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

United States estimates of the frequency of visits to physicians and patterns of medical care for the diagnosis of the irritable bowel syndrome were derived from the 1975, 1980-1981, and 1985 National Ambulatory Medical Care Surveys. These surveys of office-based physicians allow national estimates of various aspects of ambulatory care. The overall rate of visits with the diagnosis of irritable bowel syndrome in 1980-1981 and 1985 were 10.6 per thousand U.S. population. Women had 2.4 times the rate of visits by men and rates rose in both sexes until middle-age. Irritable bowel syndrome was the leading digestive disease diagnosis among gastroenterologists but only the seventh leading diagnosis among all physicians. Gastrointestinal symptoms, association with mental disorders, prescriptions, and disposition were also examined in patients with visits for irritable bowel syndrome. Among records with digestive tract symptoms and a first listed diagnosis of irritable bowel syndrome, stomach or abdominal pain was listed on only about one half of records and disorders of bowel function were listed on fewer than 40%. In 1975 and 1985, irritable bowel syndrome was noted approximately twice as often as other digestive diseases at visits with mental disorder symptoms and diagnosis, although mental disorder symptoms and diagnoses were noted at fewer than 15% of visits with irritable bowel syndrome. Medications were prescribed at approximately 75% of visits for irritable bowel syndrome; the most common were gastrointestinal medications followed by combination gastrointestinal-psychoactive medications. Subsequent appointments were scheduled following at least 50% of the visits of patients with irritable bowel syndrome.
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PMID:Irritable bowel syndrome in office-based practice in the United States. 200 37

A study of the abdominal/gastrointestinal symptom panorama in relation to socio-economic factors and health care consumption in the general population was performed in Osthammar, Sweden. A postal questionnaire was sent to a representative sample of the adult population (n = 1260). The response rate was 87%. The responders with symptoms (52.1%) subjectively rated their illness on visual analogue scales. All responders were classified as asymptomatic or having 'minor' or 'major' abdominal symptoms. Those having dyspepsia, reflux or irritable bowel syndrome were also ranked as 'minors' or 'majors'. The proportion of subjects with abdominal/gastrointestinal complaints decreased with age, mainly due to a decrease of 'major' symptoms. Also, the proportion of complainers increased among the more educated. Those on sick leave and students had more and worse symptoms than the others, despite the former seldom stating abdominal discomfort as the main reason for sick listing. Fifty-five per cent of all persons reporting abdominal/gastrointestinal symptoms had at some time consulted a doctor because of such complaints, the proportion increasing with severity, as did drug consumption and the rate of previous abdominal operations, with appendectomy as an exception. The results show that it is possible to rank the illness along a severity dimension among persons with abdominal/gastrointestinal complaints in epidemiological research.
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PMID:Socio-economic factors, health care consumption and rating of abdominal symptom severity. A report from the abdominal symptom study. 835 4

In recent years, there has been increasing interest in how gastrointestinal symptoms relate to and impact on patients' health-related quality of life. This is particularly the case for functional gastrointestinal disorders that are characterized by a lack of biological markers for disease activity. There is only a slight variation in the type of gastrointestinal symptoms reported with different gastrointestinal disorders, and patients with dyspepsia or irritable bowel syndrome, for example, often describe a variety of gastrointestinal symptoms with considerable overlap between them. The same pattern has been observed in patients with gastroesophageal reflux disease, even though heartburn and acid regurgitation are easier to distinguish from other gastrointestinal symptoms, particularly in patients in whom objective reflux is verified. Most aspects of health-related quality of life in patients with gastrointestinal disorders are compromised, irrespective of diagnosis. Patients with functional disorders seem, if anything, to display more emotional distress than those with organic disorders. Given the considerable overlap between different gastrointestinal symptom clusters, it is not surprising that these conditions have a similar impact in terms of perceived health status and quality of life. The key factors associated with the degree of perceived distress and dysfunction relate to disease severity and the presence of abdominal pain symptoms.
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PMID:Quality of life in different gastrointestinal conditions. 1002 66

The purpose was to investigate the reliability and factorial structure of the Gastro-Questionnaire for the screening and psychometric measurement of functional gastrointestinal disorders (FGDs). The questionnaire contains 27 gastrointestinal symptom items drawn from the Rome-II criteria, which are rated by frequency and severity, as well as some items to exclude organic diseases. The questionnaire was administered to 259 normal participants and to 69 participants of the annual German meeting of patients with irritable bowel syndrome. Reliability was good (Cronbach's alpha for frequency and severity items: alpha = .86 and alpha = .87). Factor analysis yielded a six-factor solution explaining 60.7% of the variance. Diagnostic frequencies ranged from 32.8% to 100% for FGDs in general, from 1.3% to 76.8% for irritable bowel syndrome, and from 7.0% to 100% for functional dyspepsia, depending on samples and symptom definitions. The Gastro-Questionnaire is a very economic, reliable, and content-valid instrument for the assessment of FGDs.
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PMID:Assessment of functional gastrointestinal disorders using the Gastro-Questionnaire. 1217 33

Approximately 697000 United States military personnel participated in the Persian Gulf War (PGW) between August 1990 and March 1991. By April 1997, over 25% of veterans reported chronic health complaints of underdetermined etiology. Gastrointestinal symptoms were among the most frequently reported symptoms including abdominal pain and diarrhea. The objectives of this study were (1). to determine if PGW veterans chronic abdominal pain and diarrhea exhibit visceral and cutaneous hypersensitivity, (2). to determine if these differences in pain sensitivity are significantly associated with psychological stress. A total of 12 veterans (ten males, two females) (39+/-9 years) who were deployed to the Persian Gulf were enrolled. Seven civilians without prior military experience (five males, two females) and five veterans (five males) who had previously been deployed for active combat were enrolled as controls (35+/-9 years). All 12 PGW veterans reported chronic abdominal pain and diarrhea (negative diagnostic workup) that developed during their tour of duty in the Persian Gulf region. All patients completed a battery of psychological assessments and then randomly received experimental visceral (rectal distension of 35 and 55 mmHg for 30s) and cutaneous (immersion of right foot in 45 and 47 degrees C water for 30s) pain stimuli after which they rated their pain intensity and pain unpleasantness on a continuous visual analogue scale (M-VAS) scale. The trials were repeated and the mean M-VAS scores for the two trials were recorded for each subject. In comparison to controls, PGW subjects reported statistically significant higher mean ratings of pain intensity and pain unpleasantness in response to 35 and 55 mmHg rectal distention (P<0.001) and in response to 45 and 47 degrees C water immersion (P<0.001) of the hand and foot. Results of the hierarchical regressions indicated that the psychological measures (i.e. anxiety, somatic focus) accounted for a significant amount of variance in each of the pain measures. PGW veterans who developed chronic abdominal pain and diarrhea during their tour of duty exhibit visceral hypersensitivity similar to patients with the irritable bowel syndrome. These veterans also have cutaneous hypersensitivity and higher levels of anxiety and somatic focus accounting for these differences in pain reporting.
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PMID:Visceral and cutaneous hypersensitivity in Persian Gulf war veterans with chronic gastrointestinal symptoms. 1262 May 99

The sequelae of Infectious Intestinal Disease (IID) in a population-based sample of cases and matched controls were investigated for a period of 3 months following the initial infection. Incident cases of IID presenting to GPs or occurring in the community and controls were studied at 3 weeks and over a 3-month follow-up period. Cases were six times more likely than controls to have gastrointestinal symptoms, particularly diarrhoea, at 3 weeks. Ten per cent of cases consulted their GP in the 3 months after episode and 2.3% were referred to hospital. GP presentation rates were twice as high in cases. Gastrointestinal symptoms persist after IID, leading to an increased likelihood of GP consultation and hospital referral. Diagnosis of irritable bowel syndrome may be more likely following IID. The burden of IID is likely to be considerable given its high incidence and the frequency of such sequelae.
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PMID:The infectious intestinal disease study of England: a prospective evaluation of symptoms and health care use after an acute episode. 1282 29

This article reviews the safety and tolerability profile of tegaserod, a novel selective partial agonist of the serotonin 5-HT(4) receptor. Tegaserod was recently approved for the treatment of women with irritable bowel syndrome (IBS) with constipation. Tegaserod exhibits rapid absorption from the small intestine, and is excreted unchanged in the faeces and as metabolites in the urine. Meal ingestion decreases its bioavailability. There is little effect of age or gender on pharmacokinetics, although plasma levels may be slightly higher in the elderly. Tegaserod has no effect on plasma levels of other drugs metabolised by cytochrome P450 enzyme systems. Gastrointestinal symptoms are the most common adverse effects of tegaserod therapy. In data pooled from phase III randomised controlled trials (RCTs) in IBS with constipation patients, diarrhoea was reported by 8.8% of patients treated with tegaserod 6mg twice daily versus 3.8% of patients receiving placebo. Similar rates have been observed in international post-US marketing RCTs. In most patients, tegaserod-induced diarrhoea was mild and transient. In RCTs, it did not elicit fluid or electrolyte disturbances, and fewer than 3% of IBS patients discontinued tegaserod due to diarrhoea. Since its release, rare cases of more severe diarrhoea and ischaemic colitis have been reported. The incidence of other gastrointestinal symptoms (e.g. abdominal pain, nausea, and flatulence) has been similar among tegaserod-treated patients and placebo-treated patients. Pooled analysis of phase III RCTs and post-US marketing RCTs have not demonstrated significant differences between tegaserod-treated patients and placebo-treated patients in the incidence of abdominal-pelvic surgery. There is no convincing evidence that rebound gastrointestinal symptoms occur upon termination of tegaserod therapy. Pooled analysis of phase III RCTs demonstrated an increase in the incidence of headaches among tegaserod-treated patients (6mg twice daily) compared with placebo-treated patients (15% vs 12.3%, respectively, p < 0.05), although post-US marketing RCTs have not observed this increase. Other extra-gastrointestinal adverse events occur with similar frequency among tegaserod-treated patients and placebo-treated patients. Tegaserod-treated patients in RCTs have not demonstrated significant prolongation of the QTc interval or cardiac arrhythmias compared with placebo-treated patients. Supra-therapeutic doses in healthy volunteers did not effect electrocardiographic parameters. Laboratory parameters are mostly unaffected by tegaserod, although several individuals have exhibited increased eosinophil counts. In summary, tegaserod exhibits a favourable safety and tolerability profile in IBS patients based on data from clinical trials. Diarrhoea is the most common adverse event associated with tegaserod use. Continued post-US marketing surveillance will further define the safety and tolerability profile of tegaserod.
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PMID:Safety profile of tegaserod, a 5-HT4 receptor agonist, for the treatment of irritable bowel syndrome. 1523 Jun 44

The objective of this study was to determine how depressive symptoms affect autonomic activity during sleep, objective and subjective sleep, and gastrointestinal symptom severity in women with irritable bowel syndrome (IBS). Seventy women who met the Rome II criteria for IBS and 21 healthy volunteers participated. All participants were recruited from the surrounding community. IBS patients were stratified into two groups based on their Beck Depression Inventory II score and 44 IBS patients with depressive symptoms (IBS+DS) were compared to 26 IBS patients without depressive symptoms (IBS-DS). Autonomic activity was measured by heart rate variability (HRV) analysis. Fifteen-minute segments were selected from a baseline presleep period, stage 2, slow-wave sleep, and rapid-eye movement sleep for heart rate variability spectral analysis. Subjective sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI) and gastrointestinal symptom severity was assessed by an 18-item questionnaire. The IBS+DS group reported significantly (P < 0.01) more sleep complaints, measured by the PSQI, than the IBS-DS group and healthy controls. The IBS+DS group took significantly (P < 0.05) longer to enter their first rapid-eye movement period than healthy controls. The IBS+DS group reported significantly (P = 0.01) increased gastrointestinal symptom severity compared to the IBS-DS group. There were no significant group differences in autonomic activity during the baseline presleep period or sleep stages. The results demonstrated that IBS patients with significant depressive symptoms had increased gastrointestinal symptom severity, increased sleep complaints, and alterations in sleep architecture compared to healthy controls and IBS patients without significant depressive symptoms.
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PMID:Modulation of sleep quality and autonomic functioning by symptoms of depression in women with irritable bowel syndrome. 1538 54

Gastrointestinal symptoms are the most common side-effects of tegaserod therapy. In data pooled from Phase III randomized controlled trials in patients with irritable bowel syndrome with constipation, diarrhoea was reported by 8.8% of patients treated with tegaserod 6 mg b.d. vs. 3.8% of patients treated with placebo. Similar rates were observed in international post-US marketing randomized controlled trials. In most patients, tegaserod-induced diarrhoea was mild and transient. In randomized controlled trials, it did not elicit fluid or electrolyte disturbances, and fewer than 3% of irritable bowel syndrome patients discontinued tegaserod due to diarrhoea. The incidence of other gastrointestinal symptoms (e.g. abdominal pain, nausea and flatulence) was similar in tegaserod-treated and placebo-treated patients. Pooled analysis of Phase III and post-US marketing randomized controlled trials did not demonstrate significant differences between tegaserod-treated and placebo-treated patients in the incidence of abdominal/pelvic surgery. No episodes of ischaemic colitis were reported in tegaserod-using patients in any Phase III or post-marketing randomized controlled trials, and post-marketing surveillance indicated that the rate of ischaemic colitis in tegaserod-using patients was lower than that in non-tegaserod-using patients. Pooled analysis of Phase III randomized controlled trials demonstrated an increase in the incidence of headaches in tegaserod-treated (6 mg b.d.) vs. placebo-treated patients (15% vs. 12.3%, respectively; P < 0.05), although post-US marketing randomized controlled trials did not demonstrate this increase. Other extra-gastrointestinal adverse events occurred with similar frequency in tegaserod-treated and placebo-treated patients. Tegaserod-treated patients in randomized controlled trials did not demonstrate significant prolongation of the QTc interval or cardiac arrhythmias compared with placebo-treated patients. In summary, tegaserod exhibits a favourable safety and tolerability profile in irritable bowel syndrome patients based on data from clinical trials.
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PMID:Review article: the safety profile of tegaserod. 1552 52

The effects of partially hydrolyzed guar gum (PHGG) were compared in patients with irritable bowel syndrome, at 10 g/day (N = 40) and 5 g/day (N = 46) for 12 weeks. Gastrointestinal symptoms (GSRS), quality of life (SF-36), and psychological symptoms (HADS) were evaluated at baseline, during treatment (months 1 and 3), and at follow-up (month 6). In both groups symptoms and quality of life improved significantly after the first month of administration until follow-up compared to those at baseline. However, the improvement was significantly reduced at follow-up compared to the end of treatment. PHGG was effective for improving somatic (gastrointestinal symptoms) and psychological (quality of life and psychological distress) symptoms over the short term. Since the improvement tended to decrease after the end of the treatment period, further studies should evaluate the benefits of PHGG at a maintenance dosage.
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PMID:Treatment effects of partially hydrolyzed guar gum on symptoms and quality of life of patients with irritable bowel syndrome. A multicenter randomized open trial. 1598 63


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