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)

Magnesium sulphate, a substance known to cause release of cholecystokinin (CCK) from the small intestinal mucosa, was given by mouth (dose 0.1g/kg in 150 ml water) to 20 patients with the irritable bowel syndrome. A rapid increase in colonic segmental motor activity (onset within two to six minutes in most cases) was seen (percentage activity increased from 16.2 to 23.7 p<0.05; mean wave amplitude from 7.1 to 9.1 cm H(2)O, NS; motility index from 144 to 259, p<0.01). This increase was most marked in 10 patients who complained of attacks of abdominal pain after food (16.1 to 29.8%, p<0.01; 6.8 to 9.6 cm H(2)O, p<0.05; 135 to 350, p<0.05), and after the magnesium sulphate three of these patients experienced an attack of their usual pain. These findings provide further evidence that ;functional' abdominal pain after food may in some cases be related to an exaggerated intestinal motor response to cholecystokinin.
Gut 1973 Dec
PMID:Effects of oral magnesium sulphate on colonic motility in patients with the irritable bowel syndrome. 478 87

Inflammatory bowel disease is a relatively common spectrum of disorders of the gastrointestinal tract in women of the reproductive age group. Although Crohn's disease may decrease fertility, female reproductive ability is normal in UC. In general, IBD is not a contraindication to pregnancy or vaginal delivery and is not an indication for therapeutic abortion. Pregnancy will have a variable effect on IBD, and the patient's experience in previous pregnancies is not prognostic of future pregnancies. Whenever possible, pregnancies should be planned when IBD is quiescent and the patient is on a minimal drug regimen. The treatment of IBD is essentially the same regardless of pregnancy. Aggressive medical management with supportive therapy, corticosteroids, and sulfasalazine is effective in the treatment for this disorder. Sulfasalazine is effective in preventing recurrence of UC. Surgical treatment may be necessary in pregnancy. An enlarged uterus may make recognition of acute complications difficult, and fear of radiation may decrease the number of diagnostic x-ray studies performed. A proctocolectomy and ileostomy is curative for UC, but no procedure will cure Crohn's disease. In pregnancy, a limited surgical procedure may be necessary. There is a high incidence of fetal loss if surgery is required in IBD. This fetal loss is probably caused by the fulminant nature of the disease rather than surgery itself. If surgery is indicated, however, it should be performed for maternal indications despite the risk to the fetus. As can be seen, management of IBD in pregnancy is not to be taken lightly and requires extensive collaboration between obstetrician, gastroenterologist, surgeon, and other support personnel.
Clin Obstet Gynecol 1983 Dec
PMID:Medical and surgical treatment of inflammatory bowel disease in pregnancy. 614 Oct 16

Eight spasmolytic drugs commonly used in the treatment of the irritable bowel syndrome were compared to verapamil with respect to their effects (all drugs injected i.v.) on the contraction of duodenum, ileum and colon induced by high K+ topical application in the anaesthetized rat. Verapamil greater than rociverine greater than papaverine greater than mebeverine greater than dicyclomine antagonized dose-dependently the contraction of duodenum and colon, the activity on duodenum being from 2 (rociverine) to 10 (verapamil) fold higher. Verapamil and rociverine, but not the other drugs mentioned above, were also active on ileum. N-Butylscopolammonium bromide, phloroglucinol and trimebutine were inactive against the contraction of the three intestinal tracts and prifinium bromide was inactive on duodenum and ileum, while it had remarkable activity on colon, unrelated to its antimuscarinic activity. The results are discussed briefly with reference to the pharmacological therapy of the irritable bowel syndrome.
Eur J Pharmacol 1983 Dec 23
PMID:Effects of spasmolytics on K+-induced contraction of rat intestine in vivo. 614 56

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.
Gut 1983 Dec
PMID:Oral domperidone: double blind comparison with placebo in irritable bowel syndrome. 635 63

Treatment programs for digestive diseases should be evaluated by randomized clinical trials. Under most circumstances, the best design for such trials requires placebo controls. For example, clinical trials should include groups of placebo-treated patients when there is no commonly accepted standard patients when there is no commonly accepted standard therapy for the disease under study, when standard therapy is of doubtful efficacy, or when standard therapy is unacceptably toxic. Moreover, illnesses--including peptic ulcer and IBD--may have sufficiently high response rates to placebo therapy as to favor placebo-controlled study designs. Placebo treatment is also free of substantial risk, at least compared to active drug treatment, when the disease process is very mild or when the study period is very short. Acceptable alternatives to placebo control include direct comparisons of new agents to standard therapy and addition of either new agents or placebo to a continuing baseline of standard therapy. Similarly, both placebo and active-treatment groups can sometimes be permitted access to standard therapy on a p.r.n. basis, with utilization thereof serving as one of the criteria of therapeutic response. Placebo-controlled trials are therefore generally feasible and desirable methods for testing the safety and efficacy of various proposed treatments for gastrointestinal diseases. High ethical standards in clinical medicine depend on high scientific standards in clinical research.
Am J Gastroenterol 1984 Dec
PMID:Placebo-controlled clinical trials in gastroenterology. A position paper of the American College of Gastroenterology. 650 16

Gut dysfunction can be demonstrated in 20-30% of normal adults without ever developing real illness. Irritable bowel syndrome is not merely a gastrointestinal disturbance, but involves the whole organism. With respect to etiology a number of factors such as constitution, mental state and environment, colonic motility, gastrointestinal peptides, low residue diet, food intolerance and infections all seem to play a role. Positive diagnosis by electromyography has not gained any clinical relevance. Treatment of gastrointestinal functional disorders is characterized by a considerable positive response to placebo and is oriented towards individual symptoms. Bran and bulking agents are effective when constipation is present, opiate-agonists have a positive influence in diarrhoea, anti-cholinergics may be of some value in abdominal pain, antidepressants and sedatives given for a limited period of time may be beneficial in psychiatric symptoms. The combination most often used in therapy of irritable bowel syndrome consists of sedatives, anticholinergics and bulking agents. Psychotherapy can prolong the positive effects of medical therapy even beyond the treatment period. Long-term follow-up reveals a satisfactory response of the symptomatology in the majority of patients.
Z Gastroenterol 1984 Dec
PMID:[The irritable colon]. 652 87

Lactose malabsorption was studied, by hydrogen breath test, in 72 adults suffering from irritable bowel syndrome, in 20 ulcerative colitis patients, and in 69 healthy subjects. The minimum dose of lactose required to cause a positive breath test was determined, and the symptoms caused and the resulting hydrogen eliminated quantified. A high incidence of lactose malabsorption was shown at standard doses (up to 50 g) in both the healthy subjects (70%) and the patients (86% and 85%, respectively). In the irritable bowel syndrome and the ulcerative colitis groups, symptoms occurred with a smaller quantity of breath hydrogen, presumably in association with a greater individual sensitivity of the colon to distension. The threshold lactose dose was notably lower in the diseased subjects who registered as evidence a prevalence of malabsorption at a 20-g lactose load. The pathogenetic role of lactose malabsorption in the irritable bowel syndrome is emphasized, as is the importance of the personal lactose tolerance.
Dig Dis Sci 1984 Dec
PMID:Hydrogen breath test quantification and clinical correlation of lactose malabsorption in adult irritable bowel syndrome and ulcerative colitis. 654 90

As in any operation for IBD, colectomy and ileorectal anastomosis should be performed only after every effort has been made to control the disease medically. Only in uncontrolled disease should early proctectomy be advised on the grounds of lack of normal physical development and sexual immaturity. Ileorectal anastomosis should not be performed upon every patient requiring surgical treatment any more than proctocolectomy and ileostomy should be performed upon every patient. Unless there is severe persistent disease of the rectum or destruction of the anal sphincter, the rectum should be preserved because severe ulcerative proctitis may heal or improve postoperatively with further medical treatment. If further surgical treatment is necessary, conversion to an ileostomy can be undertaken, and there are now other alternatives, such as the continent ileostomy and the ileoanal anastomosis, with or without a pelvic pouch.
Surg Gynecol Obstet 1983 Dec
PMID:Ileorectal anastomosis for inflammatory bowel disease in children and adolescents. 664 77

On the basis of the observations that chronic nonspecific diarrhea is a precursor of irritable colon syndrome and that chronic nonspecific diarrhea is associated with attention deficit disorder in childhood, the authors conducted a psychiatric diagnostic evaluation of 22 adults with irritable colon syndrome. Six (27%) of the patients received a diagnosis of attention deficit disorder, residual type, six (27%) were diagnosed as having dysthymic disorder, and five (23%) had had episodes of unipolar depression. The relationship between the presence of these disorders and greater severity of irritable colon syndrome was statistically significant.
Am J Psychiatry 1983 Dec
PMID:Prevalence of attention deficit disorder, residual type, and other psychiatric disorders in patients with irritable colon syndrome. 665 Jun 87

During a 2 year period, 83 patients with gastric motility problems were evaluated using radionuclide imaging. The patients presented with epigastric distress, postprandial fullness, pain, nausea, vomiting, and diarrhea; signs and symptoms suggestive of either gastroparesis or gastric outlet obstruction. Upper gastrointestinal series or endoscopy, or both, demonstrated no mechanical obstruction. After oral administration of a 300 g meal labeled with 600 muCi of technetium-99m sulfur colloid, a gastric emptying study consisting of serial images and data acquisition was performed. Of the patients studied, 52 had had peptic ulcer surgery, 17 were suspected of having gastroesophageal reflux, 8 were diabetic and suspected of having visceral enteropathy, and 6 had a history of irritable bowel syndrome. The normal mean gastric half emptying time was 77 +/- 16 minutes. Of the patients who had had gastric surgery, 90.4 percent had abnormal emptying: 69.2 percent had delayed gastric emptying and 21.2 percent had rapid gastric emptying time; 9.6 percent had normal emptying time. Of the gastroesophageal reflux group, all but two had normal gastric emptying time; 65 percent demonstrated gastroesophageal reflux within 15 minutes. Two of the patients with irritable bowel syndrome had prolonged emptying; the rest had normal emptying. All diabetic patients with gastroparesis had prolonged gastric emptying time, and all responded favorably to metoclopramide. Of the patients who previously had peptic ulcer surgery and had prolonged emptying time, 72 percent also responded favorably to metoclopramide. We conclude that radionuclide gastric imaging is a useful diagnostic test for the measurement of gastric emptying in patients with a variety of gastrointestinal motility disorders and may be helpful in assessing medical therapy and selecting those who may be candidates for surgery.
Am J Surg 1983 Dec
PMID:Assessment of gastric motility using meal labeled with technetium-99m sulfur colloid. 665 Jul 70


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