Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Irritable bowel syndrome (IBS) is a common medical disorder that is associated with significant disability and health care costs. A practical approach to diagnosis and management of patients afflicted by this disorder has previously been hampered due to incomplete understanding of its pathophysiology, lack of diagnostic precision, and absence of specific treatments. Over the last decade, epidemiological, physiological, and psychosocial data have emerged to improve our understanding of this disorder and its treatment. IBS is currently believed to result from dysregulation of intestinal motor, sensory, and central nervous system function. Symptoms are due to both disturbances in intestinal motility and enhanced visceral sensitivity. Psychosocial factors, although not part of IBS per se, have an important role in modulating the illness experience and its clinical outcome. Use of multinational symptom-based "Rome" criteria has increased diagnostic specificity and has helped to minimize studies done to exclude other disease. Finally, treatment involves an integrated pharmacological and behavioral approach that is determined by the severity of the illness and its physiological and psychosocial determinants.
Gastroenterologist 1994 Dec
PMID:Irritable bowel syndrome. 786 39

Bowel dysfunction such as irritable bowel syndrome caused by stress is well described. Previous reports suggest that 5-hydroxytryptamine (5-HT) mediates alteration of bowel motility. In this study, the effects of water-immersion stress and the administration of 5-HT on the expression of a 60-kDa heat shock protein (HSP60) in rat colonic mucosa were investigated. The effect of YM-060, a 5-hydroxytryptamine 3 (5-HT3) receptor antagonist, on the expression of this protein was also studied. Water-immersion stress and the administration of 5-HT induced synthesis of HSP60 in rat colonic mucosa. The induction of HSP60 and the number of defecations were clearly inhibited by the oral administration of YM-060. Our results suggest that the induction of HSP60 in rat colonic mucosa by water-immersion stress may be associated with gastrointestinal motility mediated by 5-HT, especially via 5-HT3 receptors.
J Gastroenterol 1994 Dec
PMID:Regulation of 60-kDa heat shock protein expression by systemic stress and 5-hydroxytryptamine in rat colonic mucosa. 787 66

Menthol-beta-D-glucuronide is a potential prodrug for colonic delivery of the spasmolytic agent menthol. Menthol is the primary constituent of peppermint oil, which is used to treat the irritable bowel syndrome. The chemical stability of menthol-beta-D-glucuronide was assessed at various pHs (1.5, 4.5, 6.0 and 7.4) over a 4 to 24 h period at 37 degrees C. The prodrug was stable, i.e., there was less than 0.1% hydrolysis of the prodrug, at pHs of 4.5, 6.0 and 7.4. At pH 1.5, the prodrug was about 20% hydrolyzed over a 4 h period suggesting the need for an enteric coating to prevent premature hydrolysis in the stomach. The stability of the prodrug was also assessed in luminal contents of the laboratory rat and in human stool samples. These studies were performed at concentrations designed to assess relative velocities of hydrolysis (i.e., substrate concentrations in excess of the Km). The prodrug was stable in luminal contents of the rat stomach, proximal small intestine, and the distal small intestine. The rate of hydrolysis of menthol-beta-D-glucuronide was 6.26 +/- 2.88 nmol min-1 mg-1 and 2.34 +/- 1.22 nmol min-1 mg-1 in luminal contents of the rat cecum and colon, respectively. The hydrolysis rate of menthol-beta-D-glucuronide was lower in human stool samples (0.52 +/- 0.46 nmol min-1 mg-1). The prodrug had a measured log octanol/buffer partition coefficient of -1.61 suggesting it should be poorly absorbed from the lumen of the gastrointestinal tract. The data support the hypothesis that menthol-beta-D-glucuronide is a candidate for the delivery of menthol to the large intestine under in vivo conditions.
Pharm Res 1994 Dec
PMID:Menthol-beta-D-glucuronide: a potential prodrug for treatment of the irritable bowel syndrome. 789 32

When no identifiable organic cause for colonic symptoms can be found, it is easy for the busy clinician to label the patient neurotic. It is evident that many of these "functional" disorders do reflect an underlying motility disorder, although our understanding is far from clear. However, currently, patients with severe constipation are evaluated in a much more rational manner and, as a consequence, are offered a reasonable therapeutic approach that can be predicted to have a good chance for success. We can hope that as our understanding of irritable bowel syndrome is strengthened, treatment will become more efficacious than the unproved and costly medications that are in use currently. Until dietary modification becomes commonplace, it is unlikely that the incidence of diverticular disease or its complications will change. Already, our understanding of ileus has allowed us to realize the benefits of laparoscopic surgery, and as our knowledge of the various gut hormones and the inhibitory role that some play in intestinal motility grows, ileus, and its resulting prolongation of hospital stay, may become less problematic.
Surg Clin North Am 1993 Dec
PMID:Pathophysiology of colonic motility disorders. 824 36

Chronic diarrhea is defined as the passage of more than 200 g of stool per day for more than three weeks. This condition may result from decreased absorption of gastrointestinal contents or increased fluid secretion into the bowel. Although chronic diarrhea can have many etiologies, irritable bowel syndrome, lactose intolerance, dietary factors, inflammatory bowel disease and colon cancer are the causes most frequently encountered in primary care practice. An orderly work-up, beginning with a complete history an a thorough physical examination, is essential. Whenever possible, treatment should be directed at the underlying cause of the diarrheal condition. If the diarrhea persists and the etiology remains obscure, administration of opiates or bile-sequestering agents often is helpful in alleviating symptoms. New approaches to decreasing secretions, such as the use of clonidine therapy, are being studied.
Am Fam Physician 1993 Dec
PMID:Chronic diarrhea: evaluation and treatment. 824 77

Despite multiple invasive diagnostic procedures including exploratory laparotomy and surgical resection, our patient's diagnosis remained an enigma. However, given the clinical scenario and the documented PG, a trial of steroids was warranted. The patient has fared well since her treatment, with resolution of all her symptoms. We feel confident that her disease process is most consistent with, and is most likely, Crohn's disease. There are several lessons to be learned from this case: 1) Inflammatory bowel disease can present at any age and belongs in a clinician's differential diagnosis of fever and diarrhea. 2) Failure to consider IBD in an elderly patient may lead to significant delay in diagnosis, and may expose the patient to unnecessary and sometimes dangerous intervention. 3) IBD in the elderly generally follows the same clinical patterns seen in younger patients. 4) Appropriate therapy can lead to prompt control or even resolution of the signs and symptoms of IBD.
Am J Gastroenterol 1993 Dec
PMID:Atypical presentation of inflammatory bowel disease in the elderly. 824 80

The aim of the study was to assess (1) the prevalence of colon related symptoms among the elderly and (2) whether different definitions identify different subjects with Irritable Bowel Syndrome. The study was carried out in a random sample of 1119 70-year-old Danes of whom 72% answered a questionnaire concerning colon related symptoms. The number of bowel movements a week ranged from 0 to 21 among men and 1 to 28 among women, 5% limits were at < 3 or > 15 movements a week. The individual symptoms occurred with prevalences between 16 and 25% among men and 27 and 41% among the women. Abdominal pain, distension and borborygmi occurred significantly more often among women than men, whereas no sex difference was found for alternating stool consistency and number of bowel movements. According to the different definitions the prevalence of Irritable Bowel Syndrome varied from 0 to 18% among men and 4 to 32% among women. The subpopulations with Irritable Bowel Syndrome identified by various definitions had less than half of the subjects in common.
J Clin Epidemiol 1993 Dec
PMID:Colon related symptoms in a 70-year-old Danish population. 826 71

Hyporesponsiveness to a universe of bacterial and dietary antigens from the gut lumen is a hallmark of the intestinal immune system. Since hyperresponsiveness against these antigens might be associated with inflammation, we studied the immune response to the indigenous intestinal microflora in peripheral blood, inflamed and non-inflamed human intestine. Lamina propria monocuclear cells (LPMC) isolated from inflamed intestine but not peripheral blood mononuclear cells (PBMC) of IBD patients with active inflammatory disease strongly proliferated after co-culture with sonicates of bacteria from autologous intestine (BsA). Proliferation was inhibitable by anti-MHC class II MoAb, suggesting that it was driven by antigen. LPMC from adjacent non-inflamed intestinal areas of the same IBD patients and PBMC or LPMC isolated from non-inflamed intestine of controls and patients with IBD in remission, in contrast, did not proliferate. PBMC or LPMC which had been tolerant to bacteria from autologous intestine, however, strongly proliferated after co-culture with bacterial sonicates from heterologous intestine (BsH). This proliferation was associated with an expansion of CD8+ T cells, increased expression of activation markers on both CD4+ and CD8+ lymphocyte subsets, and production of IL-12, interferon-gamma (IFN-gamma), and IL-10 protein. These results show that tolerance selectively exists to intestinal flora from autologous but not heterologous intestine, and that tolerance is broken in intestinal inflammation. This may be an important mechanism for the perpetuation of chronic IBD.
Clin Exp Immunol 1995 Dec
PMID:Tolerance exists towards resident intestinal flora but is broken in active inflammatory bowel disease (IBD) 853 55

To examine the applicability across subgroups of the Manning criteria commonly used to diagnose the irritable bowel syndrome, a 22-item symptom questionnaire was administered to male and female African-American and Caucasian adults (N = 1344). Principal components factor analysis with varimax rotation was used to identify symptom clusters. Consistent with the findings of a previous factor analytic study, three of the six Manning symptoms (loose stools and more frequent bowel movement with onset of pain, pain relieved by defecation) formed a cluster corresponding to the irritable bowel syndrome in all subgroups. It is concluded that: (1) The three core Manning symptoms have equal applicability to both genders and to African-Americans as well as to Caucasians. They useful symptom criteria for the diagnosis of IBS when used in conjunction with medical evaluation. (2) Three of the six Manning symptoms rarely correlate with the others; if confirmed in patient samples, this would indicate that these three symptoms are not useful for making a diagnosis of the irritable bowel syndrome.
Dig Dis Sci 1995 Dec
PMID:Irritable bowel syndrome defined by factor analysis. Gender and race comparisons. 853 26

Experimental approaches designed to define the role of reactive oxygen and nitrogen species generated by inflammatory cells in the tissue injury seen in inflammatory bowel disease rarely consider the chemical antioxidant defences against such increased oxidant stress in the mucosa. In this investigation, we have analysed components of the aqueous and lipid phase antioxidant mucosal defences by measuring the total peroxyl radical scavenging capacity and the levels of urate, glutathione, alpha-tocopherol, and ubiquinol-10 in paired noninflamed and inflamed mucosal biopsies from inflammatory bowel disease patients. Compared to paired noninflamed mucosa, decreases were observed in inflamed mucosa for total peroxyl radical scavenging capacity (55%, p = 0.0031), urate [Crohn's disease (CD), 62.2%, p = 0.066; ulcerative colitis (UC), 47.3%, p = 0.031], glutathione (UC, 59%, 7/8 patients, ns), total glutathione (UC 65.2%, 6/8 patients, ns), ubiquinol-10 (CD, 75.7%, p = 0.03; UC, 90.5%, p = 0.005). The mean alpha-tocopherol content was unchanged. These observations support our earlier findings of decreased reduced and total ascorbic acid in inflamed IBD mucosa and demonstrate that the loss of chemical antioxidant defences affects almost all the major components. The decreased antioxidant defences may severely compromise the inflamed mucosa, rendering it more susceptible to oxidative tissue damage, hindering recovery of the mucosa and return of epithelial cell layer integrity. The loss of chemical antioxidant components provides a strong rational for developing novel antioxidant therapies for the treatment of inflammatory bowel disease.
Free Radic Biol Med 1995 Dec
PMID:Depleted mucosal antioxidant defences in inflammatory bowel disease. 858 68


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>