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

Chronic idiopathic constipation is defined as the emission of less than 3 stools per week. Beside signs evoking a severe form (Hirschsprung's disease, idiopathic megacolon), a treatment with bran, at a dose of 20 grams per day, is instituted right away, which cures almost 60% of the patients (constipation secondary to dietetic errors). If this is not the case, the study of the colonic transit time of markers, anorectal manometry, defecation radiographs, enables to recognize various etiological forms (colonic inertia, irritable colon, anism, descending perineum, etc...) which require a specific treatment.
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PMID:[Constipation--a new approach]. 282 71

Constipation is a symptom of various diseases that must be differentiated in the diagnostic work-up of the patient. Most frequently however, no structural abnormalities can be identified and constipation is part of the irritable colon syndrome. A diet deficient in bulk is the main cause of constipation in western countries. As the complaints usually last for years before a physician is consulted many patients are chronically abusing laxatives. Therefore treatment is difficult and behavioral modifications of the patient are not easily achieved. He should learn that laxatives do not "clean" the bowel and that it functions normally even if there is not "one stool a day". Although there are many laxatives that can be prescribed usefully for a short time, for long term treatment only bulk forming agents and dietary fiber supplementation are recommended.
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PMID:[Constipation]. 282 45

This review examines the evidence linking dietary fibre to gastrointestinal disease. Fibre increases stool weight, decreases whole gut transit time and lowers colonic intraluminal pressure. While it may be of benefit in the treatment of constipation, the irritable bowel syndrome and diverticular disease, its role in the prevention or treatment of other gastrointestinal disease has yet to be established.
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PMID:Dietary fibre and gastrointestinal disease. 284 Jan 68

Twenty patients suffering from irritable bowel syndrome, 14 patients with pain and constipation and 6 patients with pain and diarrhoea, were studied in order to: a) Evaluate the symptomatic response to a Plantago Ovatae fiber medicine. b) Study with radio-opaque markers the colonic transit modifications that could explain the therapeutic responses. There were observed the following results: 1) Pain decreased or disappeared in 80% of the patients. 2) Constipation decreased or disappeared in 78.6% of the patients. 3) Diarrhoea decreased or disappeared in 5 of the 6 patients that were studied. 4) There was a significative increase of the feces weight without changes of the dry residue. 5) Taking all the patients as a whole the number of the retained radio-opaque markers was the same before and after the active treatment. If we evaluate the patients with constipation and the patients with diarrhoea separately the first group shows an acceleration of the colonic transit (fewer retained markers) and the second group shows a decrease of the colonic transit (more retained markers). We draw the conclusion that the Plantago Ovatae fiber regulates or moderates the colon motility and enables a physiological balance of the colonic transit.
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PMID:[Effects of medicinal fiber on colonic transit in patients with irritable colon syndrome]. 284 50

Prifinium bromide, an anticholinergic agent, was given to patients with irritable bowel syndrome in an open trial to evaluate the drug's clinical efficacy. The trial lasted four weeks, although two of the 40 patients were treated for only two weeks. Prifinium bromide was judged beneficial in 28 patients (70%), slightly beneficial in six (15%), and not beneficial in six (15%). One case of moderate constipation was the only side effect encountered. In conclusion, prifinium bromide is considered a valuable drug for the management of irritable bowel syndrome.
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PMID:Treatment of irritable bowel syndrome with prifinium bromide. 285 17

An open clinical trial with prifinium bromide, an anticholinergic agent, was carried out in 21 patients with irritable bowel syndrome showing clear psychosomatic characteristics. The clinical efficacy was evaluated by comparing the symptomatic severity before, during, and after treatment with prifinium bromide, 90 mg/day for four weeks. Of these 21 patients, 18 patients were allowed to take antacids or lactobacillus preparations concomitantly only when necessary. As a result, marked or moderate improvement in symptoms such as diarrhea and constipation was seen in 43% after two weeks and 86% after four weeks. Prifinium bromide's efficacy in the treatment of abnormal bowel movements was most evident in patients with diarrhea and slightly less evident in patients with alternation of diarrhea and constipation, and in constipated patients. Side effects attributable to the drug were encountered in four (19%) of the patients. None were serious enough to require that use of the drug be discontinued. All laboratory test values were within normal ranges before and after therapy. Overall, prifinium bromide was judged to be useful in 14 (67%) of the 21 patients studied.
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PMID:Results of prifinium bromide therapy in irritable bowel syndrome. 286

To establish the short-term and long-term results of current treatment of irritable bowel syndrome (IBS), 104 patients were studied prospectively. All patients were treated similarly and the results were assessed after a few weeks and then after at least 5 years. IBS can be diagnosed more easily than has been suggested--72% of this series were correctly diagnosed by their referring doctor, and only 12% required radiological studies to exclude organic disease. The response to treatment was considerably better than expected, possibly because of the more aggressive use of high-fibre diets and bulking agents. Thus, 85% of patients were rendered virtually symptom-free in the short term, and 68% were still virtually symptom-free 5 years later. The response to treatment was better in men than in women, in those with constipation than with diarrhoea, when the symptoms had initially been triggered by an episode of acute diarrhoea, and in patients with a relatively short history. With a few simple investigations, sympathetic explanation, and appropriate treatment, most patients with IBS have a good prognosis.
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PMID:Prognosis in the irritable bowel syndrome: a 5-year prospective study. 288 51

Dietary supplementation with wheat bran has been widely advocated as a first-line treatment of patients with the irritable bowel syndrome (IBS). Few controlled trials have been reported, and the results are, furthermore, contradictory. The present study comprised 20 patients with IBS, of whom 18 (14 women, 4 men) completed the trial. The two treatment periods of 6 weeks each, with a daily intake of 30 g coarse wheat bran or 30 g placebo bran, respectively, were randomized in a double-blind cross-over design. Wheat bran significantly (P less than 0.05) increased the stool weight and shortened the intestinal transit time but was without significant effect on the colonic motility index was shown. We conclude that coarse wheat bran used as the only treatment in IBS does not provide a sufficient effect in a 6-week period. However, wheat bran seems to be justified in the treatment of constipation.
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PMID:The effect of coarse wheat bran in the irritable bowel syndrome. A double-blind cross-over study. 298 7

Changes in diet from ancient times until the present are described. Previously relatively low in energy and animal products yet high in fibre-containing foods, diets are now high in energy and animal products (particularly fat), yet contain less fibre. The changing incidences of bowel disorders and diseases are described, with assessments of the role of diet. Clearly, diet is implicated as regards predisposition to constipation, appendicitis, colorectal cancer and diverticular disease; however, a meaningful dietary role in irritable bowel syndrome, ulcerative colitis and Crohn's disease is doubtful. In South Africa the rarity of bowel diseases in rural blacks compared with whites affords valuable aetiological information about some bowel diseases. The low occurrence thereof (except inflammatory bowel disease) in Indian and coloured populations is not readily explicable. While dietary changes in whites are being widely urged in order to combat degenerative diseases, the magnitude of changes made is unlikely to reduce the occurrence of bowel diseases. The progressive westernization of the diets and lifestyles of less-privileged populations is likely to be associated with increases in the incidences of these diseases.
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PMID:Diet and bowel diseases--past history and future prospects. 299 4

Few drugs are of proven efficacy in irritable bowel syndrome. Bulking agents probably relieve constipation, spasmolytics may alleviate pain and antidiarrhoeals help control urgency and diarrhoea. With a combination of reassurance and therapeutic intervention up to 75% of patients can be expected to improve. For the 25% who do not, alternative therapies such as stress management, psychotherapy or hypnotherapy may prove effective.
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PMID:Management of irritable bowel syndrome. 301 Nov 42


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