Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392326 (discomfort)
 22,423 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with irritable bowel syndrome (IBS) suffer from embarrassing symptoms of abdominal pain/discomfort associated with altered bowel movement, sometimes with urgency. Routine clinical examination is not able to identify the origin of symptoms, which may lead to the physicians to doubt the symptoms patients complain of. As a consequence, patients may mistrust such physicians. Diagnosis of IBS deeply depend on the subjective symptoms and judgment of the patients, without any objective parameter to show any abnormalities. Also, any diagnostic criteria is not perfect yet. Furthermore, we do not have any potent therapeutic approach yet. Therefore, we should establish good patient-physician relationship at the beginning of the approach to IBS patients.
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PMID:[Introduction: Irritable bowel syndrome]. 1689 3

Irritable bowel syndrome (IBS) is a disease entity characterized by recurrent abdominal pain or discomfort associated with altered bowel movement, in which no obvious pathogenetic lesion is identified to explain the symptoms. Postulated pathogenesis for IBS are; motility disorder, visceral sensation abnormalities, complex relationship between brain and gut, relationship to personality, and post-infectious abnormalities in the colonic mucosa. Though many possibilities are presented, diagnostic criteria for IBS are entirely based on the subjective symptoms of the patients. Stress or psychological distress seem to play some roles in the pathogenesis, any of the diagnostic criteria for IBS do not include such aspects. Manning's criteria seem to be the first one to mention the diagnostic criteria. Rome consensus (1988) provoked the attention to IBS among the investigators, with followers like Rome II (1999), and BMW(2000) in Japan. Recently, Rome III criteria was published, which is more clinical oriented.
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PMID:[Disease concept and definition of irritable bowel syndrome]. 1689 4

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders(FGIDs) characterized by chronic abdominal pain or discomfort, which is associated with changes in stool frequency and/or form. Rome II criteria for IBS was used widely in research and practice. Besides, Rome III criteria was recently published. Because IBS is a frequent disease, the spread of Rome III criteria will play an important role of pathophysiological study and new therapy in gastrointestinal medical care.
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PMID:[Use of Rome III criteria for diagnosing irritable bowel syndrome]. 1689 6

Irritable bowel syndrome (IBS) is defined as abdominal pain and discomfort with altered bowel habits in the absence of any organic disorder. More than 10% of general population are considered to be affected by IBS. A guideline on its diagnosis and treatment has been issued in Japan in 2002. Accordingly, the therapeutic approach of IBS will be reviewed here. The most important issue of treatment is the establishment of a good physician-patient relationship. Given the limited efficacy of pharmacologic therapy and known psychological factors involved, effective treatment of IBS requires a comprehensive, multifaceted approach.
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PMID:[Review: treatment of irritable bowel syndrome based upon a Japanese guideline]. 1689 16

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal (GI) disorder, but its pathophysiology remains unknown. 5-hydroxytryptamine (5-HT, serotonin) is an important neurotransmitter involved in the brain-gut connection. Alosetron, a 5-HT3 receptor antagonist, has been demonstrated in randomized, placebo-controlled trials (RCT) to be effective in diarrhea-predominant IBS(IBS-D). Constipation is the most common adverse event. Alosetron improved abdominal pain and discomfort and stool consistency in both female and male patients, but it did not improve other symptoms (sense of urgency, stool frequency and bloating) in male patients. Although less is known about the gender differences in therapeutic benefit, a new 5-HT3 antagonist, cilansetron, has demonstrated effectiveness in male and female IBS-D patients and is currently under clinical trials.
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PMID:[Antagonists of the type 3 serotonin receptor (5 -HT3) in IBS]. 1689 18

Intestinal motility, secretion, and blood flow are controlled and integrated by the enteric nervous system (ENS). The ENS is like a "brain-in-the-gut," with many of the neurophysiologic properties of the central nervous system. Serotonin is a neurotransmitter at synapses in the microcircuits of the ENS. Serotonin is also released from enterochromaffin cells and inflammatory/immune cells to act at serotonergic receptors on neurons of the ENS. Four important actions are (1) fast and (2) slow excitation of enteric neurons, (3) presynaptic inhibition of neurotransmitter release at synapses in ENS microcircuits, and (4) excitation of intestinal sensory afferent fibers. Fast excitation and stimulation of sensory afferents are mediated by 5-HT(3) serotonergic receptors and slow excitation by 5-HT(1P) receptors. Presynaptic inhibitory receptors are not conclusively defined. The efficacy of a new 5-HT(3) receptor blocking drug in the treatment of the diarrhea-predominant form of the irritable bowel syndrome in women suggests the importance of this receptor subtype in the mediation of neurogenic secretory diarrhea, motility abnormality, and abdominal pain and discomfort.
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PMID:Enteric nervous system, serotonin, and the irritable bowel syndrome. 1703 Nov 57

How to treat patients with irritable bowel syndrome (IBS) who do not respond to pharmacotherapy is an unsolved problem. Psychotherapy, which has been reported on in previous studies, is available only in specific centers. We describe in this study a novel and simple psychotherapy; that is, the fasting therapy (FT) for treatment of patients with IBS. Of 84 inpatients with IBS, 58 patients who still had moderate to severe IBS symptoms after 4-week basic treatment were investigated retrospectively. Of the 58 patients enrolled in this study, 36 underwent FT, whereas the remaining 22 received a consecutive basic treatment (control therapy). There were no significant differences in the 4-point severity scales of gastrointestinal and psychological symptoms between the 2 groups before the start of FT. The basic treatment consisted of pharmacotherapy and brief psychotherapy, whereas the FT consisted of 10 days of starvation followed by 5 days of refeeding. Changes in scores of symptoms before and after each treatment were analyzed. FT significantly improved 7 out of the 10 symptoms assessed; that is, abdominal pain-discomfort (p < .001), abdominal distension (p < .001), diarrhea (p < .001), anorexia (p = .02), nausea (p < .01), anxiety (p < .001), and interference with life in general (p < .001). However, the control therapy significantly improved only 3 out of the 10 symptoms assessed; that is, abdominal pain-discomfort (p = .03), abdominal distension (p < .01), and interference with life (p = .01). Our results suggest that FT may have beneficial effects on intractable patients with IBS.
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PMID:Effects of fasting therapy on irritable bowel syndrome. 1707 71

The characterization of the corticotropin-releasing factor (CRF) family of neuroendocrine regulatory peptides, the cloning and pharmacological characterization of two CRF receptor subtypes (CRF(1) and CRF(2)), and the development of selective CRF receptor antagonists provided new insight to unravel the mechanisms of stress and the potential involvement of the CRF system in different pathophysiological conditions, including functional gastrointestinal disorders, mainly irritable bowel syndrome (IBS), and psychopathologies such as anxiety/depression. Compelling pre-clinical data showed that brain CRF administration mimics acute stress-induced colonic responses and enhances colorectal distension-induced visceral pain in rats through CRF(1) receptors. Similarly, peripheral CRF reduced the pain threshold to colonic distension and increased colonic motility in humans and rodents. These observations mimic the manifestations of IBS, characterized by abdominal bloating/discomfort and altered bowel habits. Moreover, CRF-CRF(1) pathways have been implicated in the development of anxiety/depression. These psychopathologies, together with stressful life events, have high comorbidity with IBS, and are considered significant components of the disease. From these observations, CRF(1) receptors have been suggested as a target to treat IBS. Peripherally acting CRF(1) antagonists might directly improve IBS symptoms, as related to motility, secretion and immune response. On the other hand, central actions will be beneficial as to prevent the psychopathologies that co-exist with IBS and as a way to modulate the central processing of stress- and visceral pain-related signals. Here, we review the pre-clinical and clinical data supporting these assumptions, and address the efforts done at a pharmaceutical level to develop effective therapies targeting CRF(1) receptors for functional gastrointestinal disorders.
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PMID:CRF1 receptors as a therapeutic target for irritable bowel syndrome. 1710 Jun 12

Functional gastrointestinal disorders, such as functional dyspepsia (FD) and irritable bowel syndrome, are common pathologies of the gut. FD is a clinical syndrome defined as chronic or recurrent pain or discomfort of unknown origin in the upper abdomen. The pathophysiological mechanisms responsible for FD have not been fully elucidated, but new ideas regarding its pathophysiology and the significance of the pathophysiology with respect to the symptom pattern of FD have emerged. In particular, there is growing interest in alterations in gastric motility, such as accommodation to a meal or gastric emptying, and visceral sensation in FD. The mechanisms underlying impaired gastroduodenal motor function are unclear, but possible factors include abnormal neurohormonal function, autonomic dysfunction, visceral hypersensitivity to acid or mechanical distention, Helicobacter pylori infection, acute gastrointestinal infection, psychosocial comorbidity, and stress. Although the optimum treatment for FD is not yet clearly established, acid-suppressive drugs, prokinetic agents, eradication of H. pylori, and antidepressants have been widely used in the management of patients with FD. The therapeutic efficacy of prokinetics such as itopride hydrochloride and mosapride citrate in the treatment of FD is supported by the results of relatively large and well-controlled studies. In addition, recent research has yielded new therapeutic agents and modalities for dysmotility in FD, including agonists/antagonists of various sensorimotor receptors, activation of the nitrergic pathway, kampo medicine, acupuncture, and gastric electric stimulation. This review discusses recent research on the pathophysiology of and treatment options for FD, with special attention given to digestive dysmotility.
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PMID:Recent insights into digestive motility in functional dyspepsia. 1716 May 14

Irritable bowel syndrome (IBS) is a disease of unclear, complex pathophysiology characterised by abdominal pain and discomfort and altered bowel activity. It affects an estimated 10-15% of individuals worldwide and has a large impact on quality of life (QOL) and both direct and indirect healthcare costs. Symptoms of IBS are usually triggered by disruption of gastrointestinal (GI) function secondary to infection, dietary factors, lifestyle changes or psychological stress. While most currently available pharmacological treatments of IBS focus on symptomatic treatment of the syndrome, agents that attempt to address the pathophysiology of the disease, in particular the role of serotonin, have received much attention in recent years. However, there is growing concern that serotonergic agents as a class may be associated with rare, but serious, episodes of ischaemic colitis, with several cases of this complication having been reported in association with use of serotonergic agents that have reached the market. Thus, there remains an important need for safe and effective agents that treat the symptoms of IBS. Otilonium bromide, a spasmolytic agent, has been widely used worldwide and has been found to be effective and safe for managing abdominal pain. Clinical trials indicate that it improves baseline abdominal pain and distension, and is particularly effective in reducing diarrhoea. Combining otilonium bromide with benzodiazepines, such as diazepam, may improve the efficacy of the agent with respect to GI symptoms, while also treating underlying anxiety disorders. More research is required to confirm the efficacy and mechanisms of action associated with this combination therapy in IBS. Safety data from clinical trials and postmarketing sources indicate that otilonium bromide is well tolerated, with a safety profile comparable to placebo in clinical trials and only two reported cases of adverse reactions (urticaria) among 10-year postmarketing data. This article reviews the pathophysiology and treatment of IBS with a particular focus on the role of otilonium bromide in the management of this condition.
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PMID:Irritable bowel syndrome. 1717 77


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