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)

Biofeedback is a form of treatment that has no adverse effects and can be provided by physician extenders. The therapy relies on patients' ability to learn how to influence their bodily functions through dedicated machinery and teaching. This Review provides a comprehensive overview of all potential therapeutic applications of biofeedback for functional constipation, fecal incontinence, functional anorectal pain, IBS, functional dyspepsia, and aerophagia. Practical clinical applications of biofeedback therapy supported by randomized, controlled trials (RCTs) are limited to fecal incontinence and dyssynergic defecation. For fecal incontinence, RCTs suggest that biofeedback combining strength training and sensory discrimination training is effective in approximately 75% of patients and is more effective than placebo. However, verbal feedback provided by a therapist during extended digital examination may be equally effective, and children whose fecal incontinence is associated with constipation plus fecal impaction do no better with biofeedback than medical management. For dyssynergic defecation, RCTs show that biofeedback combining pelvic floor muscle relaxation training, practice in defecating a water-filled balloon, and instruction in effective straining is effective in approximately 70% of patients who have failed to respond to laxative treatment. For both incontinence and dyssynergic defecation, the benefits of biofeedback last at least 12 months.
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PMID:The role of biofeedback in the treatment of gastrointestinal disorders. 1852 Nov 15

Early life stress as neonatal maternal deprivation (MD) predisposes rats to alter gut functions in response to acute psychological stressors in adulthood, mimicking features of irritable bowel syndrome (IBS). We applied proteomics to investigate whether MD permanently changes the protein profile of the external colonic neuromuscular layer that may condition the molecular response to an acute stressor later in life. Male rat pups were separated 3 h/day from their mothers during the perinatal period and further submitted to water avoidance (WA) stress during adulthood. Proteins were extracted from the myenteric plexus-longitudinal muscle of control (C), WA and MD+WA rat colon, separated on 2D gels, and identified by mass spectrometry. MD amplified the WA-induced protein changes involved in muscle contractile function, suggesting that stress accumulation along life imbalances the muscle tone towards hypercontractility. Our results also propose a stress dependent regulation of gluconeogenesis. Secretogranin II - the secretoneurin precursor - was induced by MD. The presence of secretoneurin in myenteric ganglia may partially explain the stress-mediated modulation of gastrointestinal motility and/or mucosal inflammation previously described in MD rats. In conclusion, our findings suggest that neonatal stress alters the responses to acute stress in adulthood in intestinal smooth muscle and enteric neurons.
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PMID:Maternal deprivation affects the neuromuscular protein profile of the rat colon in response to an acute stressor later in life. 1854 76

Abnormal colonic motility is associated with clinical relevant conditions such as irritable bowel syndrome or constipation. Accurate assessment of colonic transit in an animal model would be useful in studying these conditions and screen potential drug candidates. The aim of this study was to assess if scintigraphic analyses could reliably evaluate total and segmental colonic transit as a measure of colonic motility of a non-absorbable radiotracer in rats. Normal Lewis rats (250-300 g) were given oral technetium-99m-rhenium sulfide colloid (15-20 MBq; 0.5 mL; n=4) followed by a rinse with water for injection (1.0 mL). Rats were fed and hydrated ad libitum. After 30 min, each rat was contained inside an 'imaging' tube then placed on a g-camera collimator. Whole body 5 min static images were acquired every 30 min up to 9 h, and then finally at 25 hours. Region of interest analyses were applied to the caecum/proximal colon, sigmoidal loop and distal colon/rectum. The tracer entered into the colon at approximately 4 hours, and the rats remained static to permit 'live' imaging. At 4 hours the % whole body activity was: 51% caecum/proximal colon, 39% sigmoidal loop, 6% distal colon/rectum; at 8 hours, 30% caecum/proximal colon, 13% sigmoidal loop, 7% distal colon/rectum. In the whole colon there was < or =1% of total activity present at 25 hours, and the half clearance time was determined as 4.0 hours. These results suggest this is a reliable technique of measuring regional colonic transit as a measure of colonic motility in normal rats. This methodology might be well suited to screen potential motility effects of drug candidates.
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PMID:Colonic transit studies with 99mTc-rhenium sulfide colloid in live rats. A preliminary study. 1881 63

The overall objective of this study was to develop a pH-dependent sustained release tablet formulation of a model drug, tegaserod maleate (TM), which is a poorly water soluble and acid labile drug in gastric milieu. The formulation's goal was to allow the dosage form to pass through the stomach intact, start disintegrating in the upper small intestine and slowly release the active in a controlled manner. Partition coefficient, contact angle and drug-excipient compatibility were investigated as part of the preformulation studies. A pH-dependent sustained release tablet was prepared using a combination of Eudragit L100 and Eudragit S100. The effects of solubilizer, disintegrant, binder, coating polymer concentration, pore former, and plasticizer on the drug release rate were determined. The results demonstrated that approximately 90% of the drug was released in a sustained release manner in the pH 6.8 phosphate buffer within 12 h while no drug was detected when subjected to drug release studies in 0.1 mol/L hydrochloric acid for 2 h. The drug release mechanism involved stress points and/or pore formation in the coated film. The coated tablets were stable at 40 degrees C/75% RH for 3 months. These results highlighted the feasibility of this coated tablet system containing TM, which may contribute to the successful treatment of irritable bowel syndrome.
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PMID:Development and evaluation of a pH-dependent sustained release tablet for irritable bowel syndrome. 1903 Dec 87

Chronic constipation and irritable bowel syndrome are heterogeneous disorders characterized by altered bowel habits, abdominal discomfort and/or difficult defecation. These conditions have a significant impact on patients' quality of life, as well as on the US economy, both in terms of healthcare costs and lost productivity. Treatment typically begins with lifestyle changes, increased fiber intake and osmotic and stimulant laxative intake. However, treatments for constipation vary in terms of their efficacy and safety. Furthermore, surveys of physicians and patients have revealed a strong desire for improved therapeutic options. Lubiprostone is a synthetic bicyclic fatty acid that is gut selective and stimulates type 2 chloride channels, resulting in increased chloride, sodium and water secretion into the lumen. The increased fluid secretion causes luminal distension, secondary peristalsis and laxation. Randomized Phase III trials have shown that lubiprostone is efficacious in the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation. The US FDA has approved lubiprostone at a dose of 24 microg twice daily for the treatment of chronic idiopathic constipation in adults, and at a dose of 8 microg twice daily for irritable bowel syndrome with constipation in adult women. Nausea, diarrhea and headaches are the most commonly reported side effects. In long-term studies, lubiprostone appears to be safe.
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PMID:Lubiprostone for constipation and irritable bowel syndrome with constipation. 1909 Jul 33

Present research was undertaken to investigate the effect of different level of 6% concentrated (w/v) aniseed extract in broiler chicks at NWFP Agricultural University Peshawar Pakistan. One hundred and sixty, day old broiler chicks were randomly assigned to four treatments, as A, B, C, receiving 20, 30 and 40 mL of 6% (w/v) concentrated aniseed infusion and D was kept as control group. Each treatment was replicated four times with ten chicks per replicate. Chicks were reared in cages in an open sided house. Vaccination was done against ND and IBD. Data were recorded for growth performance, immunity and economics. The data were subjected to statistical analysis, using Completely Randomized Design and MSTATC programme. Mean feed and water intake was nonsignificant (p > 0.05). Mean weight gain, FCR and dressing percentage was found better (p < 0.05) in group C. Mean weight of giblet, intestine, breast, fat and thigh was not altered (p > 0.05) in all groups. Mean antibody titer against IBD was higher (p < 0.05) in group C and antibody titer against ND and IB was not altered. Mean percent mortality was found higher (p < 0.05) in group D. Mean feed cost including the cost of aniseed infusion was not influenced (p > 0.05), while the gross return was found better (p < 0.05) in group B and C than other groups. Findings of the research study indicated that group C, receiving aniseed infusion at the rate of 40 ml L(-1) of water shown better growth performance, immunity and gross return. Detail research work is needed to examine the effect of aniseed in ration and its different form of extracts on poultry production under different environmental conditions.
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PMID:Efficacy of aniseed extract as immune stimulant and growth promoter in broiler chicks. 1909 89

Post-infectious irritable bowel syndrome (PI-IBS) is a common disorder wherein symptoms of IBS begin after an episode of acute gastroenteritis. The Walkerton Health Study (WHS) was initiated in 2002 to study the long-term outcomes of tragic contamination of its municipal water supply with Escherichia coli and Campylobacter species in 2000. Within a cohort of 2069 adult Walkerton residents with no prior history of chronic gastrointestinal disorders, the incidence of PI-IBS 2 years after the outbreak was 10.1% among subjects with no acute gastroenteritis vs 36.2% among those with clinically suspected gastroenteritis (P<0.001). Long-term follow-up of the WHS cohort has shown PI-IBS to have a favorable prognosis, with spontaneous remission in most patients. A recent meta-analysis of nine cohort studies estimated the pooled odds ratio for developing IBS after enteric infection to be 5.86 (95% CI 3.60-9.54). Risk factors for PI-IBS include female gender, younger age, more severe acute enteric infection, and psychiatric comorbidity. A prevailing hypothesis is that PI-IBS results from a failure to downregulate inflammation after an acute insult from gastroenteritis, a model supported by preliminary studies of intestinal permeability and pro-inflammatory genotypes. Ongoing research is testing the hypothesis that PI-IBS denotes increased susceptibility to more overt inflammatory disorders such as Crohn's disease. Although the Walkerton outbreak of acute gastroenteritis was an awful human tragedy, it is hoped that the WHS will advance our understanding of PI-IBS and improve the outcomes of people who suffer similar tragedies in the future.
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PMID:Post-infectious irritable bowel syndrome following water contamination. 1918 Jan 33

Females with Irritable Bowel Syndrome (IBS) and Temporomandibular Disorder (TMD) are characterized by enhanced sensitivity to experimental pain. One possible explanation for this observation is deficiencies in pain modulation systems such as Diffuse Noxious Inhibitory Control (DNIC). In a few studies that used brief stimuli, chronic pain patients demonstrate reduced DNIC. The purpose of this study was to compare sensitivity to prolonged heat pain and the efficacy of DNIC in controls to IBS and TMD patients. Heat pain (experimental stimulus; 44.0-49.0 degrees C), which was applied to left palm, was continuously rated during three 30-s trials across three separate testing sessions under the following conditions: without a conditioning stimulus; during concurrent immersion of the right foot in a 23.0 degrees C (control); and during noxious cold immersion in a (DNIC; 8.0-16.0 degrees C) water bath. Compared to controls, IBS and TMD patients reported an increased sensitivity to heat pain and failed to demonstrate pain inhibition due to DNIC. Controls showed a significant reduction in pain during the DNIC session. These findings support the idea that chronic pain patients are not only more pain sensitive but also demonstrate reduced pain inhibition by pain, possibly because of dysfunction of endogenous pain inhibition systems.
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PMID:Deficiency in endogenous modulation of prolonged heat pain in patients with Irritable Bowel Syndrome and Temporomandibular Disorder. 1933 15

There is an upsurge of interest in gastro-intestinal microbiology to improve the balance between positive and negative commensals. Mucosal bacteria make closer contact with the host than luminal ones and can therefore have a stronger health impact. An in vitro adhesion assay was developed to study the mucin colonization of bacteria from the mixed microbial communities of the Simulator of the Human Intestinal Microbial Ecosystem. Adhesion capacity differed substantially between bacteria and decreased from lactobacilli over fecal coliforms, bifidobacteria, and clostridia to total anaerobes. Lactobacillus rhamnosus GG adhered most selectively. Further, intestinal water lowered adhesion compared to phosphate-buffered saline. By processing the data to an Adhesion-Related Prebiotic Index, it was found that intestinal water stimulated adherence of positive commensals. Arabinoxylans decreased the adhesion capacity matrix independently, whereas inulin had less or no influence. Measurements of bacterial surface tension, surface hydrophobicity, liquid surface tension, and viscosity showed that bacterial adhesion to mucin agar is a matter of both non-specific and specific interactions. The developed methodology can be useful for the characterization of the relevant but barely investigated mucin-associated bacterial community in health and disease (e.g., IBD) as well as for its modulation with functional foods like prebiotics.
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PMID:In vitro model to study the modulation of the mucin-adhered bacterial community. 1930 5

We report a cost benefit analyses (CBA) for water interventions in rural populations of developed country sub-regions. A Bayesian belief network was used to estimate the cost benefit ratio using Monte Carlo simulation. Where possible we used input data from recently published primary research or systematic reviews. Otherwise variables were derived from previous work in the peer-reviewed or grey literature. For these analyses we considered the situation of people with small and very small community supplies that may not be adequately managed. For the three developed country sub-regions Amr-A (America region A), Eur-A (European region A) and Wpr-A (Western Pacific region A), we estimate the costs of acute diarrhoeal illness associated with small community supplies to be U$4671 million (95% CI 1721-9592), the capital costs of intervention to be USD 13703 million (95% CI 6670-20735), additional annual maintenance to be USD 804 million (95%CI 359-1247) and the CB ratio to be 2.78 (95%CI 0.86-6.5). However, we also estimated the cost of post infectious irritable bowel syndrome (IBS) following drinking water-associated acute gastroenteritis to be USD 11896 million (95%CI 3118-22657). When the benefits of reduced IBS are added to the analysis the CB ratio increases to 9.87 (95%CI 3.34-20.49). The most important driver of uncertainty was the estimate of the cost of illness. However, there are very few good estimates of costs in improving management of small rural supplies in the literature. Investments in drinking-water provision in rural settings are highly cost beneficial in the developed world. In the developed world, the CB ratio is substantially positive especially once the impact of IBS is included.
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PMID:An assessment of the costs and benefits of interventions aimed at improving rural community water supplies in developed countries. 1934 35


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