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

Sixty-three unselected cases of giardiasis, with no evidence of other systemic disease, were screened for evidence of steatorrhoea. No patient had any evidence of protein-energy malnutrition. Seventeen (27%) of the cases had steatorrhoea; three (17-8%) of the 17 patients having steatorrhoea also had D-xylose malabsorption. Vitamin B12 absorption was normal in all. Bacterial culture and qualitative analysis of bile salt in jejunal fluid was carried out in all the 17 cases having steatorrhoea as well as 13 cases with normal absorptive parameters (eight cases of irritable bowel syndrome and five cases of giardia infection) who served as controls. All the patients showing bacterial overgrowth had free bile acids in their duodenal aspirate. Free bile acids could also be detected in jejunal aspirates of five of the seven patients having no bacterial overgrowth. Two control cases of giardia infection with normal small bowel function and sterile duodenal aspirate showed evidence of bile salt deconjugation. The significance of these findings is discussed in relation to the pathogenesis of steatorrhoea in patients with giardiasis. The possible role of giardia in bile salt deconjugation is suggested.
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PMID:Mechanism of malabsorption in giardiasis: a study of bacterial flora and bile salt deconjugation in upper jejunum. 85 75

Ten patients with tropical sprue (TS) and 10 with irritable bowel syndrome (IBS) as controls were studied to characterize the immunocytes in the jejunal mucosa. IgA cells numbered 516,155 +/- 48,715 cells/mm3 in TS and 729,308 +/- 146,011/mm3 in the IBS patients. IgG cell counts were 28,885 +/- 8,081/mm3 in TS and 10,615 +/- 4,100/mm3 in IBS; IgM counts were 170,729 +/- 25,015/mm3 in TS and 169,253 +/- 45,353/mm3 in IBS. A positive correlation was present between IgM-bearing plasma cells and corresponding serum immunoglobulins (r = +0.71; p less than 0.05). No correlation was evident between the different immunocytes (IgA, IgG, and IgM) and the duration of illness, serum albumin, and tests for absorption of fat, B-12, and D-xylose (p greater than 0.05). The gut immunocytes expressed in absolute numbers were higher in our controls and TS patients than reported in Western populations.
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PMID:Quantitation of immunoglobulin-containing cells in the jejunal lamina propria in tropical sprue. 155 33

The prevalence of the small intestine bacterial overgrowth syndrome has been assessed in 109 in-patients affected by various gastrointestinal disorders using the 1 g [14C]-xylose breath test; 18 healthy subjects acted as a control group: none of them showed abnormal results (100% specificity). None of 14 patients with colonic disease had abnormal results, whereas in 44 patients with ileal diseases the test was positive in 12% to 39% of the cases. Abnormal results were found in 46% of patients who underwent partial gastric resection greater than 20 years before, 29% of patients with irritable bowel syndrome without diarrhoea (faecal wet weight less than or equal to 600 g/72 h), 56% of those with diarrhoea of obscure origin, and 25% of celiac patients. Eight out of 8 patients with altered results showed normalization of the test after antibiotic therapy. Despite its high diagnostic value in the setting of clinical research, the 1 g [14C]-xylose breath test cannot as yet be proposed as a routine investigation.
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PMID:[Diagnosis of bacterial contamination of the small intestine using the 1 g [14C] xylose breath test in various gastrointestinal diseases]. 179 Feb 5

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.
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PMID:[Efficiency of D-xilose and triglycerides absorption tests in the investigation of chronic diarrhea]. 213 89

1. In order to develop an improved differential sugar absorption test for simultaneously assessing intestinal permeability and lactose intolerance, methods were established for determining raffinose, lactose and L-arabinose in human urine. Using NAD(P)H-coupled enzymatic assays and fluorimetry, each sugar was measurable over a concentration range of approximately 3-300 mumol/l in diluted urine specimens. 2. After an overnight fast, 40 normal volunteers drank an iso-osmotic solution containing raffinose, lactose and L-arabinose. The median 5 h urinary sugar excretion was 0.26% of the ingested raffinose, 0.05% of lactose and 17.5% of L-arabinose. 3. In 143 patients with gastrointestinal disease, excretion of both ingested raffinose and lactose was significantly increased in coeliac disease in relapse or in partial remission and in Crohn's disease, but not in the irritable bowel syndrome, coeliac disease in remission or ulcerative colitis. Excretion of lactose, but not raffinose, was increased in patients with mucosal lactase deficiency, whereas excretion of L-arabinose was reduced in all disease groups except ulcerative colitis. 4. Discrimination between diseases was poor when based on individual sugar recoveries, but improved dramatically when excretion was expressed relative to that of L-arabinose. The raffinose/L-arabinose excretion ratio, an index of intestinal permeability, was greater than 0.08 in 15/15 untreated coeliac patients but less than 0.06 in all normal subjects and in 9/9 lactase-deficient patients, 15/16 recovered coeliac patients, 5/6 patients with ulcerative colitis, 13/16 patients with Crohn's disease and 61/62 patients with irritable bowel syndrome.
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PMID:Simultaneous assessment of intestinal permeability and lactose tolerance with orally administered raffinose, lactose and L-arabinose. 216 7

Breath hydrogen (H2) exhalation after xylose administration reflects the malabsorbed portion of the pentose and thus might facilitate the application of the D-xylose test. Therefore, as a complementary parameter, breath H2-exhalation in response to 25 g D-xylose was assessed in control subjects, in patients with coeliac disease, with chronic pancreatitis and with the irritable bowel syndrome. Patients with coeliac disease showed significantly higher breath H2 concentrations than the controls. Specificity and the positive predictive value of peak H2-increments greater than 56 ppm (i.e. greater than mean + 2 SD of controls) were 100%, but sensitivity was only 40%. In all patients with a positive H2 breath test, urinary D-xylose excretion and serum D-xylose increments were also abnormal. Apart from great overlap between controls and patients with coeliac disease, the failure to produce H2 in response to D-xylose in 12% of the 57 investigated subjects was the major factor limiting diagnostic efficiency of the test. Non H2 production could be shown to reflect a specific metabolic disability of the colonic flora and did not prove complete absorption of the substrate. It is concluded, that the 25 g D-xylose H2 breath test is of no clinical relevance for the diagnosis of celiac sprue but exaggerated breath H2 increases (greater than 56 ppm) with normal urinary and D-xylose tests were indicative for the irritable bowel syndrome in 5 out of 10 patients. The diagnostic impact of this constellation thus merits further investigation.
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PMID:Clinical evaluation of a 25 g D-xylose hydrogen (H2) breath test. 227 52

Sixty consecutive patients suspected of having bacterial overgrowth of the small intestine (BOG) had aerobic and anaerobic bacterial cultures made of fasting upper jejunal fluid and also a 14C-D-xylose breath test (XBT). Culture-proven BOG was present in 23 patients. In another 15 patients the presence of BOG was ruled out (diagnoses: irritable bowel syndrome, 8; chronic diarrhoea, 6; and lactose malabsorption, 1). These patients were used as controls. The other 22 of the 60 patients could not be placed in either group owing to the presence of factors known to predispose for BOG; none of them had abnormal jejunal cultures, but several had strong clinical suspicion of BOG. An abnormal XBT, defined as values exceeding upper 90% confidence limits (upper range) of the 15 patient control values within a 4-h period, was observed with the following frequencies in the 23 patients with BOG: after 60 min, 35%; after 120 min, 44%; after 180 min, 61%; and after 240 min, 65%. An abnormal XBT was observed in 41% of the 22 patients with normal jejunal cultures but with predisposition for, and clinical suspicion of, BOG. It is concluded that, compared with a relevant control material, the XBT tends to be rather insensitive and that a negative outcome of jejunal cultures is inadequate to exclude the presence of BOG.
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PMID:Diagnosis of bacterial overgrowth of the small intestine. Comparison of the 14C-D-xylose breath test and jejunal cultures in 60 patients. 391 62

We studied 12 coryneform isolates having similar biochemical profiles which did not permit their assignment to any recognized taxa. Human semen was the source for seven of these strains, whereas the other strains were isolated from urethra, urine, and blood specimens of adult male patients. These bacteria were found in significant quantities (10(4) to 10(5) CFU/ml) in semen specimens from infertile male patients with the diagnosis of prostatitis. These strains had characteristics of the genus Corynebacterium, such as 60 mol% G + C in the DNA and corynemycolic acids, meso-diaminopimelic acid, arabinose, and galactose in the cell wall. Quantitative DNA-DNA hybridizations (S1 nuclease procedure) and phylogenies based on comparisons of almost-complete small-subunit ribosomal DNA sequences confirmed that these strains constitute a single new species within the genus Corynebacterium. All 12 strains showed similar phenotypic features, i.e., good growth on sheep blood agar in contrast with poor growth on the same medium supplemented with 1% Tween 80, a positive CAMP test in the presence of Staphylococcus aureus, glucose and sucrose fermentation, and the presence of beta-glucuronidase. Some strains reduced nitrate and hydrolyzed urea or esculin. These features allowed us to distinguish these strains from members of any other coryneform taxon, and the proposed name is Corynebacterium seminale with strain IBS B12915 (CIP 104297) as the type strain. The description and delineation of these strains as a new species should be useful for further studies, including evaluations of their prevalence among the normal flora and their clinical implications.
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PMID:Corynebacterium seminale sp. nov., a new species associated with genital infections in male patients. 749 9

Urinary and/or plasmatic D-xylose tests are broadly used in clinical practice for the diagnosis of intestinal malabsorption. A 5-hr hydrogen breath test (H2 BT) has also proven useful. Our goal was to determine whether a shorter, hence more efficient, 3-hr test would perform as well as the 5-hr test. We studied 33 patients with proven malabsorption, 44 patients with irritable bowel syndrome (IBS), and 27 healthy subjects. Each individual ingested 25 g of D-xylose, and alveolar breath samples were obtained thereafter at 30 min intervals for 5 hr. Breath samples were analyzed for H2 by gas chromatography. Individual peak delta changes and area under the curve (AUC) were calculated. Simultaneously, the 5-hr cumulative urinary excretion of D-xylose was measured by colorimetry. Results of 5-hr tests were compared with those of the first 3 hrs. In the malabsorption group, the 5-hr test showed a markedly enhanced production of H2 relative to healthy controls (delta: 60.7 +/- 6.4 vs 7.7 +/- 1.5 and AUC: 8465.0 +/- 985.4 vs 393.2 +/- 232.6, P < 0.001). Results in IBS patients did not differ from those in healthy controls. Three-hour analysis also reflected an enhanced production of H2 in the malabsorption group (delta: 45.4 +/- 6.4 and AUC: 3700.0 +/- 545.6, P < 0.001 vs healthy controls).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical applicability of shortened D-xylose breath test for diagnosis of intestinal malabsorption. 795 98

Hydrogen breath tests (H2 BT) have been used extensively to investigate intestinal disaccharidase deficiencies. A potentially useful test for assessing intestinal absorptive function, the H2 BT with D-xylose (H2 BT-D-xylose), has received scant attention. We report here the results of our investigation of this test in 45 patients. Fifteen patients had proved malabsorption that was due to nontropical sprue in nine, and to lymphoma, Whipple's disease, or giardiasis in the remainder. Nine patients had small-bowel bacterial overgrowth secondary to either postsurgical sequelae or intestinal dysmotility. Twenty-one patients with irritable bowel syndrome and 21 healthy individuals served as control groups. All participants ingested 25 g of D-xylose, and alveolar breath samples were obtained thereafter at 30 min intervals for 5 hr. Breath H2 was measured by chromatography. Basal H2 production, peak change (delta) and area under the curve (AUC) were calculated. Simultaneously, 5-hr urinary excretion of D-xylose was measured by colorimetry and served as the reference test. In healthy individuals, D-xylose ingestion increased H2 production (delta = 5.8 +/- 1.4 ppm, P < 0.001). Changes were similar in patients with the irritable bowel syndrome. In contrast, the increase was of a much greater magnitude in the malabsorption group (delta = 49.9 +/- 7.2 ppm, P < 0.001 vs healthy controls). AUC analysis yielded comparable results. Test performance analysis showed that, in malabsorption the H2 BT-D-xylose had a sensitivity index of 0.86, which was identical to that of the urinary D-xylose test. Specificity was 1 and 0.95, respectively; and predictability 1 and 0.93, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Potential usefulness of hydrogen breath test with D-xylose in clinical management of intestinal malabsorption. 842 44


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