whether bowel complaints during menstruation are attributable to psychological traits such as increased somatization. To estimate prevalence, 369 clients of Planned Parenthood of Maryland were asked whether gas, diarrhea, or constipation occurred during menstruation. These subjects were compared with women referred to a gastroenterology clinic and found to have irritable bowel syndrome or functional bowel disorder (abdominal pain plus altered bowel habits but not satisfying restrictive criteria for irritable bowel syndrome). Thirty-four percent of 233 Planned Parenthood clients who denied symptoms of irritable bowel syndrome or functional bowel disorder reported that menstruation was associated with one or more bowel symptoms. Gastroenterology clinic patients with irritable bowel syndrome were significantly more likely to experience exacerbations of each of these bowel symptoms, but especially increased bowel gas. Self-reports of bowel symptoms during menstruation were not associated with psychological traits or with menses-related changes in affect.
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PMID:Evidence for exacerbation of irritable bowel syndrome during menses. 233 90

Anorectal manometry with balloon distension was performed on 28 patients with diarrhoea predominant irritable bowel syndrome, 27 patients with constipation predominant irritable bowel syndrome and 30 normal controls. In the diarrhoea predominant group balloon volumes required to perceive the sensations of gas, stool, urgency of defecation and discomfort were significantly lower than in controls or constipation predominant patients (p less than 0.001). Diarrhoea predominant patients also had a significantly lower rectal compliance than controls or constipation predominant patients (p less than 0.03) but showed no difference in motor activity induced by distension. When the constipation predominant patients were compared with controls the only significant difference that emerged was in the volume at which discomfort was perceived. No significant differences between constipated subjects and controls were found in the distension induced motor activity. Symptom severity and psychological parameters were also recorded and the diarrhoea predominant patients were found to be more anxious than those with constipation (p = 0.04). It proved possible (by comparison with the control group) to identify three abnormal rectal subtypes in patients with irritable bowel syndrome. These were a sensitive rectum (low sensation thresholds, normal or low rectal pressure), a stiff rectum (normal or low sensation thresholds, high pressure) and an insensitive rectum (high sensation thresholds, normal or high pressure) and their distribution varied considerably depending on bowel habit. Some form of rectal abnormality was identified in 75% of diarrhoea predominant patients compared with 30% of constipation predominant subjects (p = 0.002). A sensitive rectum was a particular feature of diarrhoea predominant patients being observed in 57% of patients compared with only 7% of the constipated group (p less than 0.001).
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PMID:Anorectal manometry in irritable bowel syndrome: differences between diarrhoea and constipation predominant subjects. 233 74

The importance of personality traits in nonulcer dyspepsia and irritable bowel syndrome is a controversial issue. We wished to assess the distribution of abnormal personality traits in nonulcer dyspepsia and the irritable bowel syndrome, define any relation among personality and symptoms, and determine whether personality factors discriminate among patients with functional, psychiatric, or organic gastrointestinal diseases. Patients with nonulcer dyspepsia (n = 31), irritable bowel syndrome (n = 67), organic gastrointestinal disease (n = 64), somatoform disorder (n = 36) and healthy controls (n = 128) were studied. Before diagnostic evaluation by an independent physician, all patients completed the Minnesota Multiphasic Personality Inventory and a symptom questionnaire. Symptom scores for abdominal pain and the Manning criteria, which is considered to be diagnostic for the irritable bowel syndrome, were evaluated. Personality scales in patients with nonulcer dyspepsia, irritable bowel syndrome, and organic disease were very similar. However, patients in the other groups differed from somatoform disorder on nearly all scales. In nonulcer dyspepsia, irritable bowel syndrome, and organic disease, hypochondriasis weakly correlated with pain. Subgroups of irritable bowel syndrome patients with predominant constipation and those with predominant diarrhea had similar personality traits, although hypomania was minimally increased in constipation. Patients who fulfilled the Manning criteria for irritable bowel syndrome had more psychological distress than those who did not. The Minnesota Multiphasic Personality Inventory correctly classified somatoform disorder and health 81% and 75% of the time, respectively, but it classified nonulcer dyspepsia and irritable bowel syndrome correctly in only 32% and 34% of cases. Our results suggest that psychopathology may not be the major explanation for functional gastrointestinal disorders.
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PMID:Relation among personality and symptoms in nonulcer dyspepsia and the irritable bowel syndrome. 200 21

Fifteen patients with the irritable bowel syndrome were studied to assess the effect of hypnotherapy on anorectal physiology. In comparison with a control group of 15 patients who received no hypnotherapy significant changes in rectal sensitivity were found in patients with diarrhoea-predominant irritable bowel syndrome both after a course of hypnotherapy and during a session of hypnosis (p less than 0.05). Although patient numbers were small, a trend towards normalisation of rectal sensitivity was also observed in patients with constipation-predominant irritable bowel syndrome. No changes in rectal compliance or distension-induced motor activity occurred in either subgroup nor were any changes in somatic pain thresholds observed. The results suggest that symptomatic improvement in irritable bowel syndrome after hypnotherapy may in part be due to changes in visceral sensitivity.
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PMID:Changes in rectal sensitivity after hypnotherapy in patients with irritable bowel syndrome. 238 13

In this study, gut functioning and the prevalence of functional bowel disorders among a Wellington community sample of 285 apparently healthy people was estimated using a standardised questionnaire. When asked for their opinion of their bowel functioning generally, 37% of respondents were satisfied that it was always normal, 57.2% regarded it as not always normal, and 5.6% felt it was normal less than half the time or not normal at all. However, only 11.6% had actually consulted a physician about a stomach or bowel disorder in the past year. Average bowel frequency was 8.4 movements per week (SD = 3.9) for the total sample. Approximately three quarters of the total sample had experienced diarrhoea at least occasionally, but only 2.5% half the movements or more often. Constipation was reported by 8.1% for half the time or more, and 1.8% for most bowel movements. Abdominal distension was experienced by 7.2% on half of days or more, and 3.6% on most days or daily. Abdominal pain occuring on six or more separate days in the previous year was reported by 26.4% of men and 31.9% of women. Pain not due to organic disorders that was colonic in nature and of the irritable bowel syndrome type was reported by 15.9% of men and 17.2% of women.
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PMID:Functional gastrointestinal symptoms in a Wellington community sample. 239 67

The aim of this study was to correlate colonic motility and transit in patients with constipation and symptoms of the irritable bowel syndrome. Studies were performed in 16 patients with constipation and compared with the results in 12 healthy subjects. Intraluminal pressure was measured with perfused catheter ports in the transverse colon, splenic flexure, and descending and sigmoid colon. Movement of the luminal contents was measured by following the movement of Technetium-99m-DTPA that was instilled as a bolus in the splenic flexure. In both healthy subjects and patients with constipation there was no movement of the intraluminal tracer and no increase in intraluminal pressure during fasting. After eating a meal, healthy subjects and one group of the constipated patients had an increase in the radioactive marker in the transverse colon (p less than 0.03) and in the sigmoid colon (p less than 0.03). The movement of the intraluminal contents was associated with a positive pressure gradient between the descending colon and the transverse and sigmoid colon. There was no retrograde movement of the intraluminal contents and no postprandial increase in intraluminal pressure in the second group of patients with constipation. In healthy subjects, propagating contractions, which were associated with the rapid movement of intraluminal contents, began 60 min after eating. There were no propagating contractions in patients with constipation. These studies suggest that (a) the movement of intraluminal contents in healthy and constipated patients is determined by the postprandial pressure gradients within the colon, and (b) the propagating contraction is necessary for a normal bowel habit.
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PMID:Postprandial colonic transit and motor activity in chronic constipation. 240 26

Cimetropium bromide is a new antimuscarinic compound with strong antispasmodic activity. The aim of this study was to evaluate the effects of oral cimetropium bromide on total gut transit time in patients with irritable bowel syndrome. Forty patients, divided according to their initial total gastrointestinal transit times and presenting symptoms, were treated with cimetropium bromide 50 mg t.d.s. or placebo for 1 month according to a double-blind, parallel group design. Before and after treatment all subjects ingested 24 radio-opaque markers. The total intestinal transit time was determined by evaluating the rate of disappearance of markers from plain X-ray films of the abdomen taken every 24 h for 4 days. Pain and bowel habits were also monitored. Seven patients did not complete the study. Cimetropium bromide significantly (P less than 0.01) shortened the whole gut transit time in patients with prolonged transit time (80.8 +/- 4.0 h before vs 60.8 +/- 6.7 h after treatment) and improved the global clinical condition significantly compared with placebo (P = 0.029). In patients with a short total intestinal transit time, cimetropium bromide had no effect on whole gut transit time and did not significantly improve symptoms. The results of this study indicate that oral cimetropium bromide is effective both objectively and subjectively in a subgroup of irritable bowel syndrome patients with constipation.
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PMID:Effects of cimetropium bromide on gastrointestinal transit time in patients with irritable bowel syndrome. 252 Jun 22

The importance of colonic motility disorders in the irritable bowel syndrome is now well accepted, but an accurate description of these abnormalities is still wanting. The insufficiency of investigational methods and, mainly, the heterogeneity of the disorders can explain this need. Twenty-four hour recordings of colonic myoelectrical activity can now provide a better knowledge of motor disturbances. No evidence of a specific basic disorder has been presented, and the effects of stress produce contradictory results depending on the method used. In contrast, motility patterns recorded during sleep and after a meal show segmental hyperactivity in painful constipation, abnormalities of the colonic response to feeding in painful abdominal distension, propulsive hyperactivity with absence or reduction of the "sigmoidal brake" in painless diarrhea. However, it appears clearly that myoelectrical activity disturbances can only be observed in two thirds of the patients presenting with functional digestive disorders. "Sensitivity" or personality disorders and disturbances of other organs can explain the physiopathology of "irritable bowels" where no evidence can be found that the colon is involved.
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PMID:[Colonic motility and irritable colon]. 252 24

Spastic colon is a pathological entity whose clinical symptoms are for the most part abdominal pain, constipation and episodes of diarrhea without loss of weight. In all probability, it is merely a particularly striking presentation of a GI tract that is irritable throughout its entirety. The pathophysiological basis is a disordered propulsive bowel motoricity. Etiologically, psychological factors in the presence of an appropriate genetic or acquired disposition are conceivable. Possible mediators are considered to be noradrenalin, beta-endorphin and the corticotropin-releasing factor. The diagnosis can be established with a high degree of probability on the basis of the characteristic clinical picture. A definitive diagnosis, however, requires the very careful exclusion of other possible diagnoses. Therapy includes talks with the patient, physical and dietetic measures and the use of drugs to ameliorate diarrhea or, in the case of prokinetic agents, to re-establish normal propulsive bowel activity.
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PMID:[Spastic colon (irritable colon)]. 252 95

Irritable bowel syndrome is characterized by bowel irregularity (constipation and/or diarrhea), gaseous distention and abdominal pain. Symptoms usually occur in response to various biological and environmental factors. The diagnosis is made by identifying certain clinical features in association with a negative medical evaluation. Since specific treatment is not available, the patient must be helped to adapt to this chronic or recurrent disorder.
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PMID:Irritable bowel syndrome. 254 95


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