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)

Four patients with the irritable bowel syndrome completed 28 day continuous stool collections and concurrent symptom diaries. The diaries revealed that three patients had multiple pains. When the diaries were compared with objective measurements, no relationship could be detected between the occurrence of pain or any other symptom on the one hand and stool weight, stool form or consistency, mean whole gut transit time, or interdefecatory transit on the other. Patients' descriptions of urgency, looseness and frequency of defecation give little guide to intestinal events, at least using currently available techniques.
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PMID:Is there a relationship between symptoms of the irritable bowel syndrome and objective measurements of large bowel function? A longitudinal study. 355 87

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

The value of the Crohn's disease activity index (CDAI) in defining clinical remission in Crohn's disease has been assessed in 71 studies using a new method to quantitate gut inflammatory activity: faecal 111In-labelled granulocyte excretion. The range of faecal 111In granulocyte excretion in the irritable bowel syndrome was found to be 0.2-1.9% (mean +/- SD 0.98 +/- 0.55%) of injected dose. 63 (89%) of studies with a CDAI less than 150 and 88% of studies with a serum albumin greater than 35 g/l had faecal 111In granulocyte excretion above the upper limit found in the irritable bowel syndrome ranging from 2.4% to 40%. This study shows that the majority of patients with Crohn's disease in clinical remission have significant gut inflammatory activity. Whether treatment of this activity will alter the natural history of the disease needs prospective evaluation.
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PMID:Clinical remission in Crohn's disease--assessment using faecal 111In granulocyte excretion. 394 92

We have studied 22 consecutive patients referred for investigation of severe chronic right upper quadrant pain. The majority were women whose symptoms had been present for many years. All had undergone repeated investigations of the pancreatico-biliary, gastro-intestinal, urinary, and even gynaecological systems without a satisfactory diagnosis. Most had undergone at least one abdominal operation in an unsuccessful attempt to cure their pain. In 21 of 22 patients the customary pain was completely and reproducibly mimicked by balloon distension of the small or large intestine in at least one site. The trigger sites were jejunum (15), ileum (12), right colon (nine), and duodenum (six). In 12 more than one trigger site was found. Close questioning revealed features of the irritable bowel syndrome in the majority and depression in many though the symptoms were not spontaneously volunteered. Reproduction of pain has provided a convincing demonstration to this difficult group of patients that they have a sensitive gut and allows appropriate management.
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PMID:Origin of chronic right upper quadrant pain. 401 43

The effects of inflating a balloon introduced through a sigmoidoscope to 35 cm in the pelvic colon have been observed and compared in 67 patients with the irritable colon syndrome and in 16 normal and constipated subjects acting as controls. Inflation to 60 ml caused pain in 6% of the controls at a mean diameter of 3.8 cm and in 55% of patients with the irritable colon syndrome (diameter 3.4 cm). An estimate of gut wall tension at this volume of inflation showed it to be normal in patients with the irritable colon syndrome; the incidence of pain in relation to wall tension was increased nearly tenfold in the irritable colon group. Inflation of the balloon to different volumes was normally painless to a maximum acceptable diameter which remained constant for each study under constant conditions; continued inflation eventually gave rise to pain without increasing the diameter. The pain was felt in the hypogastrium in 40%, in one or both iliac fossae in 31%, and in the rectum in 21%; the other 8% felt pain in the back or elsewhere and there were no significant differences between clinical groups. Exceptionally, in 6% of the controls, and in 52% of patients with the irritable colon syndrome, pain occurred at balloon diameters that could still be increased by 10% or more with further inflation. This was probably the outcome of a low threshold for visceral pain in the section of bowel in contact with the balloon. Colonic hyperalgesia of this kind, possibly a random occurrence, may be an important contributory factor in the aetiology of the irritable colon syndrome.
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PMID:Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. 469 35

The effect of open treatment with coarse wheat bran was compared with response to placebo, given in the form of a double blind, cross over drug trial, in patients with irritable bowel syndrome. Both bran and placebo significantly reduced the severity of most of the symptoms. Constipation was the only symptom that improved significantly with bran, but not with placebo, and was the only symptom that predicted a successful outcome with bran. Diarrhoea did not improve with bran. In fact, stools became less formed in patients presenting with this symptom. The incidence of pain and urgency was significantly more frequent on bran compared with placebo. Compared with a baseline period, bran treatment resulted in an acceleration of whole gut transit time (p less than 0.05) increases in daily stool weight (p less than 0.01) and the proportion of unformed stools (p less than 0.01) but no change in stool frequency. Coarse wheat bran was no better than placebo for most symptoms in irritable bowel syndrome, although its efficacy in constipation was confirmed.
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PMID:What is the benefit of coarse wheat bran in patients with irritable bowel syndrome? 631 44

Autoantibodies reacting with endocrine cells in the gastrointestinal mucosa were found by indirect immunofluorescence in 22 out of 268 sera (8.2%) obtained from patients with coeliac disease, Crohn's disease, ulcerative colitis, irritable bowel syndrome, and from subjects without bowel disease. A double immunofluorescence technique showed that the autoantibodies reacted with cells secreting gastric inhibitory polypeptide (glucose dependent insulinotropic polypeptide, GIP), secretin, somatostatin or enteroglucagon. Most sera contained antibodies against more than one cell type. Neither the presence of a particular antibody nor the pattern of antibody combinations appeared to be specific for any diagnostic category. The mean plasma GIP concentrations, however, both fasting and two hours after a test meal, were significantly lower in subjects with GIP cell autoantibodies. Thus gut hormone cell autoantibodies may be markers of impaired hormone secretion.
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PMID:Autoantibodies to gut hormone secreting cells as markers of peptide deficiency. 634 Nov 78

Symptom scores, stool data, and the transit of a standard, solid meal were measured in 25 patients with irritable bowel syndrome during baseline conditions and after four weeks treatment with placebo and domperidone in the form of a double-blind cross-over trial. All patients had previously undergone a comprehensive series of diagnostic investigations and had failed to respond to dietary supplementation with coarse wheat bran (10-30 g daily). Compared with placebo treatment, domperidone had no significant effect on gastric emptying, small bowel or whole gut transit times, stool weight, frequency, or consistency. Most symptoms improved significantly with both placebo and domperidone treatments, compared with the baseline period, but there was no significant difference between placebo and domperidone for any of the symptoms. Abdominal distension, however, was reported on more days per week during domperidone treatment (p = 0.02). The findings in this study do not support the use of domperidone in the management of irritable bowel syndrome.
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PMID:Oral domperidone: double blind comparison with placebo in irritable bowel syndrome. 635 63

Symptom scores, stool data, and the transit of a standard, solid meal were measured in 28 patients with irritable bowel syndrome (IBS) during baseline conditions and after five weeks of treatment with placebo and loperamide, given as a flexible dosage regime in the form of a double-blind, cross-over trial. All patients had undergone a comprehensive series of diagnostic investigations and had failed to respond to dietary supplementation with coarse wheat bran (10-30 g daily). Loperamide treatment accelerated gastric emptying, compared with placebo (1.2 +/- 0.1 vs 1.5 +/- 0.1 hr; P less than 0.001) and delayed both small bowel (6.2 +/- 0.3 vs 4.3 +/- 0.3 hr; P less than 0.001) and whole gut transit (56 +/- 5 vs 42 +/- 4 hr; P less than 0.01). Eighteen patients said they felt better taking loperamide compared with placebo and, at follow up, 15 of these patients remained satisfied with the effects of the drug. Most symptoms improved significantly on placebo compared with the baseline period, but three of these [diarrhea (P less than 0.01), urgency (P less than 0.01) and borborygmi (P less than 0.05)] showed a further significant improvement on loperamide. Improvement in diarrhea was not associated with any change in stool weight but was associated with reductions in stool frequency (P less than 0.001), passage of unformed stools (P less than 0.01), and incidence of urgency (P less than 0.001). Urgency was the only symptom that was significantly more common in the success group, compared with the group who did not feel better on loperamide.
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PMID:Role of loperamide and placebo in management of irritable bowel syndrome (IBS). 636 90

Symptoms of 50 patients with the irritable bowel syndrome were compared with those of 49 with endoscopically proven peptic ulcer disease and 49 with radiologically or endoscopically proven inflammatory bowel disease using a questionnaire which was administered after the diagnosis was made. Symptoms of bowel dysfunction including pain related to bowel movements were more likely to occur in the irritable bowel syndrome than peptic ulcer disease. Only abdominal distension, straining at stool and scybala, however, were significantly more likely in the irritable bowel syndrome than inflammatory bowel disease. Four symptoms previously shown to be more common in irritable bowel syndrome than in organic abdominal disease were combined. The more of these symptoms that were present, the more likely were the patients to have the irritable bowel syndrome than peptic ulcer disease. Symptoms of gut dysfunction are highly discriminating between irritable bowel syndrome and peptic ulcer disease but less so between irritable bowel syndrome and inflammatory bowel disease.
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PMID:Gastrointestinal symptoms in the irritable bowel compared with peptic ulcer and inflammatory bowel disease. 647 83


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