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

Previous research has demonstrated a number of conditions, such as sleep disturbance, fatigue, depression, spastic colon and mitral valve prolapse, associated with fibromyalgia. The present report describes additional symptoms and medical conditions that appear to be associated with the syndrome based on a survey of 554 individuals with fibromyalgia compared with a group of 169 controls. Individuals with fibromyalgia self report a greater incidence of bursitis, chondromalacia, constipation, diarrhea, temporomandibular joint dysfunction, vertigo, sinus and thyroid problems. Symptomatic complaints found statistically more prevalent in fibromyalgia patients included concentration problems, sensory symptoms, swollen glands and tinnitus. Other associations occurring with significant increased frequency were chronic cough, coccygeal and pelvic pain, tachycardia and weakness. Our previous report on inheritance patterns in fibromyalgia was reaffirmed with 12% reporting symptomatic children and 25% reporting symptomatic parents. Of the respondents, 70% noted that their symptoms were aggravated by noise, lights, stress, posture and weather.
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PMID:Fibromyalgia syndrome. New associations. 146 72

In this article, we review the currently available techniques for measuring small intestinal and colonic transit. In addition, we describe the characteristics of an ideal test that provided the rationale for the development and validation of a gastrointestinal and colonic transit test at the Mayo Clinic. This new technique assesses regional transit of solid radiolabeled particles of the same size through the entire digestive tract and provides further insights into motor physiologic processes of the gut. By means of a delayed-release methacrylate-coated capsule, isotopically labeled pellets are delivered to the colon as a single bolus; thereby, dispersion of isotope throughout the small bowel is avoided because of the gradual emptying of chyme from the stomach. Similar pellets labeled with a different isotope can be used to assess gastric and small bowel transit. These new methods for measuring transit have also led to insights into the pathogenesis of unexplained gastrointestinal symptoms and disease states. Thus, we demonstrated that in healthy subjects, ileocolonic transfer of chyme occurs in boluses; this transfer is impaired in patients with myopathic pseudo-obstruction. The emptying rate of the proximal colon is an important determinant of the pathophysiologic features of colonic disease; thus, colonic transit is delayed in cases of severe idiopathic constipation. In contrast, rapid emptying of the proximal colon influences stool weight in diarrhea-predominant irritable bowel syndrome. An integrated approach for studying gastric, small bowel, and colonic transit by using the same radiolabeled particle provides a useful, clinically applicable method for evaluating gastrointestinal symptoms and for measuring motor function of the entire digestive tract without need for intubation; cost and radiation exposure are acceptable.
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PMID:Measurement of small bowel and colonic transit: indications and methods. 146 28

Irritable bowel syndrome, constipation, and diarrhea may complicate a pregnancy. Complaints of IBS and constipation may be managed by nonpharmaceutical methods. A careful history should be conducted to determine whether these complaints are of an acute or a long-standing nature. Conservative treatment of IBS is recommended and may include stool-bulking agents, a high-fiber diet, elimination of offensive foods, and the behavioral treatment of passive muscle relaxation, biofeedback or supportive psychotherapy. Constipation is generally self-limiting. It also may be treated conservatively with stool-bulking agents, increases in dietary fiber, and the addition of pelvic muscle exercises, preferably using electromyographic biofeedback. Laxatives should be used judiciously (Table 1). Diarrhea is caused most often by infectious agents in pregnancy but may also be from food poisoning or a viral disease. Infectious diarrhea may be treated by mild antidiarrheal agents and safe antibiotics. Fluid replacement is the mainstay of treatment, and care should be taken, remembering that the treatment involves two patients. These complaints can generally be managed conservatively, but persistent cases should be investigated as in a nonpregnant patient.
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PMID:Diagnosis and management of irritable bowel syndrome, constipation, and diarrhea in pregnancy. 147 35

The prevalence of chronic gastrointestinal symptoms and the irritable bowel syndrome (IBS) in the elderly, and their impact on health, is largely unknown. The prevalence of symptoms compatible with IBS was estimated in a representative sample of elderly community residents, and the impact of these symptoms was determined on presentation for health care. An age- and sex-stratified random sample of noninstitutionalized Olmsted County, Minnesota, residents aged 65-93 years were mailed a valid questionnaire; 77% responded (n = 328). The age- and sex-adjusted prevalence (per 100 persons) of frequent abdominal pain was 24.3 [95% confidence interval (CI), 19.3-29.2]. Chronic constipation and chronic diarrhea had prevalences of 24.1 (95% CI, 19.1-29.0) and 14.2 (95% CI, 10.1-18.2), respectively. Fecal incontinence more than once a week was reported in 3.7 per 100 (95% CI, 1.6-5.9). The prevalence of symptoms compatible with IBS (greater than or equal to 3 Manning criteria with frequent abdominal pain) was 10.9 per 100 (95% CI, 7.2-14.6). Among the subjects sampled who had abdominal pain, chronic constipation, and/or chronic diarrhea (n = 152), only 23% had seen a physician for pain or disturbed defecation in the prior year, and this behavior was poorly explained by the symptoms. It is concluded that complaints consistent with functional gastrointestinal disorders are common in the elderly, but symptoms are a poor predictor of presentation for medical care.
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PMID:Prevalence of gastrointestinal symptoms in the elderly: a population-based study. 153 25

One hundred and nine distance runners participated in a questionnaire survey of bowel function related to running. Thirteen (12%) had had fecal incontinence while running. Sixty-eight (62%) had stopped to have a bowel movement while training. Forty-seven (43%) had "nervous" diarrhea before competition and 13 (12%) had stopped during competition for a bowel movement. Fifty-one (47%) had experienced diarrhea after racing or hard runs and 17 (16%) had seen blood in their stool in the same situations. Runners who had nervous diarrhea before competition were more likely to have symptoms of milk intolerance and irregular bowel function when not exercising, and runners who had symptoms of the irritable bowel syndrome often had to stop for a bowel movement during training. Runners with diarrhea after racing or hard runs frequently experienced severe abdominal cramps, nausea and vomiting, and occasionally, rectal bleeding at the same time. Any form of "runners' diarrhea" was unrelated to age, previous intestinal infection or food poisoning, food allergies, or dietary fiber.
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PMID:Runners' diarrhea. Different patterns and associated factors. 155 21

We examined gallbladder motility function after intramuscular injection of caerulein (0.2 micrograms/kg) to the cases of irritable bowel syndrome (IBS) by using ultrasonography. We measured gallbladder area pre and after caerulein injection (0' 5' 10' 15' 20' 25' 30' 40' 50' 60') and calculated contraction rate of gallbladder in each time. We applied one way analysis of variance among the four groups [diarrhea group (N = 9), alternative group (N = 8), constipation group (N = 8), control group (N = 15)]. Gallbladder contraction rate was low in diarrhea group and high in constipation group (p less than 0.05). And then we classified gallbladder contraction pattern to three groups (hyperkinetic, intermediate, hypokinetic). These three groups correlated bowel habits and biliary knocked pain. Therefore, constipation group showed hyperkinetic tendency and diarrhea group showed hypokinetic tendency (chi 2 analysis: p = 0.004 CMH analysis: p = 0.001). And biliary knocked pain significantly appeared in constipation group and hyperkinetic type of gallbladder (chi 2 analysis: p = 0.026, CMH analysis: p = 0.019). Consequently, it was suggested that bowel habits concerned with abnormality of gallbladder motility function in IBS.
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PMID:[A study of the dynamics of gallbladder contraction in irritable bowel syndrome]. 159 76

An unusual pattern of eosinophilic infiltration around intestinal crypts was detected in mucosal biopsy specimens of 10 patients with chronic diarrhea, half of whom had evidence of systemic connective tissue disease. The median duration of symptoms was 11 months, and no other explanation for diarrhea could be determined in any case. The cellular infiltrate on biopsy specimens was present deep in the mucosa of small and large intestinal specimens, separating crypt bases from the muscularis mucosae and penetrating the latter. Consistent with the microscopic findings, surface mucosal appearance by endoscopy was uniformly normal. These histological features of colonic biopsy specimens were statistically differentiated from those of asymptomatic subjects (n = 8), subjects with diarrhea-predominant irritable bowel syndrome (n = 6), and subjects with collagenous colitis (n = 7) or lymphocytic colitis (n = 5). Diarrhea improved in five of seven subjects treated with oral prednisone or prednisone in conjunction with azathioprine (median follow-up period, 2.2 years). Histological changes on subsequent biopsy specimens correlated closely with symptomatic status. These findings strongly suggest that chronic diarrhea is related to this pericrypt eosinophilic enterocolitis, a pathological lesion often associated with features of systemic connective tissue disease. The disorder appears responsive to corticosteroid therapy in some cases.
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PMID:Pericrypt eosinophilic enterocolitis and chronic diarrhea. 161 24

Currently available clinical tests of colonic transit, such as the radiopaque marker method, are useful to detect delayed transit but may be less sensitive for rapid transit. The aim of this study was to develop a relatively inexpensive, noninvasive, accurate test of colonic transit using selected scintigraphic observations within the first 24 hours after ingestion of a pH-sensitive, methacrylate-coated, delayed-release capsule containing 111In-labeled resin pellets. The authors' previously published colonic transit data on 22 healthy subjects, 9 patients with diarrhea-predominant irritable bowel syndrome, and 7 patients with idiopathic constipation and previously unpublished data on 4 patients with carcinoid diarrhea were analyzed. A logistic discriminant analysis was used to estimate the sensitivity and specificity of selected combinations or simple summaries of transit. Among combined transit summaries, the emptying rate of the proximal colon was significantly different between healthy and constipation groups; the geometric center of isotope in the colon at 4 hours was significantly greater in the diarrhea group than in healthy controls; the geometric center at 24 hours was significantly lower in the constipation group than in the other two groups. From the logistic discriminant analysis, simple summaries of transit also had significant discriminant value; these included the isotopic contents in the ascending, transverse, and descending colon at 4 hours and the counts in the ascending and transverse colon and stool at 24 hours. At 90% sensitivity, the specificity of the transverse colon counts at 4 hours was 79%, which is identical to the specificity of the proximal colon emptying rate, both adjusted for age. Thus, quantitation of isotopic counts in colonic regions on scans taken at 4 and 24 hours provides an accurate summary of colonic transit, with acceptable specificity at a high sensitivity in the detection of motility disorders of the colon.
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PMID:Towards a relatively inexpensive, noninvasive, accurate test for colonic motility disorders. 161 55

The use of oral non-steroidal anti-inflammatory drugs (NSAIDs) in 31 patients with collagenous colitis and in 31 matched control patients with irritable bowel syndrome or colonic diverticular disease who had also undergone colonoscopy and biopsy was investigated. The long term use (greater than 6 months) of NSAIDs was significantly commoner in the study group (19/31) than in the control group (4/31) (p less than 0.02), even assuming the most adverse drug history in six patients in whom this could not be established. In all patients with collagenous colitis taking NSAIDs, diarrhoea followed the use of these drugs, and by a mean (SD) of 5.5 (4.4) years (range 0.5 to 15 years). In three patients with collagenous colitis, diarrhoea improved after withdrawing NSAIDs; rechallenge in one was followed by a recurrence of diarrhoea, which improved after withdrawing the drug again. It is suggested that NSAIDs may play an aetiological role in the diarrhoea and thickened collagen band in some patients with collagenous colitis.
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PMID:Non-steroidal anti-inflammatory drugs as a possible cause of collagenous colitis: a case-control study. 161 88

The major aims of medical therapy in irritable bowel syndrome (IBS) are: a) to ameliorate symptoms (pain, bowel movement abnormalities, bloating) and b) to improve psychological problems of the patients. The first step of IBS therapy is the diet. In fact some forms of IBS can be ascribed to food intolerance. When abdominal pain, meteorism and constipation are the main symptoms, treatment with high-fiber diet, antispastic and antimuscarinic drugs is indicated. Sometimes amitriptyline, an antidepressant which also shows anticholinergic and analgesic properties, can be helpful. When diarrhoea is prevalent, the most effective drug is represented by loperamide. If diarrhoea is related to meal ingestion, antispastic or antimuscarinic drugs can be successfully used. In the case of diarrhoea related to documented cholorrhoea, cholestyramine can be of benefit. Furthermore, there are some resistant cases, secondary to striking psychological problems that require sedatives and antidepressant drugs and sometimes, psycho and/or hypnotherapy.
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PMID:Therapeutic strategy for the irritable bowel syndrome. 166 28


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