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

Eighteen patients with irritable colon syndrome were treated with a new anticholinergic drug (prifinium bromide) and with a placebo in a 6-wk, randomized, double-blind cross-over study. The drug was orally administered in a daily dose of 90 mg before meals. Three manifestations (pain, flatulence, constipation, and/or diarrhea), scored weekly, were used as assessment criteria. Mean over-all ratings showed a difference in favor of the drug, and were statistically significant. Side effects were rare and mild. We have come to the conclusion that this anticholinergic drug may be of benefit to patients with pain-predominant forms of irritable colon syndrome.
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PMID:Prifinium bromide in the treatment of the irritable colon syndrome. 3 42

A patient over 40 years of age who complains of lower abdominal pain, constipation or diarrhea or both, and increased flatulence should be suspected of having diverticulosis. When pain becomes more severe and persistent, diverticulitis must be considered. Diagnosis depends on roentgen demonstration of the presence of diverticula. Sigmoidoscopy and barium enema study are essential to exclude coexisting disease but in diverticulitis may need to be postponed until severe local and systemic signs of inflammation have subsided. A number of diseases can simulate diverticulitis, and differential diagnosis may present considerable difficulty. Irritable colon syndrome and acute appendicitis may be indistinguishable clinically from diverticulitis. Differentiation from carcinoma is usually not difficult, but exclusion of coexistent carcinoma may be impossible except by resection. Ulcerative colitis is also easily distinguished except when, rarely, it coexists. Crohn's disease of the colon is less easily differentiated, especially in patients over 40, in whom the two diseases often coexist. Other colonic diseases, such as ischemic colitis, and pelvic inflammatory diseases usually show characteristic features which make them readily distinguishable from diverticulitis.
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PMID:Diagnosis and differential diagnosis of colonic diverticulitis. 103 35

We studied seventy patients, 23 males and 47 females with irritable bowel syndrome in adolescence aged 13-19 yrs, who visited the department of psychosomatic medicine in Takano Hospital during about six year period of April, 1986-July, 1992. Takano Hospital is a coloproctological center in Kumamoto. In the clinical pattern of adolescent patients with irritable bowel syndrome the "gas" pattern was dominant (51.4%). Patients with the gas pattern have severe symptoms of flatus, fullness, rumbling sound and abdominal pain as well as bowel dysfunction, constipation and diarrhea in a classroom. Next, the diarrheal pattern occurred in 20.0%. Diarrheal patients complained of frequent bowel movements and retention feelings before attending school. Recurrent abdominal pain-like pattern was found in 7.1% patients. Clinical symptoms in the adolescent patients seem to derived from a mental tension and stress in a close classroom or before attending school. Many adolescenct patients (67.1%) with irritable bowel syndrome are embarrassed in school-maladjustment; leaving class early, late coming, a long absence, and a withdrawal.
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PMID:[Irritable bowel syndrome in adolescence]. 136 22

The effect of Plantago ovata on patients with chronic constipation (CC) with or without irritable bowel syndrome (IBS) has been assessed by a double blind study comprising 20 patients with CC of which 10 had associated IBS. A clinical questionnaire, weight of feces and intestinal transit time measured with radiopaque markers were done. Patients were then randomly distributed, 10 receiving PO and 10 placebo. Similar tests were done after treatment one month later. All patients receiving PO had good results against only one in the placebo group. Frequency of stools increased from 2.5 +/- 1 vs 8 +/- 2.2 stools per week, p less than 0.001 for paired data). A decrease in consistency of stools was also observed in the treated group. Fecal weight and colonic transit time were not significantly modified in placebo patients, while weight increase was observed in the treated ones (124 +/- 71 vs 194 +/- 65, gr/d p less than 0.001 for paired data) as well as a decrease in transit time (48 +/- 15 vs 34 +/- 18 hours p less than 0.05 for paired data). No adverse effects were observed and particularly no flatulence as often seen in patients on bran.
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PMID:[The efficacy of Plantago ovata as a regulator of intestinal transit. A double-blind study compared to placebo]. 152 May 45

The symptoms of 72 patients with irritable bowel syndrome were assessed by questionnaire before and 6 months after a high-fibre diet had been prescribed, to find whether those who achieved the highest fibre intake did any better than those with smaller intakes. Dietary fibre intakes were measured after 6 months by a 7-day weighed food inventory. There was a significant inverse association between the presence of symptoms and fibre intake for: incomplete defaecation, urgency and hard stools with total fibre intake; urgency and hard stools with cereal fibre intake; and borborygmi with fibre intake at breakfast. All patients with constipation, mucus, urgency or watery stools at the beginning of the study, and who were consuming more than 30 g fibre by the end, reported an improvement in these symptoms. Increasing intakes of fibre were not related in any way to abdominal distension, diarrhoea, flatulence or patient's feelings about the working of their bowels. Therefore, this study suggests that the symptoms which benefit most from the prescription of a high-fibre diet are hard stools, constipation and urgency.
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PMID:The value of prescribed 'high-fibre' diets for the treatment of the irritable bowel syndrome. 166 98

Gastrointestinal bloating is a common complaint met within the general practitioner's office. The most important cause of this symptom is an increase in the volume of gas in the gastrointestinal tract. Differential diagnoses include aerophagia, ingestion of gas-producing foods, gastric hypersecretion, bacterial overgrowth in the small intestine, disordered gastrointestinal transit, malabsorption or maldigestion of carbohydrates. In addition, nonulcer dyspepsia and the irritable bowel syndrome must be excluded. The diagnosis is based on a history of eructation, heart burn, flatulence and diarrhea, dietary habits, physical examination, laboratory analysis and apparative diagnostic measures. Therapy depends on the underlying cause of the disease.
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PMID:[Meteorism]. 191 70

The effects of prokinetic treatment with cisapride in patients with constipation-predominant irritable bowel syndrome (IBS) were evaluated in a randomized, double-blind, placebo-controlled study. Sixty-nine IBS patients were assigned to a 12-week treatment with either 5 mg cisapride or placebo t.i.d.; this dosage could be changed if necessary. The mean weekly number of days on which a stool was passed in the cisapride and placebo group increased to 5.3 and 4.4 (p less than 0.05) during weeks 8-12 of treatment, and the number of days with stools of normal consistency increased to 3.5 and 1.9 (p less than 0.05), respectively. At week 12, the reduction in severity and frequency scores for abdominal pain was significantly greater (p less than or equal to 0.05) in the cisapride group (60 and 61%) than in the placebo group (40 and 32%), as it was for abdominal distension (p less than 0.05). Cisapride tended to be better than placebo in diminishing flatulence. In 71% versus 39% of the patients the overall rating for the response to treatment was good or excellent at week 12. Cisapride was well tolerated. These results suggest that the drug will be useful for the management of constipation-predominant IBS.
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PMID:"Prokinetic" treatment of constipation-predominant irritable bowel syndrome: a placebo-controlled study of cisapride. 200 45

Food intake plays a key role in triggering or perpetuating symptoms in patients with IBS. Evaluation of the impact of diet in the individual patient requires a precise dietary history and a 7-day prospective dietary analysis, which should include the quality and quantity of food consumed, chronologic sequence and nature of symptoms, and the frequency and consistency of bowel movements. The caloric density of the meal, total fat intake, the quantity and quality of lactose-containing foods, sorbitol, fructose, and the nature and quantity of soluble and insoluble fiber intake must be noted. Patients with reflux esophageal symptoms should eliminate foods that decrease LES pressure, such as chocolate, peppermint, alcohol, and coffee. Direct esophageal mucosal irritants such as tomatoes, citrus juices, sharp condiments, and alcohol should be limited. Gastric emptying is slowed with the ingestion of fats and soluble fiber. Small bowel motility is slowed by soluble fiber and fatty foods. Gaseous syndromes may be reduced by avoidance of smoking, chewing gum, excessive liquid intake, and carbonated drinks. The reduced intake of large amounts of lactose-containing foods, sorbitol, and fructose may limit postprandial bloating. Flatus production can be lowered by reducing fermentable carbohydrates such as beans, cabbage, lentils, brussel sprouts, and legumes. Soluble and insoluble fiber ingestion will reduce sigmoidal intraluminal pressures and overcome spastic constipation when given in progressive graded doses. Effective dietary manipulations remain a key factor in reducing symptoms in IBS.
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PMID:Diet and the irritable bowel syndrome. 206 55

This placebo controlled, double-blind, cross-over trial involving 20 patients was conducted to assess the effect of ispaghula husk on the major bowel symptoms and the whole gut transit time in irritable bowel syndrome (IBS) and to determine if changes in these parameters were related to global improvement. All 20 patients were interviewed at the end of the treatment periods and 14 patients kept concurrent daily records. Ispaghula therapy resulted in improvement in global symptoms and satisfying bowel movements (P less than 0.001) but produced no change in abdominal pain or flatulence. There was a correlation between the improvement of well-being and the number of days of satisfying bowel movements (P less than 0.001) but not with the indexes of pain, stool frequency or changes in the transit time. The easing of bowel dissatisfaction appears to be a major reason for the therapeutic success of ispaghula in IBS.
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PMID:Ispaghula therapy in irritable bowel syndrome: improvement in overall well-being is related to reduction in bowel dissatisfaction. 212 22

Nineteen of 27 patients suffering from Irritable Bowel Syndrome (IBS) who had completed a multicomponent treatment involving progressive muscle relaxation, thermal biofeedback, cognitive therapy and IBS education were located and evaluated 4 yr posttreatment. Seventeen of 19 (89.5, or 63% of the total original sample) rated themselves as more than 50% improved. Six of the 12 patients (50%) who submitted symptom monitoring diaries met our criteria for clinical improvement, i.e. achieving at least a 50% reduction in primary IBS symptom scores. The means on all measures at long-term follow-up were lower than those obtained prior to treatment. When follow-up symptom means were compared with pretreatment means, significant (P less than 0.05) reductions were obtained on abdominal pain/tenderness, diarrhea, nausea, and flatulence.
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PMID:Behaviorally treated irritable bowel syndrome patients: a four-year follow-up. 222 90


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