Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Specific abnormalities of colonic and small bowel motility are identifiable and associated with symptoms in IBS. Characteristic abnormalities in colonic motility include a prolonged increase in 3-cycles/min colonic motor activity after a meal, an exaggerated increase in 3-cycles/min motor activity in response to stressors and CCK, and increased visceral sensitivity and motor activity in response to balloon distention. Symptoms in patients with IBS correlate in some cases with the abnormal gastrocolonic response and with pain induced by distention at various sites in the colon. Small bowel motility abnormalities identified reproducibly in IBS include an increase in daytime jejunal DCCs, an increase in daytime ileal PPCs, and more frequent cycling of daytime MMCs (in diarrhea-predominant IBS only). DCCs and PPCs are strongly associated with symptoms in IBS, and PPCs associated with altered ileocecal transit may be an important mechanism of symptoms in some patients with IBS. Esophageal and gastroduodenal motility abnormalities are inconsistently identified in IBS, and most symptoms in IBS appear to be secondary to small bowel or colonic dysfunction. Because of the paroxysmal nature of these motor abnormalities in IBS, prolonged motility recordings are required to better understand the pathophysiology of this syndrome. Patients with IBS may have altered visceral sensation and changes in afferent reflex mechanisms that modulate GI motility. These patients do not have a generalized increase in pain perception, but may have a distinct sensitivity to visceral afferent stimulation in both gastrointestinal and other viscera. Whether the altered "setpoint" to visceral afferent stimulation in IBS is intrinsic to the smooth muscle of viscera or secondary to CNS and ANS modulation is not known. Many of the symptoms and abnormalities of small bowel and colonic motility in IBS probably result from these changes in afferent sensation and reflex mechanisms. These findings support the concept that IBS is an abnormality of intestinal motility in conjunction with a "sensitive" gut.
 ...
PMID:Motility disorders in the irritable bowel syndrome. 206 53

A retrospective study on the syndrome of chronic diarrhea was carried out on 50 revised clinical histories. The patients were hospitalized at the E. Rebaglati M. Hospital between April 1983 and March 1988. The purpose of the study was to evaluate the signs and symptoms of the syndrome, as well as the etiological agents and the methodology used for diagnoses. The selection criteria involved patients diagnosed as suffering from "chronic diarrhea of undetermined causes" upon entry. Seven were excluded due to incomplete study whereas 2 were diagnosed as acute infections diarrhea. Forty one patients were definite cases of chronic diarrhea and they were divided between 2 groups: the first one or Chronic Organic Diarrhea (58.53%) and the second one or Chronic Functional Diarrhea (41.46%). Out of the 41 revised clinical histories with chronic diarrhea, the following were the foundings: (1) the syndrome affects the economically active populations mainly and the length of the disease was more than 3 weeks in all the patients; (2) anemia, fever, weight loss, nightime bowel movements and bloody stools suggest organic problems whereas psychiatric disorders, daytime bowel movements, abdominal pain, disease recurrence and absence of detectable organic pathology suggest functional problems; (3) the most common cause of chronic diarrhea is the Irritable Bowel Syndrome followed by infectious diseases, with parasitosis in the first place; and (4) bearing in mind the mainly colonic affection and the predominant infectious diseases, the methodology used for their diagnosis would bring out good results.
 ...
PMID:[Chronic diarrhea: clinical aspects]. 213 Oct 3

The D-xylose and triglyceride absorption tests have been widely used as screening tests to characterize malabsorption and indicate intestinal biopsy. In this paper we report the efficiency of these tests in the differential diagnosis of the various causes of chronic diarrhea and their possible relationship to jejunal villous atrophy. Two hundred and fifteen children with chronic diarrhea were submitted to the D-xylose and triglyceride absorption tests, and small intestinal biopsy. The patients were divided into 5 groups, that is: I--celiac disease, 53; II--protracted diarrhea, 24; III--environmental enteropathy, 50: IV--celiac disease under gluten free diet, 11; V--irritable bowel syndrome, 77. D-xylose and triglyceride absorption tests were within normal limits in 3.8% and 4.2% patients belonging respectively to groups I and II. On the other hand, only 7.8% of the patients belonging to group V would be included in the group of patients that would have indication for intestinal biopsy, since both tests revealed abnormal results. Moreover, both tests showed an excellent relationship with the intensity of villous atrophy.
 ...
PMID:[Efficiency of D-xilose and triglycerides absorption tests in the investigation of chronic diarrhea]. 213 89

Forty cases of irritable bowel syndrome with complete dietary histories were examined retrospectively. Included were infants and children aged 6 to 42 months, who had diarrhoea at least 4 weeks duration, a normal pattern of growth and no evidence of malabsorption or enteric infections. The majority (92.5%) of these patients had been on high carbohydrate, high protein and low fat diets prior to referral. Ten percent of the patients lost weight as a result of marginal caloric intake subsequent to restrictive dietary advice. In 19 of the 25 patients compliant to dietary recommendations, this modification was associated with the resolution of symptoms. Based on this study and previous others we suggest to carefully gather dietary intake information for all patients fulfilling the usual criteria for irritable bowel syndrome and recommend a therapeutic trial of increased dietary fat and diminished carbohydrates and even proteins intake.
 ...
PMID:[Irritable colon in children: dietary aspects]. 217 23

The aim of this study was to evaluate the efficacy of cimetropium bromide, a new antimuscarinic compound, in relieving symptoms of patients with irritable bowel syndrome over a three month period. Seventy consecutive outpatients were given cimetropium (50 mg tid) or placebo according to a double blind, randomised, parallel groups design. Symptoms were evaluated initially and at monthly intervals up to the end of the study period. One patient receiving placebo withdrew because of treatment failure. Pain score decreased by 40, 66, 85% in the cimetropium group, at the end of the first, second and third months respectively, compared with 26, 32 and 52% reductions among controls (p = 0.0005). At the end of treatment there was a 86% reduction in the number of abdominal pain episodes per day in the cimetropium group compared with 50% in the placebo group (p = 0.001). Constipation and diarrhoea scores decreased by 59 and 49% in the cimetropium treated patients, compared with 37 and 39% in controls, the differences between being not significant. At the end of the study 89% of the patients treated with cimetropium considered themselves as globally improved as opposed to 69% in the placebo group (p = 0.039). The corresponding 95% confidence intervals for the differences between the proportion of improved patients in the two groups were from 11% to 29%. Six patients taking cimetropium complained of slight dry mouth. The results of this study showed that cimetropium bromide is effective in relieving pain in patients with irritable bowel syndrome.
 ...
PMID:Longterm treatment of irritable bowel syndrome with cimetropium bromide: a double blind placebo controlled clinical trial. 218 1

Diarrhea "with" bacterial fermentation is characterized by acidic liquid stools containing high amounts of organic acids. Disaccharide malabsorption is the main cause. The mechanism of diarrhea is osmotic, and colonic fermentations reduce diarrhea. It is unlikely that starch malabsorption induces significant diarrhea, whereas a high-fiber diet is responsible for "physiologic" diarrhea. Colonic fermentations increase diarrhea due to organic colitis and the "motor diarrheas". They may be responsible for some intestinal symptoms in patients with irritable bowel syndrome. This does not imply a "hyperfermentative" process due to a hypothetical disturbance of colonic microbial ecology.
 ...
PMID:[Colonic fermentation: physiological review and role in digestive pathology]. 218 79

Diarrhea of colonic origin is fairly common in irritable colon and after long term abuse of laxatives. This form of diarrhea causes difficulties not only in diagnosis but also in treatment. Irritable colon is a functional disorder sometimes involving other segments of the bowel. The term "irritable bowel disease" is thus more appropriate. Extraintestinal symptoms are in addition quite common. Although the diagnosis can be established with great reliability using an index we consider some laboratory tests, recto-sigmoidoscopy and abdominal sonography essential to rule out organic lesions. Therapy comprises (small) psychotherapy, dietary measures and eventually transient medication. Symptoms usually persist but tolerance of the disorder should be improved. Laxative-induced colonic dysfunction results usually from false assumptions about normal defecation. Loss of water and potassium deteriorates the symptomatology leading to a vicious circle. Alterations of neurons in the enteric nervous system of the colon can be the cause but eventually the consequence of chronic intake of laxatives. Hidden abuse of laxatives can cause great diagnostic difficulties. The therapy of choice is weaning which usually is only possible gradually. Cisapride can be a useful adjuvant.
 ...
PMID:[Irritable colon and colonic disease due to laxatives]. 219 2

The importance of colonic motor disorders during the irritable bowel syndrome is recognized, but, paradoxically, their description has yet to be perfected. Among the fundamental questions that remain unanswered, three are of prime importance: a) are there one or more specific disturbances in basal colonic motility? b) can specific motor disorders be induced by certain situations, for instance, during stress? c) is there any real relationship between clinical symptoms and coexisting motor disorders? The answers to these questions are full of ambiguities; this may be explained by the difficulty with which methods of investigation are performed as well as the heterogeneous character of the disorders. Presently, recording colonic myoelectric activity over a 24 hour period or more might prove to be useful in increasing our knowledge on motor disorders. It is not at all certain that a specific basal abnormality exists and the results of the effects of stress vary according to the methods used. Segmental hyperactivity in painful constipation, abnormal colonic response to alimentation in the case of painful bloating, and propulsive hyperactivity with absence or decrease in the "sigmoid brake" during painless diarrhea have been noted on basal motor activity recordings during sleep and after meals. Myoelectric disorders, however, are seen in only two-thirds of patients with intestinal functional disorders. "Sensitivity", personality, or other disorders, and particularly, intestinal disorders, can contribute to explain the pathophysiology of "irritable bowels" in which the role of colonic disorders has yet to be shown.
 ...
PMID:[Colonic motility in the irritable bowel syndrome]. 221 Jan 77

The presently available methods of study of small bowel motility in humans include manometry (or electromyography) which records the temporospatial organization of bowel contractions and determination of intestinal transit time. Investigation of subjects with the irritable bowel syndrome has shown that the small intestine has its part in the motor disturbances. The characteristics of normal motility of the small intestine are well known: the migrating motor complex (MMC) develops during the interdigestive period, typical contractions are seen during phases 2 and 3 of the MMC, the nature and the duration of the motor response to alimentation have been described. In patients with IBS, the production of the MMC is irregular during the day hours; this is most likely due to environmental solicitations and it is recognized that intensive aliess can cause transient interruption of the development of cycles. On the other hand, the MMC develops normally during sleeping hours. Contraction derangements such as non propulsed repeated contractions in the proximal intestine and contractions propulsed too frequently in the small intestine may be found during phase 2. Some of the abnormal contractions coincide with abdominal pain. After meals, the duration of interruption of the MMC is shorter than in the normal subject. Transit time is shortened in patients with diarrhea, lengthened in patients with constipation. Patients with IBS respond excessively to certain stimuli: for instance, the motor response to cholecystokinin is increased compared to the normal subject. Intake of fatty ingesta is followed by the same type of reaction: pain is often associated with abnormal contractions.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Small bowel motility in the irritable bowel syndrome]. 221 Jan 78

In order to obtain criteria characteristic of the irritable bowel syndrome (IBS), the authors sent out questionnaires to evaluate the bowel habits and intestinal disorders in patients with IBS and to identify and compare clinical findings with patients who had other gastroenterology pathology. In this article, we discuss the results of this survey conducted in the United States, its clinical consequences and its value in identifying characteristics of patients with the IBS. In 94.2 percent of the population studied (students and employees at the North Carolina University Hospital), stool frequency ranged from 3 per week to 3 per day. Variations were dependent on the race and sex of patients: men had more frequent bowel movements than women (9.2 vs 6.7 per week; p less than 0.0001), and Caucasians had more frequent bowel movements than Blacks (7.8 vs 6.0 per week; p less than 0.0001). Definitions of constipation and diarrhea vary, which shows that the manner in which questions are asked is very important in surveys on intestinal disorders. Symptoms suggesting IBS were found in 15 to 17 percent of cases. The group of subjects with IBS: a) were mostly women (72.6 vs 54.4 percent), b) considered that psychologic stress was a cause of intestinal disorders (84.4 vs 67.6 percent) and intestinal incomfort (68.9 vs 48.0 percent), and c) used laxatives more than once a month (12.6 vs 1.5 percent). The majority of patients (62 to 77 percent) without symptoms of IBS had never sought medical advice before for their symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Characterization of intestinal function and diagnosis of irritable bowel syndrome by surveys and questionnaires]. 221 Jan 82


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>