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

Patients with the irritable bowel syndrome (IBS) often have symptoms from both proximal and distal parts of the gut. Motility disturbances have been reported to occur from the esophagus to the distal colon in IBS patients. The patients often have a decreased lower esophageal sphincter pressure and various abnormalities of esophageal peristalsis. Mean transit time in the small intestine after a meal is short in patients with diarrhoea, and long in patients with constipation and pain compared with normals. IBS patients also show abnormalities of the interdigestive MMC, particularly when exposed to stressful stimuli. Previous studies of the colonic oscillating control potential suggested an increased prevalence of 3/min. slow waves in IBS patients compared with normals, but later studies could not confirm this. Long time measurements with multiple electrodes along the colon show a high prevalence of short-lasting segmental contractions in constipated patients, while both short and long-lasting contractions are decreased in painless diarrhoea. Rectal recordings in IBS patients have shown an increased contractile response up to 3 hrs after a meal. --The disturbed gut motility in IBS patients seems to be due no neural influences rather than strictly myogenic factors.
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PMID:Gastrointestinal motility in patients with the irritable bowel syndrome. 347 13

Recent years have seen a number of studies measuring electrical activities of the human colon muscle layers. In vitro studies have enhanced our understanding of myogenic control of colon motility. In vivo studies have suggested a relationship between patterns of electrical activities and the transport of colon contents. This chapter describes the patterns of electrical and motor activity that the human colon can perform depending on the nature and intensity of the stimulus, using recent in vitro and in vivo data. In vitro studies with human tissue have shown differences between the electrical activity of the longitudinal and circular muscles. They have also revealed the unique nature of the electrical control activity of the circular muscle of human colon. The electrical oscillatory activity of this layer is variable in frequency from 1 to 60 cpm, variable in amplitude, and not omnipresent. Furthermore, the activity is sensitive to stretch and markedly altered by excitatory and inhibitory substances. In vivo data, especially spike action potential recordings for 24 h, have revealed patterns of electrical activity related to intake of meals, sleep, and also constipation. The limitations of some intraluminal techniques to record electrical activity are discussed. Further studies are needed to accurately relate in vivo activities to cellular events recorded in vitro, and to relate these to altered patterns of activity in disease. The suggestion is made that a relevant in vivo assessment of the colonic motility of a patient can only be achieved by long-lasting (24-h) studies, because of the large variability in the hour-to-hour colonic activity. Timing of experimental drug intervention is important since colonic motility undergoes diurnal changes. Recent studies into profiles of electrical and motor activity in irritable bowel syndrome (IBS) suggest that there is not a typical IBS myogenic activity. Rather, patterns of electrical activity can be related to the symptoms of IBS: diarrhea and constipation. Recent electrophysiologic data on Hirschsprung's disease reveal absence of intrinsic inhibitory innervation in the aganglionic segment. In vitro studies on tissue from diverticular disease patients show abnormal myogenic activity.
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PMID:Electrophysiology of human colon motility in health and disease. 353 12

Antidepressant treatment trials of irritable bowel syndrome (IBS) have suggested beneficial effects. Twenty-eight patients with the disorder (9 constipation-predominant, 19 diarrhea-predominant) completed a double-blind crossover study using desipramine, atropine, and placebo in random sequence. A four-week observation period preceded three six-week test periods. Bowel habits, abdominal distress, and affect were reported daily and in biweekly evaluations. Psychological assessments and rectosigmoid contractile studies were done in each period. Stool frequency, diarrhea, abdominal pain, depression, and slow contractions decreased significantly more in diarrhea-predominant patients during desipramine compared with placebo and atropine treatments. Diarrhea-prone patients' depression scores fell more in all periods than constipation-prone patients. Fifteen patients (13 diarrhea-predominant) improved globally during desipramine, five during placebo and six during atropine treatments. Desipramine may be helpful in treating IBS, perhaps through antidepressant and antimuscarinic effects.
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PMID:Effects of desipramine on irritable bowel syndrome compared with atropine and placebo. 354 19

The pathogenesis of irritable bowel syndrome (IBS) has been related more to dysmotility of the colon than to abnormalities of the small intestine. To look for small bowel abnormalities, we recorded ultraluminal pressures in 16 patients with IBS. All patients complained of abdominal pain, and diarrhea (n = 8) or constipation (n = 8) were also prominent symptoms. Comparable studies were performed on 16 age-matched controls. The observations include diurnal and nocturnal fasting recordings and the response to a fatty meal. Periodicities of the interdigestive migrating myoelectric complexes were shorter in IBS (p less than 0.05); this was due to much shorter diurnal cycles in patients with diarrhea (77 +/- 10 min) than those with constipation (118 +/- 15 min) or controls (113 +/- 10 min, both p less than 0.05). All groups exhibited circadian changes, with nocturnal cycles being more frequent. Two specific patterns of small bowel motor activity were more common in IBS--ileal propulsive waves and clusters of jejunal pressure activity (both p less than 0.05 compared to controls). Moreover, cramping abdominal pain was usually noted in IBS when ileal motility was propulsive; jejunal bursts were also sometimes associated with abdominal symptoms. We conclude that motility of the small intestine is modified in some patients with IBS and that certain motor patterns are related to their symptoms.
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PMID:Altered small bowel motility in irritable bowel syndrome is correlated with symptoms. 356 64

We studied 149 healthy children at 22 months of age and 74 at 40 months of age, employing a 24-hour dietary record based on premailed food measurement guide and telephone questionnaire. Parents cooperated in 94% of contacts. Chronic digestive complaints decreased from 27% to 5% of the sample over the study period: constipation from 16% to 3%, chronic diarrhea from 8% to 1%, and abdominal pain from 5% to 1%. Excessive fluid intake (1470 +/- 600 vs 840 +/- 300 mL/d) correlated most strongly for seven children at 22 months experiencing alternating symptoms of chronic diarrhea and constipation or abdominal pain. Many other children tolerated dietary extremes without complaint. All macronutrient categories except dietary fiber intake increased over the study period. Thus, excessive fluid intake may provoke symptoms suggesting the irritable bowel syndrome in a susceptible group of younger children. Failure to increase fiber intake from 22 to 40 months of age leaves children on an immature diet whose effects require further study.
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PMID:Are chronic digestive complaints the result of abnormal dietary patterns? Diet and digestive complaints in children at 22 and 40 months of age. 357 95

Comparisons were made among patients with IBS (n = 55), tension headache (n = 69), or migraine headache (n = 68) and nonpatient controls (n = 64) on the MMPI and several other psychological tests, including BDI, STAI, Life Events, and Psychosomatic Symptom Checklist. With two nonsignificant exceptions (MMPI scale F and Life Events) the groups were consistently ordered, in terms of increasing psychological distress: Normals less than Migraine Headache less than Tension Headache less than IBS. The IBS patients were more like the tension headache patients than any other group. Subgroups of IBS patients, on the basis of presence or absence of diarrhea or constipation in addition to abdominal pain, were generally not significantly different on the psychological tests.
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PMID:Psychological comparisons of irritable bowel syndrome to chronic tension and migraine headache and nonpatient controls. 360 89

Forty patients with irritable bowel syndrome received an antigen-exclusion diet identical to that previously reported to be highly effective in this condition. Only 15% of the group as a whole showed evidence of food intolerance manifested by an improvement in their irritable bowel symptoms. In a further 12.5% only well-being improved and this did not seem to be related to the exclusion of any particular food. Patients whose bowel dysfunction was characterized by diarrhea responded the best (3/8) whereas those with constipation consistently failed to improve.
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PMID:Exclusion diets in irritable bowel syndrome: are they worthwhile? 368 Sep 1

The irritable bowel syndrome (IBS) is the most common chronic functional gastroenterological disorder both in adults and in children. In this study we evaluate the different aspects of this syndrome, comparing our observations on 332 children with other studies. Epidemiological data (frequency, sex, age) are examined so as the family histories of gastroenterological disorders. We take in account several pathogenic hypotheses, especially with reference to the alterations of gastrointestinal motility, which could be caused by several factors (psychological, prostaglandins, bile acids, etc.). The clinical picture is very variable, variations depending on the age of children and on the time of onset of IBS. The colic of neonate, caused by retention of air, is the main symptom in the first months of life, followed by chronic diarrhoea, also defined as toddler's diarrhoea, sometime alternating with constipation. In later childhood, recurrent abdominal pain represents a common complaint, in association with diarrhoea or constipation. The principal steps for a proper diagnosis so as the main differential diagnosis are defined. We explain the most important features of management (reassuring parents, free diet), excluding prescription of drugs, that produce only a transitory and symptomatic relief, so as elimination diets, that cause only a failure to thrive without any improvement of symptoms.
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PMID:[Irritable bowel syndrome in children]. 369 25

The transit of radiolabelled preparations through the stomach, small intestine and colon was monitored in ten patients with the irritable bowel syndrome. Five patients complained of diarrhoea, and five complained of constipation. The preparations comprised a non-disintegrating capsule and a multiparticulate system. Both preparations emptied from the stomach together and at the same rates in both groups of patients. In the patients complaining of constipation, the transit times through the small intestine were the same for both preparations. In the patients complaining of diarrhoea, the capsule passed through the small intestine slightly faster than the particles, but there were no significant differences in the small-intestinal transit rates of the two patient groups. Within the colon, the transit of the capsule was faster than that of the small particles. Although movement through the colon was, on average, faster in the group of patients complaining of diarrhoea, there was considerable intersubject variability, and the differences in transit rates between the two patient groups were not statistically significant.
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PMID:Whole-bowel transit in patients with the irritable bowel syndrome. 369 63

A method for determining the profiles of gastric emptying, small intestinal residence, and colonic filling of a solid test meal, labelled with 250 microCi 99mTechnetium sulphur colloid has been evaluated in nine healthy volunteers and six patients with a disturbance in bowel habit. Mean small bowel transit time was determined by deconvolving the rate of colonic filling with the rate of gastric emptying. In normal subjects, the stomach appeared to empty exponentially with a half time of 1.2 +/- 0.3 hours (mean +/- SD). Food reached the colon by 2.8 +/- 1.5 hours. The mean small bowel transit time was 4.0 +/- 1.4 hours. In most normal subjects, the colon appeared to fill in a linear fashion with approximately 16% food residues entering every hour, and the profile of colonic filling in normal subjects was similar to the profile of ileal emptying observed after feeding a similar radiolabelled solid meal to 14 patients equipped with terminal ileostomies. There was a highly significant correlation between the onset of breath hydrogen excretion and the appearance of radioactivity over the caecum (r = 0.88, p less than 0.01), though in one third of subjects the increase in caecal radioactivity preceded the rise in breath hydrogen concentration by more than 20 minutes. There was also a highly significant correlation between the mean transit time and values for colonic filling but not values for gastric emptying. Patients with irritable bowel syndrome who had diarrhoea tended towards short small bowel transit and early colonic filling, whereas patients who have constipation tended towards long small bowel transit and delayed colonic filling. This method offers a novel means of assessing small bowel transit time, small bowel residence and the profile of colonic filling in man.
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PMID:Simultaneous measurement of gastric emptying, small bowel residence and colonic filling of a solid meal by the use of the gamma camera. 369 51


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