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

Significant changes on a standard barium follow-through examination in celiac disease have been determined by comparison with functional changes (irritable bowel syndrome), malabsorption without a villous lesion (chronic pancreatitis), and a villous abnormality without malabsorption (dermatitis herpetiformis). Patients with iron deficiency anemia formed the control group. Slight jejunal dilatation (26-30 mm) was found in 15% of the celiacs and 17% of the irritable bowel patients. Dilatation in excess of 30 mm and/or effacement of jejunal fold pattern occurred only with an abnormal jejunal biopsy, in 54% of the celiacs and 33% of the dermatitis herpetiformis patients. Patients with malabsorption by itself and 46% of the celiacs could not be distinguished from those with irritable bowel syndrome. The concept of a malabsorption pattern is considered invalid, and the diagnosis of celiac disease can be reliably established only by peroral jejunal biopsy.
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PMID:Relevance of the barium follow-through examination in the diagnosis of adult celiac disease. 55 35

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

Diverticular disease comprises a spectrum of illness beginning with the irritable bowel syndrome and progressing to the life-threatening complications of diverticulitis and hemorrhage. Step-wise progression of this disease may be seen but is not invariably present; many patients with diverticulosis do not have preceding symptoms of the irritable bowel syndrome. The typical complaints of irregularity of bowel habits and abdominal pain will usually respond to the relatively new treatment modality of a high fiber diet with added wheat bran. Barium enema x-ray examination remains the primary diagnostic modality in the investigation of diverticular disease, and colonoscopy should be used only in the presence of certain specific circumstances. Surgery, aimed at the treatment of complications of this disease, has progressed to the point where one-stage extirpation of the diseased bowel is recommended.
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PMID:Diverticular disease. 108 3

Spastic Colitis (SC) of the fifties has been deleted and included in the Irritable Bowel Syndrome, as inflammation is not present, and the disturbed intestinal motility may involve the small and large intestine. With the advent of colonoscopy, we could investigate this generalized common term. Between 1983 and 1988 we have studied 120 documented cases of SC by colonoscopy with multiple biopsies. In every patient, we relied on consecutive procedures to confirm the diagnosis. They included: Stool examination, barium enema, small bowels series, colonoscopy with multiple biopsies. Serological diagnosis of Amebiasis has been applied to 41 patients only. With a normal small bowels, barium enema revealed a severe spasm of the whole colon, or a segmental spasm in one part of the colon. In 53 cases (44%,) we have noted virtual absence of haustra in the tubular descending colon. Colonoscopy in all cases has revealed an active contraction with some congestion of the mucosa or hyperemia. Different degrees of inflammatory reaction shown on multiple biopsies make the diagnosis of SC in these cases more relevant. In the Afro-Asiatic countries where amebiasis is endemic, SC is to be considered, as colonoscopy is proving the prevalence of congested or inflammatory process in the colonic mucosa, even when stool examination is repeatedly negative for amebiasis.
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PMID:Spastic colitis and irritable bowel syndrome: which expression is prevalent? (A review of 120 cases). 141 94

Fifteen patients with abdominal pain compatible with the irritable bowel syndrome (IBS) were examined by barium enema and pressure recording. Strong circular contractions of the sigmoid colon and pressure recordings correlated with the characteristic pain in 13 of the 15 patients. In 15 control patients no pain occurred. It is concluded that pain and high pressure are caused by strong circular sigmoidal contractions. Such findings enable the radiologist to contribute to the diagnosis of IBS.
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PMID:Painful irritable bowel syndrome and sigmoid contractions. 200 7

It was investigated whether Hemoccult-II test (H-II) could reduce the number of colonic examinations in patients with the irritable bowel syndrome, with normal rigid proctoscopic findings. A negative H-II was obtained in 299 patients from general practice and a positive test in nine. Colonoscopy was done in 157 and double contrast barium enema in 142 after random allocation. The nine patients with positive H-II all had colonoscopy. Among the 299 with negative H-II, colonic adenomas were detected in ten and an early cancer in an adenoma in the sigmoid colon; overlooked rectal adenomas were found in three, rectal cancer in one, rectal carcinoid in another and a coecal cancer, which could be palpated, in a third patient. Two patients with colonic cancer and one with adenoma were detected among those with positive H-II. All patients were followed by clinical examination after one year. In conclusion, colonic examination should carry a low priority in patients with symptoms of irritable bowel, negative Hemoccult-II and normal rigid proctoscopic findings performed by an experienced examiner. The investigation confirmed the recommendation of total colonoscopy in patients with a positive H-II and added support for increasing number of endoscopy services in contrast to those of diagnostic radiology, which should be reduced.
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PMID:[Rectoscopy and Hemoccult II in irritable colon. A prospective study]. 194 12

In order to develop a scoring system for selecting patients at high risk of organic diseases of the colon, who would need a colonoscopy or a barium enema, we conducted a study with 14 GPs in the local health care district of Modena. Over one year, 254 consecutive patients who consulted their GP for chronic abdominal pain were asked to answer a guided questionnaire. A checklist of simple parameters suggestive of the presence of organic diseases of the colon was also registered by the GP. For the final diagnosis, the patients underwent either a colonoscopy or a barium enema. Data collected were analysed by means of a stepwise logistic regression analysis to obtain a weighted score for the diagnosis of either irritable bowel syndrome (score less than 0) or organic disease (score greater than 0). Out of the 25 parameters explored, six were significantly more common among patients with organic disease and weighted as positive score (namely ESR greater than 17 mm, first hour, history of blood in the stool, leukocytosis greater than 10,000 cm3, age greater than 45 years, slight fever and presence of neoplastic colonic diseases in first-degree relatives). On the contrary, five parameters were more frequent among patients with irritable bowel syndrome and weighted as negative score (namely visible distension of the abdomen, feeling of distension, presence of irritable bowel syndrome in first degree relatives, flatulence and irregularities of bowel movement). Our scoring system correctly classified 83.5% of the cases, and it was very sensitive (82.4%) for the diagnosis of organic disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A simple score for the identification of patients at high risk of organic diseases of the colon in the family doctor consulting room. The Local IBS Study Group. 228 44

The incidence of severe duodenal anomalies (MD) has been investigated in 458 patients submitted to barium meal examination and in 176 subjects comprising various clinical subgroups. The incidence of MD in patients submitted to barium meal examination was 11.6%. The incidence of MD in 25 normals was 4%, which was not significantly different from the incidence (10%) of MD in patients with gastroesophageal reflux symptoms. Compared with in normals, MD occurred with a significantly higher incidence in 45 patients with X-ray-negative dyspepsia (24%), in 36 patients with the irritable bowel syndrome (44%), and in 37 patients with asthma (38%). It is concluded that demonstration of MD in a patient is only indicative of a possible disorder.
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PMID:The incidence of severe duodenal anomalies in patients submitted to barium meal examination, in normals, and in different clinical subgroups. 343 6

Patients with Crohn's disease (n = 22), ulcerative colitis (n = 5), inactive Whipple's disease (n = 1), irritable bowel syndrome (n = 2), arthritis (n = 1) and Yersinia infections (n = 2) were examined with 111In-oxine labelled "mixed" leukocyte preparations (n = 12) or with 111In-oxine labelled "pure" granulocyte preparations (n = 21). Compared with barium enemas of the gut and colonoscopy, performed within of one week in 31 patients there was a correct location of infiltrated bowel segments in 24 patients (78%). The scan diagnosed more infiltrated segments in 4 patients (13%). In 3 patients it failed to diagnose one inflamed segment. In 24 patients the faecal 111In-excretion was expressed as percentage of the reinjected 111In-activity. All patients with non inflammatory bowel diseases and patients with inactive inflammatory bowel diseases excreted less than 2% of the reinjected 111In-activity. All but one female patient with active bowel disease excreted more than 2%. In 24 patients the correlation of ESR, CDAI and A.I. was available. There was a good correlation between ESR (r = 0.77, P less than 0.001), A.I. (r = 0.61, p less than 0.001) and the %-faecal faecal excretion. The 111In-labelling of white blood cells, especially of granulocytes, seems to be a reliable alternative method to localize infiltrated bowel segments and to assess disease activity in patients with inflammatory bowel diseases, compared to usually performed radiological, endoscopical and clinical methods.
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PMID:[111In-oxine marked leukocytes: a method for diagnosing the location and evaluating the activity of Crohn disease and ulcerative colitis]. 393 91

A retrospective analysis was made of 114 new patients attending a gastroenterology clinic, in whom the initial clinical diagnosis was irritable bowel syndrome. Barium enemas were performed in 84 patients (74%), 15 of whom were found to have significant other disease. In each case this would have been suspected from the routine haematological and biochemical screening tests. It is suggested that, in the investigation of patients under 50 years of age presenting to a gastroenterology clinic with a typical history of irritable bowel syndrome, a barium enema should only be performed if the clinical examination, sigmoidoscopy, rectal biopsy or routine blood tests are abnormal. This policy would reduce substantially the number of normal barium enemas performed.
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PMID:Irritable bowel syndrome: is a barium enema necessary? 395 99


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