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

Small doses of the carbohydrate lactulose are widely used in the clinical setting to assess small bowel transit time because lactulose is not absorbed by the small intestine and its arrival in the intestine can be detected non-invasively by breath hydrogen testing. In this study, doses of this safe, widely used substance higher than those typically administered for transit tests were given to 12 healthy young adult men to produce symptoms of gas and intestinal distention similar to those commonly experienced by patients with irritable bowel syndrome and recurrent abdominal pain. Comparison of subjective and physiological responses to the administration of 0 and 30 g of lactulose in a double-blind placebo-controlled trial demonstrated that the 30 g lactulose dose produced significant increases in a number of measures reflecting the intra-intestinal pain stimulus. The results of the present study indicate that lactulose is a realistic and ethically acceptable stimulus for the production of transient mild abdominal pain in the laboratory.
Pain 1989 Sep
PMID:Psychophysiologic responses to a realistic laboratory abdominal pain stimulus. 281 39

Celiac disease (CD) is the most common form of malabsorption in childhood when it presents with diarrhea and growth failure, a jejunal biopsy is considered the first diagnostic investigation by some authors. In adulthood, clinical symptoms of CD may mimic several different disease, such as peptic ulcer and IBS, and the first diagnostic investigation is an upper GI series. Radiological features of duodenum and small bowel were evaluated in twenty patients with adult onset celiac disease. Sign of duodenitis such as thickened folds, mucosal nodules, dilatation of duodenum and erosions were observed in 19 out of our 20 patients (95%); particularly, thickened folds in 17 (85%), nodularity in 16 (80%), duodenal dilatation in 12 (60%) and erosions in 4 (20%). In celiac disease the lesions are more severe in the upper part of small bowel, and duodenitis may be the unique sign of CD. Duodenitis may be part of a disease involving the entire small bowel; so, a duodenitis observed in the upper gastrointestinal tract requires the study of the entire small bowel--which seems to be very important in the case of celiac disease.
Radiol Med 1988 Sep
PMID:[Radiological study of the duodenum in celiac disease in adults]. 317 71

Though the pathophysiology of the irritable bowel syndrome (IBS) is commonly attributed to dysfunction of the large intestine, evidence exists to incriminate the small bowel. In order to further explore the role of the small bowel in IBS several stimuli were applied, in an attempt to unmask the dysmotility of the jejunum and ileum. These included infusions of cholecystokinin-octapeptide (CCK-OP), a high fat meal, neostigmine and balloon distension of the ileum. Three groups (n = 8) each of age and sex matched healthy volunteers were studied; patients with IBS complained of predominant constipation (n = 8) or diarrhoea (n = 8). Patients with IBS responded excessively to stimulation by CCK-OP, fatty meal, and ileal distension. In general patients with diarrhoea were more sensitive to stimuli than those with constipation. The ileum responded more to stimulation than the jejunum. As in the large bowel, stimuli appear to unmask intestinal dysmotility in patients with IBS. Motor abnormalities were often accompanied by abdominal symptoms, raising the possibility that dysfunction of the small bowel contributes to the symptoms of IBS.
Gut 1988 Sep
PMID:Dysmotility of the small intestine in irritable bowel syndrome. 319 98

Calcium-binding protein (CaBP) (molecular weight, 10,000) was measured in small-intestinal biopsy specimens from 36 patients with malabsorption syndromes: short-bowel syndrome (n = 13), untreated coeliac disease (n = 4), coeliac disease in remission (n = 7), patients with intestinal bypass owing to morbid obesity (n = 5), and in patients with chronic diarrhoea of unknown cause (n = 7). Twelve patients with no signs of malabsorption who had the irritable bowel syndrome were used as controls. Patients with small-bowel resections showed reduced concentrations of CaBP (p less than 0.01) and low intestinal calcium absorption (p less than 0.05). Small amounts of CaBP were found in intestinal specimens from patients with coeliac disease in remission (p less than 0.01), and CaBP was almost undetectable in patients with a newly diagnosed coeliac disease and avillous jejunal biopsy findings (p less than 0.001). Patients with chronic diarrhoea and patients with an intestinal bypass had CaBP concentrations comparable to those of the control group. A direct correlation was found between CaBP and the fractional calcium absorption in all patients (p less than 0.05). CaBP may therefore be considered an indicator of the efficiency of the small intestine to absorb calcium.
Scand J Gastroenterol 1988 Sep
PMID:Measurement of the 10,000-molecular weight calcium-binding protein in small-intestinal biopsy specimens from patients with malabsorption syndromes. 322 98

Sixteen clients afflicted with irritable bowel syndrome (IBS) were reassessed 1 year following completion of a multicomponent treatment package incorporating progressive muscle relaxation, thermal biofeedback, cognitive therapy, and IBS education. For the 14 patients who kept a 2-week symptom diary, significant reductions in ratings of abdominal pain and tenderness, diarrhea, and flatulence were obtained comparing pretreatment and follow-up symptom-diary ratings. Eleven of 14 clients were improved over pretreatment levels, 57% met the criteria for clinical improvement of at least a 50% reduction in major symptom scores, and all but 1 of 16 rated themselves as subjectively improved.
Biofeedback Self Regul 1986 Sep
PMID:Behavioral treatment of irritable bowel syndrome: a 1-year follow-up study. 330 Jul 87

One hundred fifty-one patients with non-ulcer dyspepsia, defined as chronic epigastric pain without concomitant symptoms of the irritable bowel syndrome and with no evidence of any organic disease other than macroscopic or microscopic gastritis/duodenitis seen at endoscopy on entry into the trial, were randomly assigned to treatment for four weeks with sucralfate or a placebo, 1 g three times a day one-half hour before meals, according to a double-blind model. Seventy-nine patients received sucralfate and 72 patients received a placebo. According to patients' subjective assessment of their symptoms at four weeks, 61 patients (77 percent) in the sucralfate group and 40 patients (56 percent) in the placebo group had become symptom-free or showed improvement, whereas the condition of 18 (23 percent) in the former group compared with 32 (44 percent) in the latter group remained unchanged or deteriorated. The difference between the groups was significant (p less than 0.01). The best response to sucralfate treatment (84 percent or more symptom-free or improved) was achieved in patients with mild or moderate symptoms and without macroscopic or microscopic inflammation of their gastric mucosa--a typical patient with non-ulcer dyspepsia. Our results indicate that sucralfate is significantly more effective than placebo in the treatment of non-ulcer dyspepsia.
Am J Med 1987 Sep 28
PMID:Sucralfate versus placebo in treatment of non-ulcer dyspepsia. 331 Jun 29

In this multivariate analysis of the irritable bowel syndrome (IBS) we describe the symptomatic and psychologic features of the condition and their possible contributions to health care seeking. We studied 72 IBS patients, 82 persons with IBS who had not sought medical treatment, and 84 normal subjects. All subjects received complete medical evaluation, diary card assessment of abdominal pain and stool habit, and standard psychologic tests of pain, personality, mood, stressful life events, illness behavior, and social support. Pain and diarrhea were the most important symptoms associated with patient status. When controlling for these symptoms we found that (a) IBS patients have a higher proportion of abnormal personality patterns, greater illness behaviors, and lower positive stressful life event scores than IBS nonpatients (p less than 0.001) and normals (p less than 0.001); (b) IBS nonpatients, although psychologically intermediate between patients and normals, are not different from normals (p less than 0.21); and (c) IBS nonpatients have higher coping capabilities, experience illness as less disruptive to life, and tend to exhibit less psychologic denial than patients. These factors may contribute to "wellness behaviors" among people with chronic bowel symptoms. We conclude that the psychologic factors previously attributed to the IBS are associated with patient status rather than to the disorder per se. These factors may interact with physiologic disturbances in the bowel to determine how the illness is experienced and acted upon.
Gastroenterology 1988 Sep
PMID:Psychosocial factors in the irritable bowel syndrome. A multivariate study of patients and nonpatients with irritable bowel syndrome. 339 17

Women with symptoms indicative of irritable bowel syndrome who had not consulted a physician were compared with female patients at a gastroenterology clinic to investigate whether self-selection for treatment accounts for psychologic abnormalities in clinic patients' with irritable bowel syndrome. Two sets of diagnostic criteria were compared: restrictive criteria based on the work of Manning and conventional criteria (abdominal pain plus altered bowel habits). Lactose malabsorbers were included as a control group because they have medically explained bowel symptoms similar to those that define irritable bowel syndrome. Thus they control for the causative effects of chronic bowel symptoms on psychologic distress. Women who met restrictive criteria for irritable bowel syndrome but had not consulted a physician had no more symptoms of psychologic distress on the Hopkins Symptom Checklist than asymptomatic controls. However, medical clinic patients with both irritable bowel syndrome and lactose malabsorption had significantly more psychologic symptoms than asymptomatic controls or nonconsulters with the same diagnoses. Individuals who met only the conventional criteria for irritable bowel syndrome reported more psychologic distress than controls, whether or not they consulted a physician. These results suggest that (a) symptoms of psychologic distress are unrelated to irritable bowel syndrome but influence which patients consult a doctor and (b) conventional diagnostic criteria identify more psychologically distressed individuals than do restrictive criteria.
Gastroenterology 1988 Sep
PMID:Symptoms of psychologic distress associated with irritable bowel syndrome. Comparison of community and medical clinic samples. 339 18

Fibrositis is a disorder of musculoskeletal pain and aching with at least a five to one female-to-male ratio. It is most commonly seen between the ages of 40 and 60, and has a prevalence in the clinic of 6 to 15 percent. Its most common mode of presentation involves generalized musculoskeletal pain and aching, but articular pain, axial skeletal pain, myalgias, and neurovascular complaints sometimes predominate. All patients have multiple areas of local tenderness called "tender points" that are easily identified during physical examination, and are diagnostic. Essential symptoms of fibrositis are disturbed sleep, morning stiffness, and fatigue. Additional rheumatic symptoms include subjective swelling, paresthesias, and numbness. Headaches and irritable bowel syndrome are common nonrheumatic complaints. Modest improvement follows treatment by tricyclic agents such as low-dose cyclobenzaprine and amitriptyline, by physical measures, and by reduction in stress. Remission occurs in 20 percent of patients, but is generally short-lived.
Am J Med 1986 Sep 29
PMID:The clinical syndrome of fibrositis. 346 12

Fibromyalgia syndromes are common noninflammatory, painful musculoskeletal disorders that vary in the extent and intensity of involvement. The biologic gradient of musculoskeletal pain varies from no or few symptoms and tender points in the majority of persons to generalized fibromyalgia with multiple tender points. Standardized criteria are needed in order to categorize different strata of the biologic gradient of fibromyalgia syndromes and differentiate them from other conditions. Both the sensitivity and specificity of criteria should be high. The course and prognosis of fibromyalgia syndromes are not yet known. Limited clinical data suggest three basic patterns: remitting-intermittent; fluctuating-continuing; and progressive. However, course patterns need to be derived scientifically. Multiple host and environmental factors seem to contribute to the onset and course of fibromyalgia syndromes, and these require definition. Generalized fibromyalgia syndromes share many constitutional manifestations with other common functional disorders, e.g., irritable bowel syndrome and tension headache syndrome, which suggest common underlying psychoneurophysiologic mechanisms in a subset of patients. Progress made in fibromyalgia research will find application in many dysfunctional syndromes without obvious organ pathology.
Am J Med 1986 Sep 29
PMID:Concepts of illness in populations as applied to fibromyalgia syndromes. 353 80


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