Caballero-Plasencia, A.M.; Valenzuela-Barranco, M. [Department of Medicine, School of Medicine, University of Granada (Spain); Herrerias-Gutierrez, J.M. [Division of Gastroenterology, University Hospital ``Virgen de la Macarena``, Sevilla (Spain); Esteban-Carretero, J.M. [Central Service of Investigation in Health Sciences, University of Cadiz, Cadiz (Spain)
Irritable bowel syndrome is the most frequent functional disorder of the digestive system. Patients with irritable bowel syndrome have motor disorders not only in the colon, but also in other parts of the digestive tract such as the oesophagus and small intestine; however, it is not known whether the stomach is also involved. We used a radiolabelled mixed solid-liquid meal (technetium-99m for the solid component, indium-111 for the liquid component) to study gastric emptying of solids (GES), liquids (GEL) and indigestible solids (GER) in 50 patients diagnosed as having irritable bowel syndrome (30 with predominant constipation and 20 with predominant diarrhoea). GER was measured by counting the number of indigestible solids remaining in the stomach 4 h after they were swallowed. In patients with irritable bowel syndrome, GES and GEL were slower than in control subjects (P<0.05). GER was normal in all patients except for two women. Thirty-two patients (64%) showed delayed GES, 29 (58%) delayed GEL, and 2 (4%) delayed GER. Among patients with irritable bowel syndrome, GES was slower in those with predominant constipation than in those with predominant diarrhoea (P<0.05); GEL and GER were similar in both groups. Gastroparesis was found in a large proportion of patients with irritable bowel syndrome, suggesting the presence of a more generalised motor disorder of the gut. (orig.) With 1 fig., 3 tabs., 48 refs.
Aldona Dlugosz; Björn Winckler; Elin Lundin; Katherina Zakikhany; Gunnar Sandström; Weimin Ye; Lars Engstrand; Greger Lindberg
Several studies have indicated that colonic microbiota may exhibit important differences between patients with irritable bowel syndrome (IBS) and healthy controls. Less is known about the microbiota of the small bowel. We used massive parallel sequencing to explore the composition of small bowel mucosa-associated microbiota in patients with IBS and healthy controls. We analysed capsule biopsies from the jejunum of 35 patients (26 females) with IBS aged 18-(36)-57 years and 16 healthy voluntee...
Irritable bowel syndrome (IBS) is a functional bowel disorder by unknown aetiology. Several reviews are written about pharmacological and psychological treatment of the disease. Nevertheless, healthcare professionals consider these patients difficult to handle in daily practice. There is an uncertainty about how to measure symptoms and to evaluate the effect of any given treatment. In the absence of objective markers, professionals feel unsure of how to manage the condition and the patients d...
Changes in the intestinal microbiome of patients with short bowel syndrome (SBS) are thought to significantly affect clinical outcome. These changes may not only delay enteral diet advancement but may also predispose patients to bacterial translocation, bacteremia, and liver disease. Patients with S...
Efsen, E; Jeppesen, P B
By definition, intestinal failure prevails when oral compensation is no longer feasible and parenteral support is necessary to maintain nutritional equilibrium. In the past, conventional treatment has mainly focused on "making the most of what the short bowel syndrome patient still had" by...
Nørholk, Lærke Marijke; Holst, Jens Juul; Jeppesen, Palle Bekker
INTRODUCTION: Parenteral support is lifesaving in short bowel syndrome patients with intestinal failure (SBS-IF), who are unable to compensate for their malabsorption by metabolic or pharmacologic adaptation. Mutually, the symptoms of SBS-IF and the inconveniences and complications in relation to...
Full Text Available Irritable bowel syndrome (IBS is a functional bowel disorder by unknown aetiology. Several reviews are written about pharmacological and psychological treatment of the disease. Nevertheless, healthcare professionals consider these patients difficult to handle in daily practice. There is an uncertainty about how to measure symptoms and to evaluate the effect of any given treatment. In the absence of objective markers, professionals feel unsure of how to manage the condition and the patients do not feel that they are taken seriously. The development of the short, self-reported questionnaire, Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS, offers a practical guide to objective measurement of symptoms and effect of given treatments into numerical values in the daily practice.
Platell, Cameron F. E.; Coster, Jane; McCauley, Rosalie D.; Hall, John C
The surgeon is invariably the primary specialist involved in managing patients with short bowel syndrome. Because of this they will play an important role in co-ordinating the management of these patients. The principal aims at the initial surgery are to preserve life, then to preserve gut length, and maintain its continuity. In the immediate postoperative period, there needs to be a balance between keeping the patient alive through the use of TPN and antisecretory agents and promoting gut ad...
Farup, Per G; Knut Hestad
Background. Irritable bowel syndrome (IBS) is associated with depression and depression with impaired cognitive functions. The primary aim was to study associations between depression and cognitive functions in patients with IBS. Methods. IBS (according to the Rome III criteria), cognitive functions (evaluated with a set of neuropsychological tests), and depression (measured with Beck Depression Inventory II and Montgomery-Åsberg Depression Scale) were analysed in patients with idiopathic dep...
Full Text Available Alireza Farnam, Mohammad H Somi, Firouz Sarami, Sara FarhangLiver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IranAim: Irritable bowel syndrome (IBS as a functional disorder of the gastrointestinal tract has been related to psychological factors. Aim of this study is to study the differences of personality factors between IBS patients compared to our general population.Methods: This study was performed in clinics of Tabriz Medical University during 2006–2007. IBS was diagnosed using the Rome II diagnostic criteria after exclusion of organic bowel pathology. The entry of each patient was confirmed following a psychiatric interview and after any comorbid psychiatry disorder was ruled out. Personality traits and score of each factor was evaluated using NEO five factor personality inventory compared to results of a previous study on general population of Iran.Results: One hundred and sixty six patients were studied. The mean age (±SD of them was 33.6(±11.4 years (60.8% female. Our study population had their symptoms for a mean interval of 47.3 month. The bowel problems were provoked by distress in more than 80% of patients. Pain in female patients was reported to be more frequent but both gender described the association between stressors and their symptoms. NEO Five-Factor Inventory showed a significantly higher level of neuroticism and conscientiousness and lower level of openness and agreeableness in theses nonpsychiatric IBS patients. Women with IBS had significantly higher levels of openness, conscientiousness, and extraversion compared to men.Conclusion: Differences were observed between IBS patients and general population. Patients with IBS may benefit from psychological interventions.Keywords: irritable bowel syndrome, personality, five-factor model
Mansueto, Pasquale; Seidita, Aurelio; D'Alcamo, Alberto; Carroccio, Antonio
Irritable bowel syndrome (IBS) is a condition characterized by abdominal pain, bloating, flatus, and altered bowel habits. The role of dietary components in inducing IBS symptoms is difficult to explore. To date, foods are not considered a cause but rather symptom-triggering factors. Particular interest has been given to the so-called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols). We aimed to summarize the evidence from the most common approaches to manage suspected food intolerance in IBS, with a particular interest in the role of FODMAPs and the effects of a low FODMAP diet. We reviewed literature, consulting PubMed and Medline by using the search terms FODMAP(s), fructose, lactose, fructans, galactans, polyols (sorbitol, mannitol, maltitol, xylitol, erythritol, polydextrose, and isomalt), irritable bowel syndrome, and functional gastrointestinal symptoms. FODMAP-restricted diets have been used for a long time to manage patients with IBS. The innovation in the so-called FODMAP concept is that a global restriction should have a more consistent effect than a limited one in preventing abdominal distension. Even though all the potential low FODMAP diets provide good relief of symptoms in many patients, there is just a little relief in others. Several studies highlight the role of low FODMAP diets to improve symptoms in patients with IBS. The evidence on this dietary approach supports the hypothesis that a low FODMAP diet should be the first dietary approach. However, many points remain to be clarified, including the evaluation of possibly significant nutrition concerns. PMID:25694210
This thesis describes some aspects of short bowel syndrome. When approximately 1 m or less small bowel is retained after extensive resection, a condition called short bowel syndrome is present. Since the advent of parenteral nutrition, the prognosis of patients with a very short bowel has dramatically improved. Patients with 40 to 100 cm remaining jejunum and/or ileum can generally be maintained with oral nutrition due to increased absorption of the small bowel remnant as result of intestinal adaptation. This study reports clinical, biochemical and nutritional aspects of short bowel patients on oral or parenteral nutrition, emphasizing data on absorption of various nutrients and on bone metabolism. Furthermore, some technical apsects concerning long-term parenteral nutrition are discussed. (Auth.)
Cameron F. E. Platell; Jane Coster; Rosalie D. McCauley; John C. Hall
The surgeon is invariably the primary specialist involvedin managing patients with short bowel syndrome. Becauseof this they will play an important role in co-ordinating themanagement of these patients. The principal aims at theinitial surgery are to preserve life, then to preserve gutlength, and maintain its continuity. In the immediatepostoperative period, there needs to be a balancebetween keeping the patient alive through the use of TPNand antisecretory agents and promoting gut adaptationwith the use of oral nutrition. lf the gut fails to adaptduring this period, then the patient may require therapywith more specific agents to promote gut adaptation suchas growth factors and glutamine. lf following this, thepatient still has a short gut syndrome, then the principaloptions remain either long term TPN, or intestinaltransplantation which remains a difficult and challengingprocedure with a high mortality and morbidity due torejection.
Dlugosz, Aldona; Winckler, Björn; Lundin, Elin; Zakikhany, Katherina; Sandström, Gunnar; Ye, Weimin; Engstrand, Lars; Lindberg, Greger
Several studies have indicated that colonic microbiota may exhibit important differences between patients with irritable bowel syndrome (IBS) and healthy controls. Less is known about the microbiota of the small bowel. We used massive parallel sequencing to explore the composition of small bowel mucosa-associated microbiota in patients with IBS and healthy controls. We analysed capsule biopsies from the jejunum of 35 patients (26 females) with IBS aged 18-(36)-57 years and 16 healthy volunteers (11 females) aged 20-(32)-48 years. Sequences were analysed based on taxonomic classification. The phyla with the highest total abundance across all samples were: Firmicutes (43%), Proteobacteria (23%), Bacteroidetes (15%), Actinobacteria (9.3%) and Fusobacteria (7.0%). The most abundant genera were: Streptococcus (19%), Veillonella (13%), Prevotella (12%), Rothia (6.4%), Haemophilus (5.7%), Actinobacillus (5.5%), Escherichia (4.6%) and Fusobacterium (4.3%). We found no difference among major phyla or genera between patients with IBS and controls. We identified a cluster of samples in the small bowel microbiota dominated by Prevotella, which may represent a common enterotype of the upper small intestine. The remaining samples formed a gradient, dominated by Streptococcus at one end and Escherichia at the other. PMID:25687743
Beck, E.; Hurwitz, B
1. Irritable bowel syndrome is a functional disorder of the lower intestinal tract affecting approximately 10% of the population and causing a wide range of symptoms. 2. Most cases of irritable bowel syndrome can be diagnosed in general practice on the basis of the presenting history and clinical examination but some patients may need to be referred to a gastro-enterologist for further assessment including sigmoidoscopy and barium enema. 3. The clinical picture may include symptoms of abdomin...
Abbasi, Mehdi HayatBakhsh; Zahedi, MohammadJavad; Darvish Moghadam, Sodaif; Shafieipour, Sara; HayatBakhsh Abbasi, Mahroo
BACKGROUND Small intestinal bacterial overgrowth (SIBO) may have a role in the pathophysiology of irritable bowel syndrome (IBS). So, the aim of this study was to assess the association between SIBO and IBS by using glucose breath test (GBT) in Kerman city as the first study in Iranian population. METHODS 107 patients with IBS and 107 healthy individuals were enrolled in our study. All the participants underwent GBT. A peak of H2 values >20 p.p.m above the basal value after glucose ingestion ...
Linda Bjork Olafsdottir; Hallgrímur Gudjonsson; Heidur Hrund Jonsdottir; Jon Steinar Jonsson; Einar Bjornsson; Bjarni Thjodleifsson
AIM:TO study if and how physicians use the irritable bowel syndrome (IBS) diagnostic criteria and to assess treatment strategies in IBS patients.METHODS:A questionnaire was sent to 191 physicians regarding IBS criteria,diagnostic methods and treatment.Furthermore,94 patients who were diagnosed with IBS underwent telephone interview.RESULTS:A total of 80/191 (41.9％) physicians responded to the survey.Overall,13 patients were diagnosed monthly with IBS by specialists in gastroenterology (SGs) and 2.5 patients by general practitioners (GPs).All the SGs knew of the criteria to diagnose IBS,as did 46/70 (65.7％) GPs.Seventy-nine percent used the patient's history,38％ used a physical examination,and 38％ exclusion of other diseases to diagnose IBS.Only 18/80 (22.5％) physicians used specific IBS criteria.Of the patients interviewed,5g/94 (62.8％) knew they had experienced IBS.Two out of five patients knew IBS and had seen a physician because of IBS symptoms.Half of those received a diagnosis of IBS.A total of 13％ were satisfied with treatment.IBS affected daily activities in 43％ of cases.CONCLUSION:Half of the patients with IBS who consuited a physician received a diagnosis.Awareness and knowledge of diagnostic criteria for IBS differ between SGs and GPs.
... Intolerance Malabsorption Narcotic Bowel Syndrome Radiation Therapy Injury Short Bowel Syndrome Symptoms & Causes Treatments Nutrition and Diet Managing Secondary Effects Medications Surgery Daily Living with SBS Resources SMA Syndrome Volvulus ...
Lund, Pernille; Sangild, Per Torp; Aunsholt, L.;
Colostrum is rich in immunoregulatory, antimicrobial and trophic components supporting intestinal development and function in newborns. We assessed whether bovine colostrum could enhance intestinal adaptation and function in adult short bowel syndrome (SBS) patients....
Panicker Radhakrishna; Arifhodzic Nermina; Al Ahmad Mona; Ali Seham
Context : Excess prevalence of irritable bowel syndrome in asthma has been reported, suggesting a link between these two conditions. Aims: To investigate the association between irritable bowel syndrome (IBS) and asthma, and explore the symptoms of IBS among asthma patients in Kuwait. Settings and Design: Case control study. Methods: In a tertiary center, for allergy and asthma, 138 patients aged 20-65 years, with asthma, diagnosed clinically and by spirometry,were compared with 145 hea...
Abbasi, Mehdi HayatBakhsh; Zahedi, MohammadJavad; Darvish Moghadam, Sodaif; Shafieipour, Sara; HayatBakhsh Abbasi, Mahroo
BACKGROUND Small intestinal bacterial overgrowth (SIBO) may have a role in the pathophysiology of irritable bowel syndrome (IBS). So, the aim of this study was to assess the association between SIBO and IBS by using glucose breath test (GBT) in Kerman city as the first study in Iranian population. METHODS 107 patients with IBS and 107 healthy individuals were enrolled in our study. All the participants underwent GBT. A peak of H2 values >20 p.p.m above the basal value after glucose ingestion was considered suggestive of SIBO. SPSS software version 17 was used for data analysis. P value SIBO. We suggest a Placebo-controlled bacterial eradication study for identifying the role of SIBO in IBS. PMID:25628852
Hardy, J.G.; Clark, A.G.; Wood, E.; Reynolds, J.R.
The transit of radiolabelled preparations through the stomach, small intestine and colon was monitored in ten patients with the irritable bowel syndrome. Five patients complained of diarrhoea, and five complained of constipation. The preparations comprised a non-disintegrating capsule and a multiparticulate system. Both preparations emptied from the stomach together and at the same rates in both groups of patients. In the patients complaining of constipation, the transit times through the small intestine were the same for both preparations. In the patients complaining of diarrhoea, the capsule passed through the small intestine slightly faster than the particles, but there were no significant differences in the small-intestinal transit rates of the two patient groups. Within the colon, the transit of the capsule was faster than that of the small particles. Although movement through the colon was, on average, faster in the group of patients complaining of diarrhoea, there was considerable intersubject variability, and the differences in transit rates between the two patient groups were not statistically significant. (orig.).
Patrick Basu; N James Shah; Nithya Krishnaswamy; Tommy Pacana
AIM: To determine the prevalence of restless legs syndrome (RLS) in patients with irritable bowel syndrome (IBS).METHODS: Patients with diarrhea-predominant IBS (n = 30), constipation-predominant IBS (n = 30), or mixed-symptom IBS (n = 30) were recruited from the community between March 2008 and February 2009. Rifaximin 200 mg three times daily was administered empirically to alleviate small intestinal bowel overgrowth in all patients. The presence of RLS was assessed via an RLS questionnaire and polysomnography. RESULTS: Twenty-six patients with IBS (29%) were diagnosed with RLS using the RLS questionnaire. Twenty-four of the 26 patients (92%) underwent polysomnog Pacanaraphy, and all had confirmation of RLS. A greater percentage of patients with RLS had diarrhea-predominant IBS (62%) compared with patients with constipation-predominant IBS (4%) or mixed-symptom IBS (33%). CONCLUSION: Restless legs syndrome is prevalent in patients with IBS, especially those with diarrheal symptoms. Assessment of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.
KASAP, Elmas; BOR, Serhat; İLTER(), Tankut
Background/aim: It is known that abdominal region operations are more common in patients with irritable bowel syndrome. The aim of this study was to determine the frequency of abdominal region operations in patients with irritable bowel syndrome. Materials and methods: 116 patients hospitalized between January 1998 and December 2002 with irritable bowel syndrome were evaluated retrospectively for previous abdominal region operation. Control group was composed of 53 healthy people and p...
Ewa B. Joć
1. Quality of life of patients with irritable bowel syndrome is substantially reduced in all the examined spheres. 2. Education of patients with IBS resulted in enhanced quality of life and reduced disease-related complaints. 3. Education of patients with IBS plays a significant role in the entire therapeutic process.
Matarese, Laura E; Jeppesen, Palle B; O'Keefe, Stephen J D
Short bowel syndrome (SBS) is a heterogeneous disorder with broad variation in disease severity arising from different types of intestinal resection. The spectrum of malabsorption ranges from intestinal insufficiency to intestinal failure. Individualized patient strategies involving modifications...
Soundy, Andrew; Lee, Rhonda T.; Kingstone, Tom; Singh, Sukhdev; Pankaj R Shah; Roberts, Lesley
Background The use and value of different complementary therapies requires investigation. In particular, qualitative research is required to understand the perceptions and experiences of patients who undergo healing therapy as one type of complementary therapy. The aim of this research is to consider patients perceptions and experiences following a course of healing therapy. Methods Twenty two patients took part in this study. This included 13 patients with irritable bowel disease (3 male, 10...
... may include nutritional support medications surgery intestinal transplant Nutritional Support The main treatment for short bowel syndrome is nutritional support, which may include the following: Oral rehydration. Adults ...
Jeppesen, Palle Bekker
Short bowel syndrome results from surgical resection, congenital defect or disease-associated loss of absorption. Parenteral support (PS) is lifesaving in patients with short bowel syndrome and intestinal failure who are unable to compensate for their malabsorption by metabolic or pharmacologic adaptation. Together, the symptoms of short bowel syndrome and the inconvenience and complications in relation to PS (e.g. catheter-related blood steam infections, central thrombosis and intestinal fai...
Semnani, Sh. (MD
Full Text Available Background and Objective: The patients with Post-Infectious Irritable bowel syndrome (PI-IBS, a subtype of irritable bowel syndrome, suffer from bacterial gastroenteritis. Since campylobacter Jejuni (CJ is one of the most common agents in this syndrome, we aimed to evaluate the prevalence of Campylobacter Jejuni in patients with Irritable Bowel Disease. Material and Methods: This case - control study was conducted on 160 patients divided into 2 equal groups of healthy and unhealthy. The presence of Anti- CJ antibody (IgG and IgA was evaluated by ELISA and the comparison was performed by chi-square test. Results: The mean age of case (31.51 and control (31.84 was not statistically different (P = 0.87. Titer of Anti- Campylobacter Jejuni antibody IgG was positive in 25% of patients and 18.8% of the healthy ones (p=0.02. IgA Seropositivity in patients was 7.5% but no one in control group was positive (p =0.01 Conclusion: The Seroprevalence of CJ in patients with IBS was higher significantly than that of control group. Thus, Cj can be known as one of the causes of Post-infection in patients with IBS in our region and it should be paid more attention in diagnostic assessment of these patients. Keyword: Irritable Bowel Syndrome; Campylobacter Jejuni; Antibody
Full Text Available "nBackground: The irritable bowel syndrome (IBS is one of the most common chronic medical conditions. Various mechanisms, including altered gut flora and/or small bowel bacterial overgrowth, have been suggested to play a role in the development of gas-related symptoms aim of study. The clinical evidence of small intestinal bacterial overgrowth as an important etiology of irritable bowel syndrome continues to accumulate. Clinical symptoms of bacterial overgrowth and irritable bowel syndrome are similar; however, a definitive cause-and-effect relationship remains unproven. It is unclear whether motility dysfunction causes bacterial overgrowth or gas products of"nenteric bacteria affect intestinal motility in irritable bowel syndrome."n "nMethods: In a randomized double-blind placebo-controlled trial consisting of treatment with bismuth subcitrate. Primary efficacy variable was subjective symptoms; frequency of abdominal pain, Number of bowel movement & Bloating/distension."n "nResults: 119 patients were enrolled (59 bismuth subcitrate and 60 placebo recipients. At the end of phase 2, all symptom scores dropped significantly both in bismuth subcitrate and placebo group (p<0.001. There was not a significant difference in symptom relief with bismuth subcitrate versus placebo administration."n "nConclusions: There was not a significant difference in symptom relief with bismuth subcitrate versus placebo in IBS patients. Whether antibiotics can improve quality of life in patients with irritable bowel syndrome warrants further research."nInterventions: Participants were randomly assigned to receive 120mg bismuth subcitrate four times daily for 14 days (n=59 or placebo (n=60.
Donohoe, Claire L
The short bowel syndrome (SBS) is a state of malabsorption following intestinal resection where there is less than 200 cm of intestinal length. The management of short bowel syndrome can be challenging and is best managed by a specialised multidisciplinary team. A good understanding of the pathophysiological consequences of resection of different portions of the small intestine is necessary to anticipate and prevent, where possible, consequences of SBS. Nutrient absorption and fluid and electrolyte management in the initial stages are critical to stabilisation of the patient and to facilitate the process of adaptation. Pharmacological adjuncts to promote adaptation are in the early stages of development. Primary restoration of bowel continuity, if possible, is the principle mode of surgical treatment. Surgical procedures to increase the surface area of the small intestine or improve its function may be of benefit in experienced hands, particularly in the paediatric population. Intestinal transplant is indicated at present for patients who have failed to tolerate long-term parenteral nutrition but with increasing experience, there may be a potentially expanded role for its use in the future.
Alterations in gastrointestinal (GI) permeability and immune measures are present in some patients with irritable bowel syndrome (IBS) but the relationship to symptoms is poorly defined. In adults with IBS, we compared permeability, unstimulated peripheral blood monocyte (PBMC) interleukin-10 (IL-10...
Rodrigo Sáez, Luis Ricardo; Blanco, Ignacio; Bobes, Julio; de Serres, Frederick J
Introduction Irritable bowel syndrome (IBS) and fibromyalgia syndrome (FMS) are two common central sensitization disorders frequently associated in the same patient, and some of these patients with IBS plus FMS (IBS/FMS) could actually be undiagnosed of coeliac disease (CD). The present study was an active case finding for CD in two IBS cohorts, one constituted by IBS/FMS subjects and the other by people with isolated IBS. Methods A total of 104 patients (89.4% females) fulfilling the 1990 AC...
Jeppesen, Palle B; Pertkiewicz, Marek; Messing, Bernard; Iyer, Kishore; Seidner, Douglas L; O'keefe, Stephen J D; Forbes, Alastair; Heinze, Hartmut; Joelsson, Bo
Teduglutide, a glucagon-like peptide 2 analogue, might restore intestinal structural and functional integrity by promoting growth of the mucosa and reducing gastric emptying and secretion. These factors could increase fluid and nutrient absorption in patients with short bowel syndrome with...... intestinal failure (SBS-IF). We performed a prospective study to determine whether teduglutide reduces parenteral support in patients with SBS-IF....
El-Salhy, Magdy; Gundersen, Doris Irene
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that is characterized by intermittent abdominal pain/discomfort, altered bowel habits and abdominal bloating/distension. This review aimed at presenting the recent developments concerning the role of diet in the pathophysiology and management of IBS. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, and there is no evidence that gluten causes the debated new diagnosis of non-coel...
Kalani M; Foroutan H; Rahimi R.; Ghofrani H; Ahadpoor Behnami Sh
"nBackground: The irritable bowel syndrome (IBS) is one of the most common chronic medical conditions. Various mechanisms, including altered gut flora and/or small bowel bacterial overgrowth, have been suggested to play a role in the development of gas-related symptoms aim of study. The clinical evidence of small intestinal bacterial overgrowth as an important etiology of irritable bowel syndrome continues to accumulate. Clinical symptoms of bacterial overgrowth and irritable bowel syndr...
Kuo, Braden; Bhasin, Manoj; Jacquart, Jolene; Scult, Matthew A.; Slipp, Lauren; Riklin, Eric Isaac Kagan; Lepoutre, Veronique; Comosa, Nicole; Norton, Beth-Ann; Dassatti, Allison; Rosenblum, Jessica; Thurler, Andrea H.; Surjanhata, Brian C.; Hasheminejad, Nicole N.; Kagan, Leslee
Introduction: Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) can profoundly affect quality of life and are influenced by stress and resiliency. The impact of mind-body interventions (MBIs) on IBS and IBD patients has not previously been examined. Methods: Nineteen IBS and 29 IBD patients were enrolled in a 9-week relaxation response based mind-body group intervention (RR-MBI), focusing on elicitation of the RR and cognitive skill building. Symptom questionnaires and infla...
To find out the effect of Rifixamin in patients of irritable bowel syndrome with predominant diarrhea. Material and methods.: This study was carried out from January 2012 to September 2012 on patients presenting to medical OPD of Mayo Hospital, Lahore. Study design: It is descriptive type of study. Result: Out of 30 patients presenting to medical OPD with diagnosis of diarrhea predominant irritable bowel syndrome 18 (60%) were females and 12 (40 %) were males. The age of the patients were between 13-38 years. All the patients were prescribed Tab. Rifaximin 550 mg three times a day for 14 days and were assessed for their complaints like diarrhea its frequency and consistency using 5 point scale for stool consistency, abdominal pain and abdominal bloating using Li Kert scoring. The patients were assessed for their complaints on day 15 and again after 2 months. It was found out that out of 30 patients 18 (60%), patients showed improvement in their global symptoms of irritable bowel syndrome at 15 day of follow up, but at 2 months of follow up out of 18 (60%) patients who responded to Rifaximin treatment at 15 day only 12 (40%) patients reported to have consistent improvement in symptoms while 6 (20%) patients again developed, diarrhea abdominal pain and bloating 2 (6%) patients left the study at 3rd day of treatment due to increase in frequency of diarrhea. It was observed that drug was more effective in females and older individuals. Out of 18 patients who responded 11 (61%)were females and the patients were of relatively of older age. Conclusion: It was found out that treatment with Rifaximin provided significant relief of IBS symptoms, bloating abdominal pain and diarrhea. (author)
Jeppesen, Palle Bekker
adaptation. Together, the symptoms of short bowel syndrome and the inconvenience and complications in relation to PS (e.g. catheter-related blood steam infections, central thrombosis and intestinal failure associated liver disease) may impair the quality of life of patients. The aim of treatment is to......Short bowel syndrome results from surgical resection, congenital defect or disease-associated loss of absorption. Parenteral support (PS) is lifesaving in patients with short bowel syndrome and intestinal failure who are unable to compensate for their malabsorption by metabolic or pharmacologic...... restoration of the structural and functional integrity of the remaining intestine with significant intestinotrophic and proabsorptive effects, facilitating a reduction in diarrhea and an equivalent reduction in the need for PS in patients with short bowel syndrome and intestinal failure....
Ali Gholamrezaei; Behzad Zolfaghari; Ziba Farajzadegan; Kianoosh Nemati; Hamed Daghaghzadeh; Hamid Tavakkoli; Mohammad Hassan Emami
There is a growing interest of clinical and epidemiological researches in the field of functional gastrointestinal disorders in our society. Accordingly, validated and culturally adapted instruments are required for appropriate measurement of variables specially the quality of life. The aim of our study was the linguistic validation of the Irritable Bowel Syndrome-Quality of Life questionnaire (IBS-QOL) for Iranian IBS patients with Persian language. Following the standard forward-backward tr...
Mary-Joan Gerson; Gerson, Charles D.
Chronic illnesses such as irritable bowel syndrome are not experienced by patients in isolation. They live in a context of relationships, including spouses and partners, other family members, friends and business associates. Those relationships can have an effect, both positive and negative, on the course of illness and may also be affected by the experience of living with a chronic illness like IBS. We review the general literature regarding the effect of relationship factors on chronic i...
Enck, Paul; Aziz, Qasim; Barbara, Giovanni; Farmer, Adam D; Fukudo, Shin; Mayer, Emeran A; Niesler, Beate; Quigley, Eamonn M M; Rajilić-Stojanović, Mirjana; Schemann, Michael; Schwille-Kiuntke, Juliane; Simren, Magnus; Zipfel, Stephan; Spiller, Robin C
Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with a high population prevalence. The disorder can be debilitating in some patients, whereas others may have mild or moderate symptoms. The most important single risk factors are female sex, younger age and preceding gastrointestinal infections. Clinical symptoms of IBS include abdominal pain or discomfort, stool irregularities and bloating, as well as other somatic, visceral and psychiatric comorbidities. Currently, the diagnosis of IBS is based on symptoms and the exclusion of other organic diseases, and therapy includes drug treatment of the predominant symptoms, nutrition and psychotherapy. Although the underlying pathogenesis is far from understood, aetiological factors include increased epithelial hyperpermeability, dysbiosis, inflammation, visceral hypersensitivity, epigenetics and genetics, and altered brain-gut interactions. IBS considerably affects quality of life and imposes a profound burden on patients, physicians and the health-care system. The past decade has seen remarkable progress in our understanding of functional bowel disorders such as IBS that will be summarized in this Primer. PMID:27159638
Camila Bitu Moreno BRAGA
Full Text Available Background Patients with short bowel syndrome have significant fluid and electrolytes loss. Objective Evaluate the mineral and electrolyte status in short bowel syndrome patients receiving intermittent parenteral nutrition or oral feeding. Methods Twenty two adults with short bowel syndrome, of whom 11 were parenteral nutrition dependent (PN group, and the 11 remaining had been weaned off parenteral nutrition for at least 1 year and received all nutrients by oral feeding (OF group. The study also included 14 healthy volunteers paired by age and gender (control group. Food ingestion, anthropometry, serum or plasma levels of sodium, potassium, phosphorus, magnesium, calcium, zinc, iron and copper were evaluated. PN group subjects were evaluated before starting a new parenteral nutrition cycle. Results The levels of sodium, potassium, phosphorus, calcium and zinc were similar between the groups. The magnesium value was lower in the PN group (1.0 ± 0.4 mEq /L than other groups. Furthermore, this electrolyte was lower in the OF group (1.4 ± 0.3 mEq /L when compared to the Control group (1.8 ± 0.1 mEq/L. Lower values of copper (69±24 vs 73±26 vs 109±16 µg/dL were documented, respectively, for the PN and OF groups when compared to the control group. Conclusion Hypomagnesemia and hypocupremia are electrolyte disturbances commonly observed in short bowel syndrome. Patients with massive intestinal resection require monitoring and supplementation in order to prevent magnesium and copper deficiencies.
Full Text Available Context : Excess prevalence of irritable bowel syndrome in asthma has been reported, suggesting a link between these two conditions. Aims: To investigate the association between irritable bowel syndrome (IBS and asthma, and explore the symptoms of IBS among asthma patients in Kuwait. Settings and Design: Case control study. Methods: In a tertiary center, for allergy and asthma, 138 patients aged 20-65 years, with asthma, diagnosed clinically and by spirometry,were compared with 145 healthy, non-asthmatic controls matched for age, gender and nationality. Cases and controls completed a self-administered questionnaire of irritable bowel syndrome diagnosis (ROME II criteria. Statistical Analysis Used: The data were analyzed using SPSS software, and proportions were tested with Chi-square or Fisher′s test. Odds ratio (OR with 95% Confidence Interval (CI were calculated to identify the associated risk factors. The demographic variables were selected for logistic regression analysis. Results : A significantly large proportion (39.13% of asthmatics had IBS as compared to 7.93% controls (P < 0.001. A higher proportion of females with IBS were observed in cases and controls (74%, 61.54%. IBS was seen in 87% cases using inhalers, and in 13% with additional oral theophylline (P < 0.001. As many as 66.6% cases, had IBS with relatively short duration of asthma (1-5 years, P < 000. Predominant symptoms of IBS in asthmatics were abdominal discomfort or distension (64.8% vs. 11.5%, (P < 0.000, OR = 14.1; 95%CI: 3.748-53.209, bloated feeling of abdomen (74.1% vs. 34.62% (P < 0.001, OR = 5.38; 95%CI:1.96-14.84, increased frequency of stools (63%, P < 0.006. Conclusions: Irritable bowel syndrome in asthmatics was significantly high, more in the female asthmatics. Abdominal discomfort, persistent bloated feeling, increased frequency of passing stools were the most common IBS symptoms observed.
Vavricka, Stephan R; Greuter, Thomas; Scharl, Michael; Mantzaris, Gerassimos; Shitrit, Ariella B; Filip, Rafal; Karmiris, Konstantinos; Thoeringer, Christoph K; Boldys, Hubert; Wewer, Anne V; Yanai, Henit; Flores, Cristina; Schmidt, Carsten; Kariv, Revital; Rogler, Gerhard; Rahier, Jean-François
BACKGROUND: Cogan's syndrome (CSy) is a very rare autoimmune disorder, mainly affecting the inner ear and the eye, and is associated with inflammatory bowel disease (IBD). METHODS: This was a European Crohn's and Colitis Organisation (ECCO) retrospective observational study, performed as part of...... the CONFER project. A call to all ECCO members was made to report concomitant CSy and inflammatory bowel disease (IBD) cases. Clinical data were recorded in a standardized questionnaire. RESULTS: This international case series reports on 22 concomitant CSy-IBD cases from 14 large medical centres. Mean...... duration of IBD until diagnosis of CSy was 8.7 years (range 0.0-38.0) and mean age at CSy diagnosis was 44.6 years (range 9.0-67.0). Six patients had underlying ulcerative colitis (UC) and 16 had Crohn's disease. Eleven patients (50%) had active disease at CSy diagnosis. Sixteen patients were under IBD...
El-Salhy, M.; Mazzawi, T; Gundersen, D.; Hausken, T.
In a previous study, chromogranin A (CgA) cell density in the colon of patients with irritable bowel syndrome (IBS) was found to be reduced. It has been suggested that intestinal CgA cell density may be used as a marker for the diagnosis of IBS. The rectum harbours a larger number of large intestinal endocrine cells and is more accessible for biopsies than the colon. The present study aimed at determining the CgA cell density in the rectum of IBS patients. A total of 47 patients with IBS that...
Nielsen, O.H.; Gjorup, T.; Christensen, F.N.
A new method employing 99mTc-labeled pellets for determination of the gastric emptying rate and small bowel transit time is described. The participants were six normal subjects and 16 patients with irritable bowel syndrome (eight with diarrhea and eight with obstipation as the primary complaint). The gastric emptying rate was the same in the three groups. The patients in the obstipation group had a significantly longer small bowel transit time than the normals (P less than 0.02) and the patients in the diarrhea group (P less than 0.01). There was no demonstrable difference between the small bowel transit time in the normals and in the patients in the diarrhea group.
Full Text Available Andrey E Dorofeyev1, Elena A Kiriyan2, Inna V Vasilenko1, Olga A Rassokhina1, Andrey F Elin11National Medical University, Donetsk, Ukraine; 2Gastroenterological Center of Poltava Hospital Clinic, Poltava, UkraineObjectives: The aim of this study was to analyze the clinical efficacy and cytomorphologic changes of colon mucosa following the treatment of patients suffering from irritable bowel syndrome (IBS with mesalazine (5-aminosalicylic acid [5-ASA].Methods: In this controlled, randomized, blind clinical trial, a total of 360 patients with varying subtypes of IBS were randomly treated with 500 mg of mesalazine qid or by standard therapy without mesalazine for a period of 28 days. Pre- and post-treatment pain intensity, pain duration, meteorism, stool abnormalities and endoscopic parameters were monitored, and biopsies or brush biopsies were examined histologically.Results: Treatment of IBS patients with mesalazine significantly reduced intensity and duration of pain in all subtypes of IBS, except for duration of pain in the subtype “undifferentiated”, where the difference was not significant. In addition, in patients with diarrhea type and undifferentiated type of IBS, mesalazine also significantly reduced the abnormal stool pattern. In comparison to the control group, administration of mesalazine reduced the incidence of endoscopic and cytomorphologic changes of the bowel mucosa, including changes in colon mucus, mucus production, cytologic or histologic parameters, epithelial cell degeneration, appearance of leukocytes and macrophages and cell infiltrations.Conclusion: Mesalazine was effective in reducing several symptoms characteristic of IBS. It significantly reduced pain intensity and duration and improved cytohistologic parameters of the bowel mucosa.Keywords: 5-amino salicylic acid, 5-ASA, abdominal pain, irritable bowel syndrome, IBS, meteorism, stool abnormalities
El-Salhy, Magdy; Gilja, Odd Helge; Gundersen, Doris Irene; Hausken,Trygve
AIM: To study the different endocrine cell types in the oxyntic mucosa of patients with irritable bowel syndrome (IBS). METHODS: Seventy-six patients with IBS were included in the study (62 females and 14 males; mean age 32 years, range 18-55 years), of which 40 also fulfilled the Rome III criteria for functional dyspepsia (FDP). Of the entire IBS cohort, 26 had diarrhea as the predominant symptom (IBS-D), 21 had a mixture of diarrhea and constipation (IBS-M), and 29 had constipation as th...
Jeppesen, Palle B
A primary goal of intestinal rehabilitation programs is to facilitate intestinal adaptation. Adult patients with short bowel syndrome (SBS) who are dependent on parenteral nutrition and/or intravenous fluid (PN/IV) support have 2 hormonal pharmacologic treatment options available that may promote...... a 4-week inpatient course of somatropin in combination with a glutamine-supplemented diet for adults with SBS. Somatropin treatment significantly reduced parenteral support requirements by 1.1 L/d in these patients. The most common adverse events were peripheral edema and musculoskeletal events...
Full Text Available Background: Extraintestinal symptoms are common in patients with irritable bowel syndrome (IBS. In the present study, we determined the relationship between psychological disorders and extraintestinal symptoms in patients with IBS. Methods: Adult patients with IBS referred to 4 gastroenterology clinics in Isfahan, Iran, completed the irritable bowel severity scoring system, extraintestinal symptoms scale, Hospital Anxiety and Depression Scale, and Irritable Bowel Syndrome Quality of Life (IBS-QOL Questionnaire. Univariate and multivariate analyses were conducted. Results: The patients included 113 females and 45 males with mean age of 34.8 ± 11.1 years. Cumulative frequency of extraintestinal symptoms was 3.3 ± 2.4 (0 to 10. Anxiety and depression were present in 79.7% and 54.4% of the patients, respectively. Frequency of extraintestinal symptoms was correlated with anxiety and depression (r = 0.289 to 0.531, IBS severity (r = 0.373 to 0.505, and quality of life (r = -0.317 to -0.398. Severity of IBS was independently associated with extraintestinal digestive symptoms’ frequency (β = 0.248. Female gender, education level, and anxiety were independently associated with extraintestinal non-digestive symptoms’ frequency (β = -0.225 to 0.260. Severity of IBS and frequency of non-digestive symptoms were independent predictors of quality of life (β = -0.494 and -0.218. After controlling for psychological factors, IBS severity and depression were independent predictors of quality of life (β = -0.435 and -0.318. Conclusion: Extraintestinal symptoms and psychological disorders are common in patients with IBS and impact their quality of life. Psychological disorders are associated with extraintestinal symptoms, especially non-digestive symptoms. These results highlight the need for an integrated biopsychosocial approach to the management of IBS patients with physical and mental comorbidities.
Börsch, G; Jahnke, A; Bergbauer, M; Nebel, W
We present a case of solitary nonspecific ileal ulcer found by coloileoscopy in a patient with previously assumed irritable bowel syndrome. Follow-up endoscopies two weeks after initiation of short-term prednisone therapy, and again four months later, demonstrated rapid and persistent healing. This observation raises the question of whether or not primary ileal ulcers are indeed as rare as previously assumed when only surgical and autopsy findings were taken into consideration. Also, the natural history of this clinical entity, in general, could be somewhat more benign than suggested by those ulcers in which complications make surgery necessary, since these cases may not adequately reflect the full clinical spectrum of nonspecific small-bowel ulcers. PMID:6628147
Takayama, Satoru; Ochi, Yasuo; Yasuda, Akira; Sakamoto, Masaki; Takahashi, Hideki; Akamo, Yoshimi; Takeyama, Hiromitsu
Gastrointestinal obstruction is a common preterminal event in patients with gastric and pancreatic cancer who often undergo palliative bypass surgery. Although endoscopic palliation with self-expandable metallic stents has emerged as a safe and effective alternative to surgery, experience with this technique remains limited. In particular, a proximal jejunal obstruction requires more technical expertise than a duodenal obstruction. Palliative treatment modalities include both surgical and non...
Nimzing G Ladep; Taiwo J Obindo; Moses D Audu; Edith N Okeke; Abraham O Malu
AIM: To study the brain-gut interaction and the effect of behavioral or psychiatric conditions on irritable bowel syndrome (IBS) in an African population.METHODS: IBS was diagnosed using the Rome Ⅱ diagnostic criteria. The entry of each patient was confirmed following detailed explanations of the questions. Four hundred and eighteen patients were studied. Subjects satisfying the Rome Ⅱ criteria for IBS were physically examined and stool microscopy was done to identify the presence of "alarm factors". Depression was diagnosed using the symptom-check list adapted from the Research Diagnostic Criteria (DSM-Ⅳ) of the American Psychiatric Association.RESULTS: Seventy-five (56.8%) of the 132 IBS patients were depressed whereas only 54 (20.1%) of the 268 non-IBS patients were depressed. There was a significant relationship between IBS and depression (x2= 54.29,Odds ratio = 5.21, 56.8 ± 8.4 vs 20.1 ± 5.2, P = 0.001).Even though constipation predominant IBS patients were more likely to be depressed, no significant relationship was found between the subtype of IBS and depression (x2= 0.02, OR = 0.95, P = 0.68).CONCLUSION: IBS is significantly associated with major depression but not gender and bowel subtypes of the patients. Patients with IBS need to be evaluated for depression due to the highly significant relationship between the two conditions.
Kruis, Wolfgang; Chrubasik, Sigrun; Boehm, Stephan; Stange, Christiane; Schulze, Juergen
Purpose To study the therapeutic effects of probiotic Escherichia coli Nissle 1917 (EcN) in irritable bowel syndrome (IBS) and identify subgroups benefiting most. Background Some trials investigating therapeutic effects in irritable bowel syndrome have shown benefits in IBS subgroups only. Probiotic treatment seems to be promising. Methods Patients with irritable bowel syndrome (120; Rome II) were recruited to a prospective double-blind study and randomized to either EcN (n = 60) or placebo (...
Skok, Pavel; Ocepek, Andreja
During the course of Crohn's disease, some patients require surgical bowel resection due to intestinal stenosis. Attention is drawn to a possible complication of such surgical procedures: in a patients with Crohn's disease, short bowel syndrome developed following several small and large intestine resections that were necessary in the treatment of recidiving acute bowel obstructions. When the remnant small bowel is shorter than 200 cm, characteristic symptoms of short bowel syndrome develop i...
Barrett, Jacqueline S.; Canale, Kim EK; Richard B Gearry; Irving, Peter M.; Gibson, Peter R
AIM: To determine whether Lactobacillus casei strain Shirota (Yakult®) can alter small intestinal bacterial overgrowth (SIBO), as tested by the lactulose breath test, and whether this is associated with changes in symptoms in irritable bowel syndrome (IBS).
Masand, Prakash S.; Gupta, Sanjay; Schwartz, Thomas L; Virk, Subhdeep; Hameed, Ahmad; Kaplan, David S.
Background: This open-label pilot study investigated whether the selective serotonin reuptake inhibitor (SSRI) citalopram improves symptoms of irritable bowel syndrome (IBS), a functional gastrointestinal disorder with frequent psychiatric comorbidity.
Domann, Eugen; Fischer, Florence; Glowatzki, Fabian; Fritzenwanker, Moritz; Hain, Torsten; Zechel-Gran, Silke; Giffhorn-Katz, Susanne; Neubauer, Bernd A
d-Lactic acidosis with associated encephalopathy caused by overgrowth of intestinal lactic acid bacteria is a rarely diagnosed neurological complication of patients with short bowel syndrome. Here, we report the draft genome sequence of Lactobacillus delbrueckii strain #22 isolated from a patient with short bowel syndrome and previous d-lactic acidosis/encephalopathy. PMID:27469967
Pedersen, Natalia; Vegh, Zsuzsanna; Burisch, Johan; Jensen, Lisbeth; Ankersen, Dorit Vedel; Felding, Maria; Andersen, Nynne Nyboe; Munkholm, Pia
In the present study we report on changes in irritable bowel syndrome-severity scoring system (IBS-SSS) and irritable bowel syndrome-quality of life (IBS-QoL) in 19 IBS patients, aged 18 to 74 years (F/M: 14/5), during 12 wk registering their symptoms on the web-application (www.ibs.constant-care.dk). During a control period of the first 6-wk patients were asked to register their IBS-SSS and IBS-QoL on the web-application weekly without receiving any intervention. Thereafter, low fermentable ...
Celayir, Sinan; Sarımurat, Nüvit; Ilıkkan, Barbaros; ERAY, Nur; Yeşildağ, Ebru; Yeker, Daver
Necrotizing enterocolitis atresia volvulus gastroschisis are the most common causes of short bowel syndrome in the pediatric population Although the prognosis for patients with short bowel syndrome improved since the advent of parenteral nutrition the cost of long term total parenteral nutrition and attendant morbidity and mortality cannot be ignored in these patients Long term follow up of a case with short small intestine of 25 cm length following surgery is presented and the problems assoc...
Full Text Available Chronic illnesses such as irritable bowel syndrome are not experienced by patients in isolation. They live in a context of relationships, including spouses and partners, other family members, friends and business associates. Those relationships can have an effect, both positive and negative, on the course of illness and may also be affected by the experience of living with a chronic illness like IBS. We review the general literature regarding the effect of relationship factors on chronic illness followed by a focus on IBS symptomatology. We then discuss the challenges experienced by partners of IBS patients, followed by the effects of spousal violence, the particular relationship of mothers with IBS and their children, the effects of social support, and the importance of family dynamics and IBS. The final segment includes conclusions and recommendations. The topic, relationships and IBS, may have a significant effect on the lives of IBS patients and deserves more attention than it has received.
An evaluation of the effect of 1 year of a gluten-free diet was performed in patients with irritable bowel syndrome and fibromyalgia syndrome displaying lymphocytic enteritis. Gluten withdrawal produced a slight but significant improvement of the functional symptoms, suggesting that gluten might be partly responsible for this clinical picture. This hypothesis should be confirmed by a double-blind placebo-controlled trial since it cannot be ruled out that the studied patients displayed a subje...
MAZZAWI, TAREK; Hausken, Trygve; Gundersen, Doris Irene; El-Salhy, Magdy
Diet is important in triggering the symptoms of irritable bowel syndrome (IBS). This study investigated the impact of dietary guidance on the symptoms, quality of life and habitual diet of patients with IBS. Forty‑six patients who fulfilled the Rome III criteria for the diagnosis of IBS were included. Of these patients, 17 completed the entire study. Each patient attended three sessions (~45 min in duration) and received individual guidance on their dietary management. The patients were asked...
Pilipenko, V I; Burliaeva, E A; Isakov, V A
Irritable bowel syndrome (IBS) is the most prevalent functional disease of the gastrointestinal tract. This highly prevalent condition is best diagnosed by assessing the constellation of symptoms with which patients present to their physicians. Because some critics have previously questioned whether irritable bowel syndrome and other functional gastrointestinal disorders truly exist because they do not have defining structural features, the Rome Foundation fostered the use of symptom-based criteria for universal use. In most cases treatment is reduced to symptomatic therapy because a lot of unknown in pathogenesis by irritable bowel syndrome. Irritable bowel syndrome leads to decrease of quality of life of the patients and could be one of the reasons of patients' disability. Food is believed by patients promotes symptoms and the diet or avoiding specific food can reduce symptoms. Possible role of different food and microbiota in the pathophysiology of irritable bowel syndrome, as well as the data from randomized, controlled clinical trials dedicated to the effects of diet in irritable bowel syndrome are summarized and discussed in this review. The efficacy of the diet, enriched by fiber, prebiotics, probiotics, peppermint oil, curcumin and vitamin B6 in irritable bowel syndrome patients was shown in numerous studies. In some studies restriction in consumption of fermented carbohydrates, coffee and alcohol, as well as diet with elimination IgG-sensed food was also shown to be effective in irritable bowel syndrome. Food intolerances, defined as non-toxic non-immune adverse reactions to food, include reactions to bioactive chemicals in foods and metabolic reactions to poorly absorbed dietary carbohydrates. New dietary approaches like polyunsaturated fatty acids intake correction and the low tryptophan intake are discussed. PMID:23808281
Chey, William D
Food sits at the intersection between gastrointestinal (GI) physiology and symptoms in patients with the irritable bowel syndrome (IBS). It is now clear that the majority of IBS sufferers associate eating a meal with their GI and non-GI symptoms. This is hardly surprising when one considers that food can affect a variety of physiologic factors (motility, visceral sensation, brain-gut interactions, microbiome, permeability, immune activation, and neuro-endocrine function) relevant to the pathogenesis of IBS. In recent years, clinical research has increasingly focused on diet as a treatment for IBS. There is a relative paucity of data from rigorous, randomized, controlled trials for any dietary intervention in IBS patients. Currently, the largest body of literature has addressed the efficacy of dietary restriction of fermentable oligo, di, monosaccharides, and polyols (FODMAPs). In the future, dietary treatments for IBS will move beyond the current focus on elimination to embrace supplementation with "functional" foods. PMID:26856749
... your anus. The doctor will fill your large intestine with barium . You may be asked to change positions several times during the test. February 23, 2015 Previous: Symptoms and Causes of Irritable Bowel Syndrome Next: Treatment for Irritable Bowel Syndrome Digestive Disease ...
El-Salhy, M; Lomholt-Beck, B; Gundersen, D
The diagnosis of irritable bowel syndrome (IBS) is based on symptom assessment such as the Rome III criteria. It is sometimes difficult to clinically distinguish IBS from adult-onset celiac disease (CD). Individuals with CD presenting with relatively vague abdominal symptoms are at risk of been dismissed as having IBS. This study aimed to investigate the prevalence of patients with CD among those that fulfill the Rome III criteria for IBS from among patients referred to the gastroenterology section of our hospital over the last 5 years. The study included a total of 968 patients with an average age of 32 years (range 18-59 years). Females constituted 95% of all patients. Duodenal biopsies were obtained during standard gastroscopy. Sections from these biopsies were stained with haematoxylin and eosin and immunostained for human leucocytes CD45 using the avidin-biotin complex (ABC) method. The sections were then histopathologically examined. Four patients had CD: one with Marsh type 3b, and 3 with Marsh type 1. All four of these patients were positive for tissue transglutminase antibodies (anti-t-TG) IgA and were females aged 24, 20, 36 and 38 years. These 4 patients fulfilled the Rome III criteria for the sub-type IBS-diarrhea. This amounts to a prevalence of 0.4% of CD in IBS patients. The present findings support the notion that IBS patients should be routinely examined for CD. This applies to all subtypes of IBS. PMID:21468583
EM Eriksson; IE M(o)ller; RH S(o)derberg; HT Eriksson; GK Kurlberg
AIM: To compare irritable bowel syndrome (IBS) patients with apparently healthy persons and to evaluate body awareness therapy, which is a physiotherapeutic remedy focusing on normalising tensions in the body,for the treatment of IBS with the hypothesis that altered body tension is associated with the syndrome.METHODS: Twenty-one IBS patients received bodyawareness therapy two hours weekly for 24 wk. At baseline as well as after 12 and 24 wk, they underwent examinations including resource oriented body examination in combination with body awareness scale evaluation and filled in gastrointestinal and psychological symptom questionnaires. Saliva cortisol was analysed. A group of 21 apparently healthy persons underwent the same examinations once.RESULTS: Compared to the apparently healthy group,IBS patients scored higher at baseline for gastrointestinal and psychological symptoms. They showed more often alterations in normal body tension patterns, as well as deviating cortisol slopes in saliva. After 24 wk of body awareness therapy, their gastrointestinal and psychologicai symptoms were reduced overall. Somatic symptoms decreased in parallel with depressive symptoms. Whole body pain score decreased, coping ability as well as biochemical stress markers improved.CONCLUSION: IBS patients scored higher for gastrointestinal and psychological symptoms, and presented with altered biochemical stress markers. Their body tension deviated compared to healthy controls. Furthermore,body awareness therapy gave relief of both somatic complaints, psychological symptoms and normalised body tension. These findings indicate that distorted tension constitutes an important part of the symptoms in IBS.
Objective: To evaluate the symptom profile, course and prognosis of patients with irritable bowel syndrome (IBS) over a 15 years period. Study Design: An observational study. Place and Duration of Study: Shifa International Hospital, Islamabad, Pakistan, from 1996 to 2011. Methodology: Patients diagnosed with IBS at the study centre were followed for their clinical features, course over the period of time, management and its results. Only those patients were included in the study who completed the follow-up period. Results: A total of 292 patients with mean age of 40.44 +- 13.69 years were inducted. There were 156 (53.4%) males and 136 (46.6%) females. Nearly all male and female patients had abdominal pain and bloating. However, constipation was seen in 79.4% females and 71.6 males. Diarrhea was seen in 46.5% females and 42.7% males. Both constipation and diarrhea were seen in 27.3% female and 15.6% males. A high number of patients had concomitant illnesses and a large proportion of them had sleep disturbances, exacerbations with stress and had food sensitivities. Conclusion: This longitudinal follow-up study showed that, in our setting, there were more males suffering from this illness; females had more constipation-dominant features. Prognosis over the course of illness was excellent in all patients. (author)
Mazzawi, Tarek; El-Salhy, Magdy
Chromogranin A (CgA) is a common marker for enteroendocrine cells in the gut, and CgA-immunoreactive cell densities are abnormal in patients with irritable bowel syndrome (IBS). The majority of patients with IBS report that their symptoms develop after consuming certain foodstuffs. In the present study, we investigated the effects of dietary guidance on the total enteroendocrine cell densities in the small intestine, as detected by CgA. A total of 14 patients with IBS underwent a gastroscopy ...
Fassov, Janne; Lundby, Lilli; Worsøe, Jonas; Buntzen, Steen; Laurberg, Søren; Krogh, Klaus
Background Irritable bowel syndrome (IBS) is among the most common gastrointestinal disorders worldwide. In selected patients with severe diarrhoea-predominant or mixed IBS subtypes sacral nerve stimulation (SNS) alleviates IBS-specific symptoms and improves quality of life. The mode of action, however, remains unknown. The present study aimed to evaluate the effect of SNS on small intestinal motility in IBS patients. Methods Twenty patients treated with SNS for severe diarrhoea-predominant o...
Clive H Wilder-Smith; Joan Robert-Yap
AIM: To investigate the role of endogenous pain modulatory mechanisms in the central sensitization implicated by the visceral hypersensitivity demonstrated in patients with irritable bowel syndrome (IBS).Dysfunction of modulatory mechanisms would be expected to also result in changes of somatic sensory function.METHODS: Endogenous pain modulatory mechanisms were assessed using heterotopic stimulation and somatic and visceral sensory testing in IBS. Pain intensities (visual analogue scale, VAS 0-100) during suprathreshold rectal distension with a barostat, cold pressor stimulation of the foot and during both stimuli simultaneously (heterotopic stimulation) were recorded in 40 female patients with IBS and 20 female healthy controls.RESULTS: Rectal hypersensitivity (defined by 95% CI of controls) was seen in 21 (53%), somatic hypersensitivity in 22 (55%) and both rectal and somatic hypersensitivity in 14 of these IBS patients. Heterotopic stimulation decreased rectal pain intensity by 6 (-11 to -1) in controls, but increased rectal pain by 2 (-3 to +6) in all IBS patients (P＜0.05) and by 8 (-2 to +19) in IBS patients with somatic and visceral hypersensitivity (P＜0.02).CONCLUSION: A majority of IBS patients had abnormal endogenous pain modulation and somatic hypersensitivity as evidence of central sensitization.
Barbara, Giovanni; Cremon, Cesare; Carini, Giovanni; Bellacosa, Lara; Zecchi, Lisa; De Giorgio, Roberto; Corinaldesi, Roberto; Stanghellini, Vincenzo
The potential relevance of systemic and gastrointestinal immune activation in the pathophysiology and symptom generation in the irritable bowel syndrome (IBS) is supported by a number of observations. Infectious gastroenteritis is the strongest risk factor for the development of IBS and increased rates of IBS-like symptoms have been detected in patients with inflammatory bowel disease in remission or in celiac disease patients on a gluten free diet. The number of T cells and mast cells in the...
Viola Andresen; Peter Kobelt; Claus Zimmer; Bertram Wiedenmann; Burghard F Klapp; Hubert Monnikes; Alexander Poellinger; Chedwa Tsrouya; Dominik Bach; Albrecht Stroh; Annette Foerschler; Petra Georgiewa; Marco Schmidtmann; Ivo R van der Voort
AIM: To determine by brain functional magnetic resonance imaging (fMRI) whether cerebral processing of non-visceral stimuli is altered in irritable bowel syndrome (IBS) patients compared with healthy subjects. To circumvent spinal viscerosomatic convergence mechanisms,we used auditory stimulation, and to identify a possible influence of psychological factors the stimuli differed in their emotional quality.METHODS: In 8 IBS patients and 8 controls, fMRI measurements were performed using a block design of 4 auditory stimuli of different emotional quality (pleasant sounds of chimes, unpleasant peep (2000 Hz), neutral words, and emotional words). A gradient echo T2*-weighted sequence was used for the functional scans.Statistical maps were constructed using the general linear model.RESULTS: To emotional auditory stimuli, IBS patients relative to controls responded with stronger deactivations in a greater variety of emotional processing regions, while the response patterns, unlike in controls, did not differentiate between distressing or pleasant sounds.To neutral auditory stimuli, by contrast, only IBS patients responded with large significant activations.CONCLUSION: Altered cerebral response patterns to auditory stimuli in emotional stimulus-processing regions suggest that altered sensory processing in IBS may not be specific for visceral sensation, but might reflect generalized changes in emotional sensitivity and affectire reactivity, possibly associated with the psychological comorbidity often found in IBS patients.
Torii, Akira; Toda, Gotaro
Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. The prevalence rate is 10-20% and women have a higher prevalence. IBS adversely affects quality of life and is associated with health care use and costs. IBS comprises a group of functional bowel disorders in which abdominal discomfort or pain is associated with defecation or a change in bowel habit, and with features of disordered defecation. The consensus definition and criteria for IBS have been formalized in the "Rome II criteria". Food, psychiatric disorders, and gastroenteritis are risk factors for developing IBS. The mechanism in IBS involves biopsychosocial disorders; psychosocial factors, altered motility, and heightened sensory function. Brain-gut interaction is the most important in understanding the pathophysiology of IBS. Effective management requires an effective physician-patient relationship. Dietary treatment, lifestyle therapy, behavioral therapy, and pharmacologic therapy play a major role in treating IBS. Calcium polycarbophil can benefit IBS patients with constipation or alternating diarrhea and constipation. PMID:15206545
Schwartz, Lauren K; O'Keefe, Stephen J D; Fujioka, Ken; Gabe, Simon M; Lamprecht, Georg; Pape, Ulrich-Frank; Li, Benjamin; Youssef, Nader N; Jeppesen, Palle B
OBJECTIVES: In the pivotal 24-week, phase III, placebo-controlled trial, teduglutide significantly reduced parenteral support (PS) requirements in patients with short bowel syndrome (SBS). STEPS-2 was a 2-year, open-label extension of that study designed to evaluate long-term safety and efficacy of teduglutide. METHODS: Enrolled patients had completed 24 weeks of either teduglutide (TED/TED) or placebo (PBO/TED) in the initial placebo-controlled study or qualified for that study, but were not...
Tarek Mazzawi; Doris Gundersen; Trygve Hausken; Magdy El-Salhy
The large intestine contains five types of endocrine cells that regulate its functions by sensing its luminal contents and releasing specific hormones. Chromogranin A (CgA) is a common marker for the gastrointestinal endocrine cells, and it is abnormal in irritable bowel syndrome (IBS) patients. Most IBS patients relate their symptoms to certain food elements. The present study investigated the effect of dietary guidance on the total endocrine cells of the large intestine as detected by CgA i...
Burness, Celeste B; McCormack, Paul L
The recombinant analogue of human glucagon-like peptide-2 (GLP-2) teduglutide (Gattex(®), Revestive(®)) is a novel therapy for short bowel syndrome (SBS). GLP-2 is a naturally occurring hormone that regulates the growth, proliferation and maintenance of cells lining the gastrointestinal tract. Subcutaneous teduglutide is the first long-term medical therapy approved for the treatment of adult patients with SBS who are dependent on parenteral support (parenteral nutrition and/or intravenous fluids). In a pivotal, double-blind, multicentre, phase III study in adult patients with SBS who were dependent on parenteral support, a significantly higher proportion of teduglutide 0.05 mg/kg/day recipients than placebo recipients achieved at least a 20% reduction from baseline in weekly parenteral support volume at week 20 and maintained at week 24 (primary endpoint). The overall mean reduction in weekly parenteral support volume from baseline was greater in patients who received teduglutide compared with those who received placebo. Additionally, more teduglutide-treated patients achieved at least a one-day reduction in parenteral support than those receiving placebo. Subcutaneous teduglutide had an acceptable tolerability profile; the most frequently reported adverse events were of gastrointestinal origin, consistent with the underlying disease condition and the known mechanism of action of teduglutide. PMID:23729002
Marano, A.R.; Caride, V.J.; Shah, R.V.; Prokop, E.K.; Troncale, F.J.; McCallum, R.W.
Diffuse disturbance in gastrointestinal motility may be present in patients with irritable bowel syndrome (IBS). To further investigate small intestinal motility in IBS patients small intestinal transit time (SITT) was determined and related to the symptom status. 11 female patients with IBS (mean age 29 years) were divided into those whose predominate symptom was diarrhea (N=6), and those with only constipation (N=5). All subjects ingested an isosmotic solution of lactulose (10 gm in 150cc of water) labeled with 99m-Tc-DTPA (Sn). The patient was studied supine under a 25 inch gamma camera with data collected at 1 frame per minute for 180 minutes or until activity appeared in the ascending colon. Regions of interest were selected over the cecum and ascending colon. The time of first appearance of radioactivity in the region of the cecum was taken as the small intestinal transit time. SITT in the 5 normal females was 98.7 +- 13 min (mean +- SEM). SITT in the IBS patients with diarrhea, 67.3 +- 7 min was significantly faster (p< 0.08). SITT in the constipated IBS patients, 126 +- 12 min, was slower than normals and significantly different from diarrhea patients (p< 0.001). These studies show that IBS patients with diarrhea have significantly faster SITT than normals while constipated IBS patients have significantly slower SITT than the diarrhea subgroup. Further, this study emphasizes the need to study the various symptomatic subgroups of IBs patients independently and indicates a possible role for abnormal SITT in the pathogenesis of IBS.
... KB) Alternate Language URL Irritable Bowel Syndrome in Children Page Content On this page: What is irritable ... GI tract [ Top ] How common is IBS in children? Limited information is available about the number of ...
... Bruce D. Naliboff, PhD, Clinical Professor of Medical Psychology in the Dept. of Psychiatry and Biobehavioral Sciences, ... Gynecological Aspects of Irritable Bowel Syndrome Symptom Diary Testing in IBS Changes You Should Not Ignore if ...
... of IBS Who We Are Contact Us Donate Sleep and Irritable Bowel Syndrome Sleep difficulties are common ... More: Treating Pain in IBS How to improve sleep While there are a variety of medications that ...
Full Text Available Abstract Background Irritable bowel syndrome (IBS and functional dyspepsia (FD show considerable overlap and are both associated with psychiatric comorbidity. The present study aimed to investigate whether IBS patients with FD show higher levels of psychopathology than those without FD. As a preliminary analysis, it also evaluated the psychopathological differences, if any, between IBS patients featuring the two Rome III-defined FD subtypes, i.e. postprandial distress syndrome (PDS and epigastric pain syndrome (EPS. Methods Consecutive outpatients (n = 82, F = 67, mean age 41.6 ± 12.7 years referred to our third level gastroenterological centre, matching the Rome III criteria for IBS and, if present, for concurrent FD, were recruited. They were asked to complete a 90-item self-rating questionnaire, the Symptom Checklist 90 Revised (SCL-90-R, in order to assess the psychological status. Comparisons between groups were carried out using the non-parametric Mann-Whitney U test. Results Patients with IBS only were 56 (68.3%, F = 43, mean age 41.6 ± 13.3 years and patients with both IBS and FD were 26 (31.7%, F = 24, mean age 41.8 ± 11.5 years, 17 of whom had PDS and 9 EPS. Patients with both IBS and FD scored significantly higher on the SCL-90-R GSI and on eight out of the nine subscales than patients with IBS only (P ranging from 0.000 to 0.03. No difference was found between IBS patients with PDS and IBS patients with EPS (P ranging from 0.07 to 0.97, but this result has to be considered provisional, given the small sample size of the two subgroups. Conclusions IBS-FD overlap is associated with an increased severity of psychopathological features. This finding suggests that a substantial subset of patients of a third level gastroenterological centre with both IBS and FD may benefit from psychological assessment and treatment.
Full Text Available Abstract One hundred and fifteen patients with symptoms suggestive of irritable bowel syndrome (IBS according to Rome III criteria and 209 patients with gastrointestinal symptoms different from IBS (control were identified through medical records from the Gastroenterology Clinic of the "Dr. Manuel Gea Gonzalez General Hospital" from January 2008 to March 2010. No statistical differences in IBS data as compared with control groups were observed except in bloating, that was more frequent in the IBS group (P = 0.043. Although the pathogenicity of specific intestinal protozoa could not be demonstrated due to lack of association with the development of gastrointestinal symptoms, Blastocystis spp, in the IBS group, exhibited a trend of association to diarrhoea (odds ratio = 2.73, 95% confidence interval = 0.84-8.80, P = 0.053, while having any parasite and diarrhoea was significant (odds ratio = 3.38, 95% confidence interval = 1.33-8.57, P = 0.008. The association between Blastocystis and diarrhoea in IBS patients although not conclusive is an interesting finding; nonetheless more extensive case-controlled studies are required to clearly define the role of some "non-pathogenic" parasites in intestinal disease and IBS.
Barbara Grazioli; Francesco Luzza; Giovanni Matera; Costanza Laratta; Giuseppina Schipani; Giovanni Guarnieri; Ester Spiniello; Maria Imeneo; Andrea Amorosi; Alfredo Focà
AIM: To evaluate the prevalence of Giardia lamblia (G.lamblia) infection in patients with irritable bowel syndrome (IBS) and dyspepsia and to establish which is the most accurate test to diagnose the infection in this setting.METHODS: One hundred and thirty-seven patients who consecutively attended the Outpatient Gastroenterology Clinic for the first time between January 2002 and December 2003 due to symptoms of IBS and/or dyspepsia were recruited. All patients underwent clinical evaluation,first-step haematology and chemistry tests, serologic assays for celiac disease, lactose-H2 breath test, abdominal ultrasonography, and esophagogastroduodenoscopy.Helicobacter pylori status was evaluated. In patients with symptoms of IBS older than 45 years, colonoscopy was also performed. In all patients, duodenal biopsies and stool samples were examined for trophozoites and cysts of G.lamblia by several methods.RESULTS: G. lamblia was identified in 9 patients. The following diagnoses were also made: IBS (100/137, 73%), functional dyspepsia (62/137, 45%), organic dyspepsia (33/137, 24%), and lactose intolerance (75/137, 55%). A significant association was found between giardiasis and Hpylori infection (x2=6.632,OR= 12.4, CI= 1.5-68.1). There were no symptoms that reliably allowed the recognition of giardiasis.Direct search of the parasite in duodenal biopsy and stool sample examinations gave concordant results in all cases while histological examination of duodenal biopsies displayed a low sensitivity (e.g., 22.2%).CONCLUSION: In this consecutive series, diagnosis of G. lamblia infection accounted for 6.5% of patients with IBS and dyspepsia. Duodenal biopsies for diagnosis of giardiasis may be unnecessary if stool sample examination is performed.
Giovanni Gasbarrini; Marcello Candelli; RiccardoGiuseppe Graziosetto; Sergio Coccheri; Ferdinando Di Iorio; Giuseppe Nappi
AIM: To evaluate the efficacy of water supplementation treatment in patients with functional dyspepsia or irritable bowe syndrome (IBS) accompanying predominant constipation.METHODS: A total of 3 872 patients with functional dyspepsia and 3609 patients with irritable bowel syndrome were enrolled in the study by 18 Italina thermal centres.Patients underwent a first cycle of thermal therapy for 21 d. A year later patients were re-evaluated at the same centre and received another cycle of thermal therapy.A questionnare to collect personal data on social and occupational status, family and pathological case history,life style, clinical records, utilisation of welfare and health structure and devices was administered to each patient at basal time and one year after each thermal treatment.Sixty patients with functional dyspepsia and 20 with IBS and 80 healthy controls received an evaluation of gastric output and oro-cecal transit time by breath test analysis.Breath test was performed at basal time and after water supplementaton therapies. Gastrointestinal symptoms were evaluated at the same time points. Breath samples were analyzed with a mass spectometer and a gascromatograph. Results were expressed as T1/2 and T-lag for octanoic acid breath test and as oro-cecal transit time for lactulose breath test.RESULTS: A significant reduction of prevalence of symptoms was observed at the end of the first and second cycles of thermal therapy in dyspeptic and IBS patients.The analysis of variance showed a real and persistant improvement of symptoms in all patients. After water supplementation for 3 wk a reduction of gastric output was observed in 49 (87.5%) of 56 dyspeptic patients.Both T1/2 and T-lag were significantly reduced after the therapy compared to basal values [91± 12 (T1/2) and 53 ± 11 (T-lag), Tables 1 and 2] with results of octanoic acid breath test similar to healthy subjects. After water supplementation for 3 wk oro-cecal transit time was shorter than that at the
Agata Mulak; Leszek Paradowski
AIM: To evaluate the effect of sumatriptan, a selective 5-HT1 agonist, on anorectal function in irritable bowel syndrome (IBS) patients.METHODS: Twenty-two IB5 patients selected according to the Rome Ⅱ criteria (F 15, M 7; mean age 29.3±6.8,range 22-44 years) were examined. The study was blind,randomized and placebo-controlled with a crossover design. Anorectal manometry and rectal balloon distension test were performed before and after the administration of placebo and sumatriptan.RESULTS: The administration of sumatriptan caused a significant increase in the resting anal canal pressure from 9.2±2.0 kPa to 13.1±3.3 kPa (P＜0.0001) connected with the increase in the anal sphincter length and high pressure zone. After sumatriptan injection a remarkable increase in the threshold for the first sensation from 27±9 mL to 34±12 mL (P＜0.05) and urge sensation from 61±19 mL to 68±18 mL (P＜0.01) was observed.Sumatriptan did not affect either the volume evoking the rectoanal inhibitory reflex or the results of the straining test.CONCLUSION: 5-HT1 receptors participate in the regulation of anorectal function. Elucidation of the role of 5-HT1 receptors in the pathophysiological mechanisms of IBS may have some therapeutic implications.
Uday C Ghoshal; Sunil KUMAR; Mehrotra, Mansi; Lakshmi, CP; Misra, Asha
Introduction Small intestinal bacterial overgrowth (SIBO) occurs in varying frequency in irritable bowel syndrome (IBS). We studied the frequency of SIBO in IBS and chronic non-specific diarrhea (CNSD). Methods 129 patients with IBS (Manning's criteria), 73 with CNSD (≥ 4 weeks diarrhea with two of these tests normal [urine D-xylose, fecal fat and duodenal biopsy]) and 51 healthy controls (HC) were evaluated for SIBO using glucose hydrogen breath test (GHBT). Diarrhea-predominant IBS (D-IBS) ...
Background: Irritable bowel syndrome (IBS) is a gastrointestinal disorder manifested by abdominal discomfort or pain, bloating and abdominal distension, and changes in the defecation pattern between diarrhoea and constipation. A significant proportion of IBS patients attribute their symptoms to food items and food intolerance. More information is needed on the effect of diet management in the treatment of IBS and this thesis is a contribution with effort to adva...
Full Text Available There is a growing interest of clinical and epidemiological researches in the field of functional gastrointestinal disorders in our society. Accordingly, validated and culturally adapted instruments are required for appropriate measurement of variables specially the quality of life. The aim of our study was the linguistic validation of the Irritable Bowel Syndrome-Quality of Life questionnaire (IBS-QOL for Iranian IBS patients with Persian language. Following the standard forward-backward translation method, the IBS-QOL was translated into the Persian language and completed by 141 IBS patients. Patients also completed the IBS Symptom Severity Scale (IBS-SSS and Hospital Anxiety and Depression Scale (HADS. One-week retest was performed on 30 randomly selected patients. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and intraclass correlation coefficient (ICC, respectively. To analyze the discriminant validity, the IBS-QOL scores was correlated to the IBS-SSS and HADS scores. According to the results, reliability analyses were acceptable for all of the IBS-QOL domains (Cronbach's alpha=0.68 to 0.90 and ICCs=0.77 to 0.91. Discriminant validity was supported by the presence of correlations of the IBS-QOL scores with disease severity (r = -0.628, depression (r = -0.692, and anxiety (r = -0.711 scores; P < 0.001. These results indicate that the Persian version of the IBS-QOL is a reliable instrument with sufficient psychometric requirements to assess quality of life in Iranian IBS patients with Persian language.
Weaver, Kristen R; Sherwin, LeeAnne B; Walitt, Brian; Melkus, Gail D’Eramo; Henderson, Wendy A
AIM: To summarize and synthesize current literature on neuroimaging the brain-gut axis in patients with irritable bowel syndrome (IBS). METHODS: A database search for relevant literature was conducted using PubMed, Scopus and Embase in February 2015. Date filters were applied from the year 2009 and onward, and studies were limited to those written in the English language and those performed upon human subjects. The initial search yielded 797 articles, out of which 38 were pulled for full text review and 27 were included for study analysis. Investigations were reviewed to determine study design, methodology and results, and data points were placed in tabular format to facilitate analysis of study findings across disparate investigations. RESULTS: Analysis of study data resulted in the abstraction of four key themes: Neurohormonal differences, anatomic measurements of brain structure and connectivity, differences in functional responsiveness of the brain during rectal distention, and confounding/correlating patient factors. Studies in this review noted alterations of glutamate in the left hippocampus (HIPP), commonalities across IBS subjects in terms of brain oscillation patterns, cortical thickness/gray matter volume differences, and neuroanatomical regions with increased activation in patients with IBS: Anterior cingulate cortex, mid cingulate cortex, amygdala, anterior insula, posterior insula and prefrontal cortex. A striking finding among interventions was the substantial influence that patient variables (e.g., sex, psychological and disease related factors) had upon the identification of neuroanatomical differences in structure and connectivity. CONCLUSION: The field of neuroimaging can provide insight into underlying physiological differences that distinguish patients with IBS from a healthy population. PMID:27158548
Brint, Elizabeth K
The pathogenesis of irritable bowel syndrome (IBS) is poorly understood. One contributory factor may be low-grade mucosal inflammation, perhaps initiated by the microbiota. Toll-like receptors (TLRs) are a family of pathogen-recognition receptors of the innate immune system. The aim of this study was to evaluate the potential involvement of TLRs in IBS to further understand the involvement of the innate immune system in this complex disorder.
Park, Jung Ho; Park, Dong Il; Kim, Hong Joo; Cho, Yong Kyun; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik; Won, Kyoung Hee; Park, Soon Min
Background/Aims Small-intestinal bacterial overgrowth (SIBO) is a frequent finding in patients with irritable bowel syndrome (IBS). Many patients with IBS also have abnormal intestinal permeability, which is probably due to low-grade inflammation in the intestinal mucosa. Our aim was to verify the relationship between SIBO and small-intestinal permeability in IBS patients. Methods A cohort of 38 IBS patients (20 women and 18 men; age range 16-70 years; mean age 40.2 years) with symptoms that ...
Reza Valizadeh; Elham Basereh; Shahram Mami; Zahra Amin Parast
Background: Irritable Bowel Syndrome is a prevalent syndrome which is identified by change intestine movements. In this research the effect of relaxation on life quality of IBS patients referring to Dehloran’s Shohada hospital, Iran, in 2015 has been investigated. Materials and Methods: This research is a semi-experimental pre-test – post-test, which was conducted on 24 people with IBS. After the test and the pre-test, relaxation curing was conducted for eight weeks, each week 60 minutes, usi...
Al-Ajlan, Abdulrahman S
The present study is to determine the prevalence and implication of coeliac disease (CD) among adult Saudis and compared to those with diagnosed irritable bowel syndrome. This prospective study was conducted among 980 adults. Out of that, 482 subjects (staff and students of Riyadh Health Science College) were designated as control cohorts for undetected coeliac disease. Furthermore, another contingent of 498 subjects diagnosed with irritable bowel syndrome (IBS) at Prince Salman Hospital and Al-Iman General Hospital also constituted a segment of the overall initial 1020 subjects. Both cases and control were tested for serological markers of coeliac disease (tissues transglutaminase (tTGAs) and endomysial autoantibody (EMAs) and were confirmed by histopathology test. All the positive for cases of coeliac disease were screened for iron deficiency anaemia, Vitamin D deficiency, and osteoporosis and weight assessment. The percentage of coeliac disease in control subjects and patients diagnosed with irritable bowel syndrome (IBS) were found to be 1.9% and 9.6% respectively, about 38% of the total coeliac disease patients are among females of middle age (20-39-years) and 16% of the males in the same age range. Whereas, 20% and 25% of all coeliac disease cases with ages of 40-59 were remarked as females and males respectively. The identical nature and overlap of symptoms of the two conditions could possibly result in misdiagnosis of coeliac diseases or over-diagnosis of irritable bowel syndrome. The findings of the study might also give considerable implications of the disease in the nutritional level which is noticeable. PMID:27298578
El-Salhy, Magdy; Gundersen, Doris
Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that is characterized by intermittent abdominal pain/discomfort, altered bowel habits and abdominal bloating/distension. This review aimed at presenting the recent developments concerning the role of diet in the pathophysiology and management of IBS. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, and there is no evidence that gluten causes the debated new diagnosis of non-coeliac gluten sensitivity (NCGS). The component in wheat that triggers symptoms in NCGS appears to be the carbohydrates. Patients with NCGS appear to be IBS patients who are self-diagnosed and self-treated with a gluten-free diet. IBS symptoms are triggered by the consumption of the poorly absorbed fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) and insoluble fibre. On reaching the distal small intestine and colon, FODMAPS and insoluble fibre increase the osmotic pressure in the large-intestine lumen and provide a substrate for bacterial fermentation, with consequent gas production, abdominal distension and abdominal pain or discomfort. Poor FODMAPS and insoluble fibres diet reduces the symptom and improve the quality of life in IBS patients. Moreover, it changes favourably the intestinal microbiota and restores the abnormalities in the gastrointestinal endocrine cells. Five gastrointestinal endocrine cell types that produce hormones regulating appetite and food intake are abnormal in IBS patients. Based on these hormonal abnormalities, one would expect that IBS patients to have increased food intake and body weight gain. However, the link between obesity and IBS is not fully studied. Individual dietary guidance for intake of poor FODMAPs and insoluble fibres diet in combination with probiotics intake and regular exercise is to be recommended for IBS patients. PMID:25880820
Wang, Hongling; Zhou, Guoying; Luo, Linjie; Crusius, J Bart A; Yuan, Anlong; Kou, Jiguang; Yang, Guifang; Wang, Min; Wu, Jing; von Blomberg, B Mary E; Morré, Servaas A; Peña, A Salvador; Xia, Bing
Celiac disease (CD) is common in Caucasians, but thought to be rare in Asians. Our aim was to determine the prevalence of CD in Chinese patients with chronic diarrhea predominant irritable bowel syndrome (IBS-D).From July 2010 to August 2012, 395 adult patients with IBS-D and 363 age and sex-matched healthy controls were recruited in Zhongnan Hospital of Wuhan University and Xiaogan Central Hospital in Hubei province, central China. Patients with IBS-D were diagnosed according to the Rome III criteria. Serum Immunoglobulin (IgA/IgG) anti-human tissue transglutaminase (anti-htTG)-deamidated gliadin peptide (DGP) antibodies were measured in a single ELISA (QUANTA Lite h-tTG/DGP Screen). Upper endoscopy with duodenal biopsies and HLA-DQA1 and HLA-DQB1 genotyping were performed in seropositive subjects and a gluten-free diet was prescribed.Seven IBS-D patients (7/395, 1.77%) and 2 healthy controls (2/363, 0.55%), were positive for anti-htTG/DGP antibodies. Of these 9 cases, 1 was lost to follow-up, 3 were suspected to have CD and 5 were eventually diagnosed as CD with intestinal histological lesions classified as Marsh Type II in 2 and Type III in 3. Of these 5 diagnosed CD patients, 4 (4/395, 1.01%) were from the IBS-D group and 1 (1/363, 0.28%) from the healthy control had asymptomatic CD. Two Type III CD patients with relatively high titers in the serologic assay were homozygous and heterozygous for haplotype HLA-DQA1*03-DQB1*03:03 (HLA-DQ9.3), respectively.In the present study, CD was present in 1.01% of patients with IBS-D and in 0.28% of the control group. We like to suggest that the haplotype HLA-DQA1*03-DQB1*03:03 (HLA-DQ9.3), which is common in Chinese, is a new susceptibility factor for CD in China. Larger screening and genetic studies are needed in the Chinese population of different regions. PMID:26496305
... foods are linked to other digestive conditions like lactose intolerance or celiac disease , though, so it's important to ... MORE ON THIS TOPIC Gastroesophageal Reflux Disease (GERD) Lactose Intolerance Inflammatory Bowel Disease Ulcers Digestive System Eating Well ...
Ross, Colin A.
Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the…
Saadi, Mohammed; McCallum, Richard W.
Irritable bowel syndrome (IBS) is the most common functional bowel disease that affects up to 15% of the US population. The majority of patients with IBS have significant bloating and gas. Recent evidence is beginning to suggest that patients with IBS may have an alteration in the gastrointestinal flora. Specifically, findings suggest that patients with IBS have excessive bacteria in the small bowel, referred to as bacterial overgrowth. Therefore there may be benefits of antibiotic-based ther...
Jeppesen, Palle Bekker
Short bowel syndrome results from surgical resection, congenital defect or disease-associated loss of absorption. Parenteral support (PS) is lifesaving in patients with short bowel syndrome and intestinal failure who are unable to compensate for their malabsorption by metabolic or pharmacologic adaptation. Together, the symptoms of short bowel syndrome and the inconvenience and complications in relation to PS (e.g. catheter-related blood steam infections, central thrombosis and intestinal failure associated liver disease) may impair the quality of life of patients. The aim of treatment is to maximize intestinal absorption, minimize the inconvenience of diarrhea, and avoid, reduce or eliminate the need for PS to achieve the best possible quality of life for the patient. Conventional treatments include dietary manipulations, oral rehydration solutions, and antidiarrheal and antisecretory treatments. However, the evidence base for these interventions is limited and treatments that improve the structural and functional integrity of the remaining intestine are needed. Teduglutide, an analog of glucagon-like peptide 2, improves intestinal rehabilitation by promoting mucosal growth and possibly by restoring gastric emptying and secretion, thereby reducing intestinal losses and promoting intestinal absorption. In a 3-week, phase II balance study, teduglutide reduced diarrhea by around 700 g/day and fecal energy losses by around 0.8 MJ/day. In two randomized, placebo-controlled, 24-week, phase III studies, similar findings were obtained when evaluating the fluid composite effect, which is the sum of the beneficial effects of teduglutide - reduction in the need for PS, increase in urine production and reduction in oral fluid intake. The fluid composite effect reflects the increase in intestinal fluid absorption (and the concomitant reduction in diarrhea) and may be used in studies in which metabolic balance assessments are not performed. In studies of up to 24 weeks
Yang, Jian-Feng; Fox, Mark; Chu, Hua; Zheng, Xia; Long, Yan-Qin; Pohl, Daniel; Fried, Michael; Dai, Ning
AIM: To validate 4-sample lactose hydrogen breath testing (4SLHBT) compared to standard 13-sample LHBT in the clinical setting. METHODS: Irritable bowel syndrome patients with diarrhea (IBS-D) and healthy volunteers (HVs) were enrolled and received a 10 g, 20 g, or 40 g dose lactose hydrogen breath test (LHBT) in a randomized, double-blinded, controlled trial. The lactase gene promoter region was sequenced. Breath samples and symptoms were acquired at baseline and every 15 min for 3 h (13 ...
Lewis, James H
Ischaemic colitis (IC) is the most common form of ischaemic injury to the gastrointestinal (GI) tract. IC typically presents with the sudden onset of lower abdominal pain, cramping and rectal bleeding, and is usually self-limited with low morbidity, although it may cause gangrenous or fulminant colitis, especially when the right colon is involved. Multiple medical conditions, as well as several pharmacological agents, are associated with IC, including irritable bowel syndrome (IBS) and drugs used for its treatment that act on gut serotonin 5-HT receptors. These include the selective 5-HT(3) receptor antagonist alosetron, currently approved for the treatment of severe diarrhoea-predominant IBS in women who fail to respond to conventional treatment, and cilansetron, another 5-HT(3) receptor antagonist that is no longer in clinical development. In addition, the 5-HT(4) receptor partial agonist tegaserod, which was approved for the treatment of constipation-predominant IBS in women, was associated with IC in the postmarketing setting, as was renzapride, a 5-HT(4) agonist/5-HT(3) antagonist. Although several hypotheses have been proposed, the pathophysiological basis for development of IC with 5-HT(3) receptor antagonists or 5-HT(4) receptor agonists remains unknown. Of interest, several population-based studies demonstrated that a diagnosis of IBS (independent of serotonergic therapies) increases the risk of developing IC 2- to 4-fold. As a result, IBS patients with the acute onset of abdominal pain, tenderness, diarrhoea or lower intestinal bleeding, especially those with predisposing conditions or medications, should be evaluated promptly for IC. The management of IC remains supportive; most cases of non-gangrenous IC, as seen in the alosetron and tegaserod databases, have been transient and have resolved spontaneously without complications or death. Despite the small number of deaths associated with alosetron in patients with complications of constipation and
Nomura Shinobu; Fujii Yasushi
Abstract Background To investigate non-patient irritable bowel syndrome (IBS) change to IBS and to determine factors predictive of the onset of IBS, individual biological factors, psychological factors, behavioral factors, and environmental factors were examined. Methods The subjects were 105 non-patient IBS (male = 59, female = 46, average age:21.49 ± 2.37), including 68 of the diarrhea-predominant type and 37 of the constipation-predominant type selected from 1,409 university and technical ...
Full Text Available The aim of this study was to analyze the data of endoscopy and symptoms in 118 Mexican patients with irritable bowel syndrome (IBS, dyspepsia, non-erosive reflux disease (NERD and erosive esophagitis (EE. IBS criteria were fulfilling for dyspepsia patients in 47%, for NERD in 48%, and for EE patients in 48% of cases. Esophagitis was present in 42% of patients with IBS and in 45% of patients with dyspepsia. A higher prevalence of hiatus hernia was found in EE vs. NERD. Heartburn and acid eructation were associated with the presence of esophagitis; acid eructation, regurgitation and nocturnal pain with duodenitis; and heartburn and regurgitation with hiatus hernia. Males more frequently reported: ucus in feces, abdoinal distension, nausea and gastritis; and oen ore frequently reported esophagitis and duodenitis. Patients with NERD (OR 2.54, 95% CI 1.08 to 5.99, p=0.04, tenesmus and early satiety, and men had an increase risk for reporting hard or lumpy stools. In conclusion, nearly half of the Mexican patients with NERD, EE and dyspepsia fulfill criteria for IBS. A large number of symptoms were correlated with endoscopy, which can be used to improve the indication of the endoscopy and its implementation in clinical studies.O objetivo deste estudo foi analisar os dados de endoscopia e sintomas de 118 pacientes mexicanos com síndrome do intestino irritável (IBS, dispepsia, doença do refluxo não-erosiva (NERD e esofagite erosiva (EE. Os pacientes com IBS preencheram os critérios para dispepsia em 47%, para NERD em 48%, e para pacientes EE em 48% dos casos. Esofagite estava presente em 42% dos pacientes com IBS e em 45% dos pacientes com dispepsia. A maior prevalência de hérnia de hiato foi encontrada na EE em comparação com NERD. Azia e eructação ácida foram associadas à presença de esofagite; eructação ácida, regurgitação e dor noturna, com duodenite; e azia e regurgitação com hérnia de hiato. Os homens relataram mais
Liliana David; Alexandru Babin; Alina Picos; Dan Lucian Dumitrascu
Background and aim. Small intestinal bacterial overgrowth is encountered in bowel disorders, including irritable bowel symptoms. Low degrees of inflammation have been recently reported in the irritable bowel syndrome. We looked for the association between intestinal inflammation and small intestinal bacterial overgrowth in irritable bowel syndrome.Methods. Small intestinal bacterial overgrowth was assessed by the H2 glucose breath test in 90 consecutive patients with irritable bowel syndrome....
Pedersen, Natalia; Vegh, Zsuzsanna; Burisch, Johan;
In the present study we report on changes in irritable bowel syndrome-severity scoring system (IBS-SSS) and irritable bowel syndrome-quality of life (IBS-QoL) in 19 IBS patients, aged 18 to 74 years (F/M: 14/5), during 12 wk registering their symptoms on the web-application (www.......ibs.constant-care.dk). During a control period of the first 6-wk patients were asked to register their IBS-SSS and IBS-QoL on the web-application weekly without receiving any intervention. Thereafter, low fermentable oligo-, di-, mono-saccharides and polyols (FODMAP) diet (LFD) was introduced for the next 6 wk while continuing...... significantly during the LFD period, median: 67 (37-120), P < 0.01. The significant reduction in disease activity during the control period shows a positive effect of the web-application on IBS symptoms when presented as a "traffic light". However adding the diet reduced IBS-SSS to < 150, inactive to mild...
Pedersen, Natalia; Vegh, Zsuzsanna; Burisch, Johan; Jensen, Lisbeth; Ankersen, Dorit Vedel; Felding, Maria; Andersen, Nynne Nyboe; Munkholm, Pia
In the present study we report on changes in irritable bowel syndrome-severity scoring system (IBS-SSS) and irritable bowel syndrome-quality of life (IBS-QoL) in 19 IBS patients, aged 18 to 74 years (F/M: 14/5), during 12 wk registering their symptoms on the web-application (www.ibs.constant-care.dk). During a control period of the first 6-wk patients were asked to register their IBS-SSS and IBS-QoL on the web-application weekly without receiving any intervention. Thereafter, low fermentable oligo-, di-, mono-saccharides and polyols (FODMAP) diet (LFD) was introduced for the next 6 wk while continuing the registration. Though a small sample size a significant improvement in disease activity (IBS-SSS) was observed during both the control period, median: 278 (range: 122-377), P = 0.02, and subsequently during the LFD period, median: 151 (range: 29-334), P traffic light". However adding the diet reduced IBS-SSS to < 150, inactive to mild symptoms. In the future results from larger scale trials are awaited. PMID:24914395
Jeppesen, P B; Sanguinetti, E L; Buchman, A; Howard, L.; Scolapio, J S; Ziegler, T R; Gregory, J; Tappenden, K A; Holst, J.; Mortensen, P B
Background and aims: Glucagon-like peptide 2 (GLP-2) may improve intestinal absorption in short bowel syndrome (SBS) patients with an end jejunostomy. Teduglutide (ALX-0600), a dipeptidyl peptidase IV resistant GLP-2 analogue, prolongs the intestinotrophic properties of GLP-2 in animal models. The safety and effect of teduglutide were investigated in SBS patients with and without a colon in continuity.
Foxx-Orenstein, Amy E
Irritable bowel syndrome is a functional bowel disorder with gastrointestinal symptoms (e.g. abdominal pain, straining, urgency, incomplete evacuation, nausea, and bloating) that occur alongside bowel function alterations (i.e. constipation, diarrhea, or both). Patients with irritable bowel syndrome may also experience comorbid anxiety and depression. Irritable bowel syndrome is common, with a prevalence estimated between 3% and 28%, affecting patient health and quality of life. Patients with moderate or severe irritable bowel syndrome generally seek medical care, whereas those with milder symptoms may choose self-management. Most patients with irritable bowel syndrome receive outpatient care, but irritable bowel syndrome-related hospitalizations do occur. The pathophysiology of irritable bowel syndrome is multifactorial (i.e. genetics, immune components, changes in the gut microbiota, disturbances in physiologic stress response systems, and psychosocial factors). Management of irritable bowel syndrome can include lifestyle changes, dietary interventions, counseling, psychologic medication, and agents that affect gastrointestinal motility. A number of therapies have emerged in recent years with clinical trial data demonstrating efficacy and safety for patients with irritable bowel syndrome, including agents that target gastrointestinal motility (i.e. linaclotide), gastrointestinal opioid receptors (i.e. asimadoline, eluxadoline), and gut microbiota (i.e. rifaximin). Linaclotide has been shown to significantly improve stool frequency and abdominal pain compared with placebo in constipation-predominant irritable bowel syndrome (number needed to treat, 5.1). Asimadoline shows efficacy in patients with moderate-to-severe irritable bowel syndrome-related pain. Rifaximin provided adequate relief of global irritable bowel syndrome symptoms versus placebo for a significantly greater percentage of patients with diarrhea-predominant irritable bowel syndrome (p < 0
Hocke, M; Seidel, T; Sprott, H; Oelzner, P; Eitner, K; Bosseckert, H
Background: Changes in electrogastrographic parameters are described in patients with irritable bowel syndrome, sclerodermia, dyspepsia, and delayed gastric emptying in static measurements. However, no information is available about changes in ambulatory measurements. The objective of this study was to find parameters that discriminate between these diseases using cutaneous 24-h-electrogastrography. Methods: Cutaneous 24-h electrogastrography (EGG) measurements were taken from 20 patients with dyspepsia, 10 patients with systemic sclerosis (sclerodermia, SSc), 7 patients with irritable bowel syndrome (IBS), 7 patients with delayed gastric emptying, and 10 healthy volunteers. Measurements were made using a DIGITRAPPER EGG (Synectics Medical Inc., Stockholm, Sweden) and the accompanying computerized data analysis package (ElectroGastroGram Version 6.30, Gastrosoft Inc., Synectics Medical Inc., Stockholm, Sweden). Frequency and power were compared pre- and postprandially, as well as during the entire day of measurement. Results: The 24-h measurements in healthy volunteers revealed 45.00%+/-12.12% normal values (2.4-3.7 cpm), 30.10%+/-7.15% bradygastric values (3.7 cpm). There was no significant change in frequency between rest and motion, but there was a significant increase in power (P<0.05). There was significantly more bradygastria in patients with dyspepsia periprandially as well as after 24 h (P<0.01) than in healthy volunteers. The mean power of patients with dyspepsia was significantly higher than that of patients with IBS (P<0.05). Conclusion: Cutaneous 24-h-EGG may be used as an additional means of differentiating between dyspepsia and IBS. PMID:11395301
Lee, Oh Young
Altered motility remains one of the important pathophysiologic factors in patients with irritable bowel syndrome (IBS) who commonly complain of abdominal pain and stool changes such as diarrhea and constipation. The prevalence of IBS has increased among Asian populations these days. Gastrointestinal (GI) physiology may vary between Asian and Western populations because of differences in diets, socio-cultural backgrounds, and genetic factors. The characteristics and differences of GI dysmotili...
Cuomo, Rosario; Andreozzi, Paolo; Zito, Francesco Paolo; Passananti, Valentina; De Carlo, Giovanni; Sarnelli, Giovanni
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders in Western countries. Despite the high prevalence of this disorders, the therapeutic management of these patients is often unsatisfactory. A number of factors have been suggested to be involved in the pathogenesis of IBS, including impaired motility and sensitivity, increased permeability, changes in the gut microbiome and alterations in the brain-gut axis. Also food seems to play a critical role: the most of ...
Major, Giles; Robin C. Spiller
Purpose of review The review aims to update the reader on current developments in our understanding of how the gut microbiota impact on inflammatory bowel disease and the irritable bowel syndrome. It will also consider current efforts to modulate the microbiota for therapeutic effect. Recent findings Gene polymorphisms associated with inflammatory bowel disease increasingly suggest that interaction with the microbiota drives pathogenesis. This may be through modulation of the immune response,...
Man, Fernando; Bustos Fernández, Luis María
Irritable bowel syndrome is a highly prevalent condition responsible for almost one third of visits to the gastroenterologist and huge expenses for diagnosis, treatment and loss of working days. A unique pathophysiologic mechanism has not been elucidated yet and several possibilities have been proposed such as senso-perception and motor disturbances, the effect of stress and anxiety, serotonin receptor failures, activation of abnormal brain areas and pain modulation differences, among others. The absence of a biological marker has led the investigators to consider this syndrome as an exclusion diagnostic condition, once the organic diseases have been discarded The changes in gut microbiota have recently raised great interest among gastroenterologists. The study of the small intestinal bowel overgrowth syndrome, the effect of antibiotics upon the flora, the recognition of post-infectious irritable bowel syndrome and the action of probiotics, together with the effect of malabsortion of diet carbohydrates have brought some new light in our knowledge. The present update will focus on the published evidence about the subject, bearing in mind that the mechanisms elicited here are only suitable for a subgroup of patients. PMID:24516961
Nightingale, J M
Patients with a short bowel have usually had a bowel resection for Crohn's disease. Two types of short-bowel patient can be distinguished: those with a jejunostomy and those with their jejunum anastomosed to a functioning colon. Both types of patient have problems with macronutrient absorption, although those with a colon experience fewer problems because some energy from unabsorbed carbohydrate is salvaged in the colon. Patients with a jejunostomy have problems with large stomal losses of water, sodium and magnesium, whereas those with a jejuno-colic anastomosis rarely have problems with water and electrolyte absorption. Patients with a jejunostomy 100-200 cm from the duodeno-jejunal flexure ('absorbers') usually absorb more from the diet than they pass through the stoma and therefore require oral electrolyte or nutrient supplements. Those with a residual jejunal length of less than 100 cm usually secrete more from the stoma than they take in orally ('secretors') and therefore require long-term parenteral fluid or nutrient supplements. A high output resulting from a jejunostomy is treated by reducing the oral intake of hypotonic fluid, administering a sipped glucose-saline solution and, often, by giving drugs that reduce intestinal motility (most effective in absorbers) or gastrointestinal secretions (most effective in secretors). Gallstones are common both in short-bowel patients with and in those without a colon (45%), and calcium oxalate renal stones occur in the former (25%). However, it is now possible to provide adequate nutrition and fluid supplements for most patients with a short bowel, and the prospects for the rehabilitation of such patients are good. PMID:7552632
Mullin, Gerard; Lee, Linda
Focus Areas: Integrative Approaches to Care, Pediatrics The irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and altered bowel movements. The diagnosis of IBS is established by the Rome III criteria. IBS afflicts 10% to 15% of the US population (30 million Americans) and is the most common digestive disorder seen in the primary care setting. Patients with IBS have an impaired quality of life and high rate of absenteeism from work with diminished pr...
Banet, D E; McClave, S A; Callen, J P
A 39-year-old woman with chronic, recurrent Sweet's syndrome (acute febrile neutrophilic dermatosis) and possible Crohn's disease was successfully treated with oral metronidazole. After 4 years of recurrent skin lesions which involved the hands and face, our patient developed genital and perianal ulcerations which were also histopathologically characterized by a neutrophilic infiltrate. In addition, she had a nondeforming polyarthritis that accompanied recurrences of her skin lesions. The patient was given oral metronidazole, an agent frequently used for perianal Crohn's disease, and achieved complete resolution of the perianal and perineal ulcers, the cutaneous lesions of Sweet's syndrome and the associated polyarthritis. PMID:7799365
Begtrup, Luise M; Engsbro, Anne Line; Kjeldsen, Jens;
assessed by a strategy of exclusion (analyses of blood, stool samples for intestinal parasites, and sigmoidoscopies with biopsies) or a positive strategy (analyses of blood cell count and C-reactive protein). Patients were followed for 1 year. The primary end point was difference in change of HRQOL from......BACKGROUND & AIMS: Guidelines recommend a positive strategy based on symptom criteria to diagnose patients with irritable bowel syndrome (IBS). We conducted a randomized noninferiority trial to determine whether a positive diagnostic strategy is noninferior to a strategy of exclusion, with regard...... were registered. RESULTS: A positive strategy was noninferior to a strategy of exclusion (difference, 0.64; 95% confidence interval, -2.74 to 1.45). The positive diagnostic strategy had lower direct costs. Each approach had similar effects on symptoms, satisfaction, and subsequent use of health...
Jeppesen, P B; Gilroy, R; Pertkiewicz, M;
Teduglutide, a GLP-2 analogue, may restore intestinal structural and functional integrity by promoting repair and growth of the mucosa and reducing gastric emptying and secretion, thereby increasing fluid and nutrient absorption in patients with short bowel syndrome (SBS). This 24-week placebo-co...
Portincasa, Piero; Moschetta, Antonio; Baldassarre, Giuseppe; Donato F. Altomare; Palasciano, Giuseppe
AIM: Psychological factors, altered motility and sensation disorders of the intestine can be variably associated with irritable bowel syndrome (IBS). Such aspects have not been investigated simultaneously. The aim of this paper was to evaluate gastrointestinal motility and symptoms, psychological spectrum and quality of life in a large group of IBS patients in southern Italy.
Objective To observe the efficacy,adverse effects and the influence on the depression and anxiety scoringof combined venlafaxine sustained release tablet with pinaverium for treating patients with dominant-diarrhea irritable bowel syndrome (IBS-D) .Methods With randomized,parallel control,multi-center and opening study
... the esophagus, stomach, and small intestine so the radiologist and a health care provider can see the shape of these ... to create images. For a CT scan, a health care provider may give the patient a ... and a radiologist interprets the images. The patient does not need ...
Full Text Available Abstract Background Persons with Irritable bowel syndrome (IBS are seriously affected in their everyday life. The effect across different cultural settings of IBS on their quality of life has been little studied. The aim was to compare health-related quality of life (HRQOL of individuals suffering from IBS in two different cultural settings; Crete, Greece and Linköping, Sweden. Methods This study is a sex and age-matched case-control study, with n = 30 Cretan IBS cases and n = 90 Swedish IBS cases and a Swedish control group (n = 300 randomly selected from the general population. Health-related quality of life, measured by SF-36 and demographics, life style indicators and co-morbidity, was measured. Results Cretan IBS cases reported lower HRQOL on most dimensions of SF-36 in comparison to the Swedish IBS cases. Significant differences were found for the dimensions mental health (p Conclusion The results from this study tentatively support that the claim that similar individuals having the same disease, e.g. IBS, but living in different cultural environments could perceive their disease differently and that the disease might affect their everyday life and quality of life in a different way. The Cretan population, and especially women, are more seriously affected mentally by their disease than Swedish IBS cases. Coping with IBS in everyday life might be more problematic in the Cretan environment than in the Swedish setting.
Kim, Sun Jung; Kim, Bo Ram; Lee, Song Mi; Kong, Hee Jung
Short Bowel Syndrome (SBS) is a condition that causes malabsorption and nutrient deficiency because a large section of the small intestine is missing or has been surgically removed. SBS may develop congenitally or from gastroenterectomy, which often change the motility, digestive, and/or absorptive functions of the small bowel. The surgical procedure for SBS and the condition itself have high mortality rates and often lead to a range of complications associated with long-term parenteral nutrition (PN). Therefore, careful management and appropriate nutrition intervention are needed to prevent complications and to help maintain the physiologic integrity of the remaining intestinal functions. Initial postoperative care should provide adequate hydration, electrolyte support and total parenteral nutrition (TPN) to prevent fatal dehydration. Simultaneously, enteral nutrition should be gradually introduced, with the final goal of using only enteral nutrition support and/or oral intake and eliminating TPN from the diet. A patient should be considered for discharge when macro and micronutrients can be adequately supplied through enteral nutrition support or oral diet. Currently, there is more research on pediatric patients with SBS than on adult patient population. A 35-year-old man with no notable medical history was hospitalized and underwent a surgery for acute appendicitis at a local hospital. He was re-operated on the 8th day after the initial surgery due to complications and was under observation when he suddenly complained of severe abdominal pain and high fever. He was immediately transferred to a tertiary hospital where the medical team discovered free air in the abdomen. He was subsequently diagnosed with panperitonitis and underwent an emergency reoperation to explore the abdomen. Although the patient was expected to be at a high risk of malnutrition due to short bowel syndrome resulting from multiple surgeries, through intensive care under close cooperation
Kim, Sun Jung; Kim, Bo Ram; Lee, Song Mi; Kong, Hee Jung; Shin, Cheung Soo
Short Bowel Syndrome (SBS) is a condition that causes malabsorption and nutrient deficiency because a large section of the small intestine is missing or has been surgically removed. SBS may develop congenitally or from gastroenterectomy, which often change the motility, digestive, and/or absorptive functions of the small bowel. The surgical procedure for SBS and the condition itself have high mortality rates and often lead to a range of complications associated with long-term parenteral nutri...
Ozlem Donat Eker
Full Text Available Irritable bowel syndrome is a disabling functional disorder with a frequent comorbidity of depression though underlying mechanisms remain yet little understood. Various signs and symptoms have been determined as diagnostic criteria in recent years and standardized as Rome-III criteria. Irritable bowel syndrome can have constipation-dominant, diarrhea-dominant or mixed clinical presentations. Main features can be summarized as continuous and recurrent abdominal pain or discomfort associated with a change of stool frequency or consistency and usually relief of symptoms with defe-cation in the absence of physical or laboratory abnormalities indicative of an organic etiology. The frequency of major depressive disorder diagnosis reaches up to two thirds of irritable bowel syndrome patients. Moreover, the comorbidity of irritable bowel syndrome among patients with major depression is highly frequent (30%. The mechanism underlying irritable bowel syndrome which have been considered as a kind of a somatization disorder for a long time and now as a functional bowel disease is in the brain-gut axis. Low grade mucosal inflammation and cytokines originating from mucosal inflammation have important functions in the pathophysiology of irritable bowel syndrome and its comorbidity with major depression. Besides the inflammatory factors lumbosacral visceral hyperexcitability which is an individual variation is proposed as the main underlying cause of irritable bowel syndrome. Visceral hyper-excitability is mediated by cytokines and neuro-mediators and stress is known to increase the effect of this mechanism. Furthermore, molecules participating in this mechanism (e.g. cytokines, corticotrophin releasing factor, neurokinins and monoamines play important roles in the pathophysiology of depression. Increased activation in the pain matrix (thalamus – insula – prefrontal cortex and insufficiency of endogenous pain inhibitory system are regarded as possible
Full Text Available Background: Irritable Bowel Syndrome is a prevalent syndrome which is identified by change intestine movements. In this research the effect of relaxation on life quality of IBS patients referring to Dehloran’s Shohada hospital, Iran, in 2015 has been investigated. Materials and Methods: This research is a semi-experimental pre-test – post-test, which was conducted on 24 people with IBS. After the test and the pre-test, relaxation curing was conducted for eight weeks, each week 60 minutes, using the protocol relaxation which was prepared already. One week after the tests, the post-test questionnaire was filled up (sf-36 to measure the effect of the probable cure. Analysis of the data was performed using SPSS Version 20. Results: Most of the academic degrees were BA, 42% and the least was Diploma 16%. The results of this study showed significant difference in life quality improvement in IBS patients in both control and witness groups (P<0.001. Also there was a significant relationship among. Relaxation public health, bodily health overall criteria, psychological health overall criteria and pain in IBS patients (P<0.001. Conclusion: The attained results showed that relaxation can be useful beside other psychological cures as a psychological curer in improving the life quality of IBS patients.
Generali, Joyce A; Cada, Dennis J
This Hospital Pharmacy feature is extracted from Off-Label Drug Facts, a publication available from Wolters Kluwer Health. Off-Label Drug Facts is a practitioner-oriented resource for information about specific drug uses that are unapproved by the US Food and Drug Administration. This new guide to the literature enables the health care professional or clinician to quickly identify published studies on off-label uses and determine if a specific use is rational in a patient care scenario. References direct the reader to the full literature for more comprehensive information before patient care decisions are made. Direct questions or comments regarding Off-Label Drug Uses to firstname.lastname@example.org. PMID:25673889
Generali, Joyce A; Cada, Dennis J.
This Hospital Pharmacy feature is extracted from Off-Label Drug Facts, a publication available from Wolters Kluwer Health. Off-Label Drug Facts is a practitioner-oriented resource for information about specific drug uses that are unapproved by the US Food and Drug Administration. This new guide to the literature enables the health care professional or clinician to quickly identify published studies on off-label uses and determine if a specific use is rational in a patient care scenario. Refer...
Jeppesen, P B; Gilroy, R; Pertkiewicz, M; Allard, J P; Messing, B.; O'Keefe, S. J.
Background and aims Teduglutide, a GLP-2 analogue, may restore intestinal structural and functional integrity by promoting repair and growth of the mucosa and reducing gastric emptying and secretion, thereby increasing fluid and nutrient absorption in patients with short bowel syndrome (SBS). This 24-week placebo-controlled study evaluated the ability of teduglutide to reduce parenteral support in patients with SBS with intestinal failure. Methods In 83 patients randomised to receive subcutan...
Full Text Available Irritable Bowel Syndrome (IBS and Inflammatory Bowel Disease (IBD can profoundly affect quality of life and are influenced by stress and resiliency. The impact of mind-body interventions (MBIs on IBS and IBD patients has not previously been examined.Nineteen IBS and 29 IBD patients were enrolled in a 9-week relaxation response based mind-body group intervention (RR-MBI, focusing on elicitation of the RR and cognitive skill building. Symptom questionnaires and inflammatory markers were assessed pre- and post-intervention, and at short-term follow-up. Peripheral blood transcriptome analysis was performed to identify genomic correlates of the RR-MBI.Pain Catastrophizing Scale scores improved significantly post-intervention for IBD and at short-term follow-up for IBS and IBD. Trait Anxiety scores, IBS Quality of Life, IBS Symptom Severity Index, and IBD Questionnaire scores improved significantly post-intervention and at short-term follow-up for IBS and IBD, respectively. RR-MBI altered expression of more genes in IBD (1059 genes than in IBS (119 genes. In IBD, reduced expression of RR-MBI response genes was most significantly linked to inflammatory response, cell growth, proliferation, and oxidative stress-related pathways. In IBS, cell cycle regulation and DNA damage related gene sets were significantly upregulated after RR-MBI. Interactive network analysis of RR-affected pathways identified TNF, AKT and NF-κB as top focus molecules in IBS, while in IBD kinases (e.g. MAPK, P38 MAPK, inflammation (e.g. VEGF-C, NF-κB and cell cycle and proliferation (e.g. UBC, APP related genes emerged as top focus molecules.In this uncontrolled pilot study, participation in an RR-MBI was associated with improvements in disease-specific measures, trait anxiety, and pain catastrophizing in IBS and IBD patients. Moreover, observed gene expression changes suggest that NF-κB is a target focus molecule in both IBS and IBD-and that its regulation may contribute to
Full Text Available The large intestine contains five types of endocrine cells that regulate its functions by sensing its luminal contents and releasing specific hormones. Chromogranin A (CgA is a common marker for the gastrointestinal endocrine cells, and it is abnormal in irritable bowel syndrome (IBS patients. Most IBS patients relate their symptoms to certain food elements. The present study investigated the effect of dietary guidance on the total endocrine cells of the large intestine as detected by CgA in 13 IBS patients. Thirteen control subjects were also included. Each patient received three sessions of dietary guidance. Colonoscopies were performed on controls and patients (at baseline and at 3–9 months after receiving guidance. Biopsy samples from the colon and rectum were immunostained for CgA and quantified by computerized image analysis. The densities of CgA cells in the total colon (mean ± SEM among the controls and the IBS patients before and after receiving dietary guidance were 83.3±10.1, 38.6±3.7, and 64.7±4.2 cells/mm2, respectively (P=0.0004, and were unchanged in the rectum. In conclusion, the increase in CgA cell density after receiving dietary guidance may reflect a change in the densities of the large intestinal endocrine cells causing an improvement in the IBS symptoms.
Chu, Hua; Fox, Mark; Zheng, Xia; Deng, Yanyong; Long, Yanqin; Huang, Zhihui; Du, Lijun; Xu, Fei; Dai, Ning
Small intestinal bacterial overgrowth (SIBO) has been implicated in the pathogenesis of irritable bowel syndrome (IBS). Psychosocial factors and low-grade colonic mucosal immune activation have been suggested to play important roles in the pathophysiology of IBS. In total, 94 patients with IBS and 13 healthy volunteers underwent a 10 g lactulose hydrogen breath test (HBT) with concurrent 99mTc scintigraphy. All participants also completed a face-to-face questionnaire survey, including the Hospital Anxiety and Depression Scale, Life Event Stress (LES), and general information. Serum tumour necrosis factor-α, interleukin- (IL-) 6, IL-8, and IL-10 levels were measured. The 89 enrolled patients with IBS and 13 healthy controls had no differences in baseline characteristics. The prevalence of SIBO in patients with IBS was higher than that in healthy controls (39% versus 8%, resp.; p = 0.026). Patients with IBS had higher anxiety, depression, and LES scores, but anxiety, depression, and LES scores were similar between the SIBO-positive and SIBO-negative groups. Psychological disorders were not associated with SIBO in patients with IBS. The serum IL-10 level was significantly lower in SIBO-positive than SIBO-negative patients with IBS. PMID:27379166
Full Text Available Caroline Canavan, Joe West, Timothy Card Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK Abstract: Irritable bowel syndrome (IBS is a functional condition of the bowel that is diagnosed using clinical criteria. This paper discusses the nature of the diagnostic process for IBS and how this impacts epidemiological measurements. Depending on the diagnostic criteria employed, IBS affects around 11% of the population globally. Around 30% of people who experience the symptoms of IBS will consult physicians for their IBS symptoms. These people do not have significantly different abdominal symptoms to those who do not consult, but they do have greater levels of anxiety and lower quality of life. Internationally, there is a female predominance in the prevalence of IBS. There is 25% less IBS diagnosed in those over 50 years and there is no association with socioeconomic status. IBS aggregates within families and the genetic and sociological factors potentially underlying this are reviewed. Patients diagnosed with IBS are highly likely to have other functional disease and have more surgery than the general population. There is no evidence that IBS is associated with an increased mortality risk. The epidemiological evidence surrounding these aspects of the natural history is discussed. Keywords: irritable bowel syndrome, epidemiology, prevalence, mortality, natural history
Angèle PM Kerckhoffs; Melvin Samsom; Michel E van der Rest; Joris de Vogel; Jan Knol; Kaouther Ben-Amor; Louis MA Akkermans
AIM: To determine the composition of both fecal and duodenal mucosa-associated microbiota in irritable bowel syndrome (IBS) patients and healthy subjects using molecular-based techniques. METHODS: Fecal and duodenal mucosa brush samples were obtained from 41 IBS patients and 26 healthy subjects. Fecal samples were analyzed for the composition of the total microbiota using fluorescent in situ hybridization (FISH) and both fecal and duodenal brush samples were analyzed for the composition of bifidobacteria using real-time polymerase chain reaction. RESULTS: The FISH analysis of fecal samples revealed a 2-fold decrease in the level of bifidobacteria (4.2 ± 1.3 vs 8.3 ± 1.9, P < 0.01) in IBS patients compared to healthy subjects, whereas no major differences in other bacterial groups were observed. At the species level, Bifidobacterium catenulatum levels were significantly lower (6 ± 0.6 vs 19 ± 2.5, P < 0.001) in the IBS patients in both fecal and duodenal brush samples than in healthy subjects. CONCLUSION: Decreased bifidobacteria levels in both fecal and duodenal brush samples of IBS patients compared to healthy subjects indicate a role for microbiotic composition in IBS pathophysiology.
Hausteiner-Wiehle, Constanze; Henningsen, Peter
This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is l...
Raithel, Martin; Rau, Tilman T; Hagel, Alexander F; Albrecht, Heinz; de Rossi, Thomas; Kirchner, Thomas; Hahn, Eckhart G
This is the first report describing a case where prolonged, severe malabsorption from brown bowel syndrome progressed to multifocally spread small bowel adenocarcinoma. This case involves a female patient who was initially diagnosed with chronic jejunitis associated with primary diffuse lymphangiectasia at the age of 26 years. The course of the disease was clinically, endoscopically, and histologically followed for 21 years until her death at the age 47 due to multifocal, metastasizing adenocarcinoma of the small bowel. Multiple lipofuscin deposits (so-called brown bowel syndrome) and severe jejunitis were observed microscopically, and sections of the small bowel showed dense lymphoplasmacytic infiltration of the lamina propria as well as blocked lymphatic vessels. After several decades, multifocal nests of adenocarcinoma cells and extensive, flat, neoplastic mucosal proliferations were found only in the small bowel, along with a loss of the mismatch repair protein MLH1 as a long-term consequence of chronic jejunitis with malabsorption. No evidence was found for hereditary nonpolyposis colon carcinoma syndrome. This article demonstrates for the first time multifocal carcinogenesis in the small bowel in a malabsorption syndrome in an enteritis-dysplasia-carcinoma sequence. PMID:26420973
Middleton, S J; Coley, A.; Hunter, J O
Candida albicans was sought in stool samples from 38 patients with irritable bowel syndrome and 20 healthy controls. In only three patients with irritable bowel syndrome was C. albicans discovered and these patients had either recently received antibiotics or the stool sample had been delayed more than 24 hours in transit. C. albicans was isolated from none of the control stool samples. We conclude that C. albicans is not involved in the aetiology of the irritable bowel syndrome.
Seidner, Douglas L; Joly, Francisca; Youssef, Nader N
Objectives: In clinical trials, treatment with the glucagon-like peptide 2 analog teduglutide was associated with improved fluid and nutrient absorption and increased intestinal villus height and crypt depth in patients with short bowel syndrome (SBS). Plasma citrulline, an amino acid produced by enterocytes, is considered a measure of enterocyte mass. This analysis assessed changes in plasma citrulline levels in patients with SBS in 2 phase III clinical studies of teduglutide. Methods: Both ...
Nagieva S.; Svintsitskyy A.; Kuryk O.; Korendovych I.
Objective. To assess histological changes of colonic mucosa in patients with clinically different types of irritable bowel syndrome (IBS) before and after the treatment with tetracyclic antidepressant and selective serotonin reuptake inhibitor. Methods. Adult patients (over 18 years) with confirmed diagnosis of IBS were examined. Biopsy specimens were taken from colon during colonoscopy for the next histological examination. One expert gastrointestinal pathologist assessed all tissue samples....
Michalsen, Vilde Lehne; Vandvik, Per Olav; Farup, Per Grønaas
Background: Reduced quality of life (QoL) is often the main problem for patients with irritable bowel syndrome (IBS). This study aimed at finding predictors of reduced physical and mental quality of life (QoL) accessible for intervention. Methods: Consecutive patients with IBS (according to the Rome II criteria) visiting a general practitioner were included in a prospective cohort study and followed up for 6−9 months. At the last visit, information about sociodemographic charac...
Céline Nourrisson; Julien Scanzi; Bruno Pereira; Christina NkoudMongo; Ivan Wawrzyniak; Amandine Cian; Eric Viscogliosi; Valérie Livrelli; Frédéric Delbac; Michel Dapoigny; Philippe Poirier
Blastocystis is a protistan parasite living in the digestive tract of many animals, including humans. This highly prevalent intestinal parasite is suspected to be linked to Irritable Bowel Syndrome (IBS), a chronic functional bowel disorder. Here, we first compared the prevalence of Blastocystis among 56 IBS patients (40 IBS with constipation (IBS-C), 9 IBS with diarrhea (IBS-D), 4 mixed IBS (IBS-M) and 3 unsubtyped IBS (IBS-U) according to the Rome III criteria) and 56 control (i.e. without ...
NAKAI, Akio; Kumakura, Yoshikata; Boivin, Michel; Rosa, Pedro; Diksic, Mirko; D’Souza, Doreen; Kersey, Kathryn
BACKGROUND: Irritable bowel syndrome (IBS) is the most common functional bowel disorder and has a strong predominance in women. Recent data suggest that the brain may play an important role in the pathophysiology of IBS in the brain-gut axis. It is strongly suspected that serotonin (5-HT), a neurotransmitter found in the brain and gut, may be related to the pathophysiology of IBS. It is reported that a 5-HT3 antagonist is effective only in female patients with diarrhea-predominant IBS.OBJECTI...
Full Text Available Background & Objective: The purpose of this study was the comparison of anxiety sensitivity and happiness between patients with Irritable Bowel Syndrome (IBS and normal matched group. Materials & Methods: The Subjects were 35 (21 females and 14 male IBS patients diagnosed by gastroenterologist and 35 (25 female and 10 males normal matched group all in 14– 63 old age. Anxiety Sensitivity Index (ASI-R, Oxford Happiness Questionnaire (OHQ, and a checklist applied as measures of anxiety sensitivity, happiness and demographic information. Results: Data analysis indicates that IBS patients significantly are higher than matched group in fear of publicly observable symptoms (P= 0.032, fear of cardiovascular symptoms (P= 0.01, fear of gastrointestinal symptoms (P= 0.001, fear of dissociative and neurological symptoms (P= 0.018, & general anxiety sensitivity (P= 0.003, and lower in joy (P= 0.005, control (P= 0.008, self- esteem (P= 0.001 calm (P= 0.006 and general happiness (P= 0.001. Although no significant differences were found in life satisfaction (P= 0.083 & efficacy (P= 0.09, fear of respiratory symptoms (P= 0.067, and fear of cognitive control deficiency (p= 0.097. Conclusion: As a psychological variable anxiety sensitivity can predict treatment seeking of IBS patient, and happiness negatively influenced by both anxiety sensitivity and IBS.
Lee, Hyuk; Park, Dong Il; Kim, Hong Joo; Cho, Yong Kyun; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik; Chae, Seoung Wan
Background/Aims Although mucosal mast cell tryptase is known to significantly increase intestinal permeability, the relationship between mucosal mast cells and intestinal permeability remains unclear. The objective of this study was to evaluate the correlation among intestinal permeability, tryptase activity and mucosal mast cell count. Methods Rectal biopsies from 16 patients with diarrhea-predominant irritable bowel syndrome (IBS-D) and 7 normal subjects were assessed for tryptase activity and macromolecular permeability using horseradish peroxidase in Ussing chambers. In addition, mucosal mast cell levels were immunohistochemically quantified via image analysis. Results Rectal biopsy of tissues from IBS-D patients showed significantly increased permeability compared with those from normal controls (0.644 ± 0.08 and 0.06 ± 0.00 ng/2 hr/mm2, P 0.05). However, correlation analysis revealed that only mucosal mast cell count was significantly correlated with intestinal permeability in IBS-D patients (r = 0.558, P < 0.05). Conclusions This study demonstrated a positive correlation between the number of mucosal mast cells and intestinal permeability, suggesting that mucosal mast cells play an important role for increased intestinal permeability in patients with IBS-D. PMID:23667756
Shinozaki, Masae; Kanazawa, Motoyori; Kano, Michiko; Endo, Yuka; Nakaya, Naoki; Hongo, Michio; Fukudo, Shin
Autogenic training (AT) is a useful and comprehensive relaxation technique. However, no studies have investigated the effects of AT on irritable bowel syndrome (IBS). In this study we tested the hypothesis that AT improves symptoms of IBS. Twenty-one patients with IBS were randomly assigned to AT (n = 11, 5 male, 6 female) or control therapy (n = 10, 5 male, 5 female). AT patients were trained intensively, while the control therapy consisted of discussions about patients' meal habits and life styles. All patients answered a question related to adequate relief (AR) of IBS symptoms and four questionnaires: Self-induced IBS Questionnaire (SIBSQ), Self-reported Depression Scale (SDS), State-Trait Anxiety Inventory (STAI), and Medical Outcome Short Form 36 Health Survey (SF-36). The proportion of AR in the last AT session in the AT group (9/11, 81.8%) was significantly higher than that in the controls (3/10, 30.0%, Chi-square test, p = 0.048). Two subscales of the SF-36, i.e., social functioning and bodily pain, were significantly improved in the AT group (p < 0.05) as compared to the control group. Role emotional (p = 0.051) and general health (p = 0.068) showed a tendency for improvement in the AT group. AT may be useful in the treatment of IBS by enhancing self-control. PMID:19997775
Hutchings, H. A.; Wareham, K; Baxter, J. N.; Atherton, P.; J. G. C. Kingham; Duane, P; Thomas, L.; Thomas, M.; C. L. Ch'ng; Williams, J G
Background. Irritable bowel syndrome (IBS) is a chronic, difficult to treat condition. The efficacy of Aloe vera in treating IBS symptoms is not yet proven. The purpose of this study was to determine if Aloe vera is effective in improving quality of life. Methods. A multicentre, randomised, double-blind, cross-over placebo controlled study design. Patients were randomised to Aloe vera, wash-out, placebo or placebo, washout, Aloe vera. Each preparation (60 mL) was taken orally twice a day. Pat...
Henström, Maria; D'Amato, Mauro
Irritable bowel syndrome (IBS) is a common condition with a complex and largely unknown etiology. There is no cure, and treatment options are mainly directed to the amelioration of symptoms. IBS causes reduced quality of life and poses considerable repercussions on health and socioeconomic systems. There is a heritable component in IBS, and genetic research is a valuable tool for the identification of causative pathways, which will provide important insight into the pathophysiology. However, although some gene-hunting efforts have been conducted and a few risk genes proposed, IBS genetic research is lagging behind compared to other complex diseases. In this mini-review, we briefly summarize existing genetic studies, discuss the main challenges in IBS genetic research, and propose strategies to overcome these challenges for IBS gene discovery. PMID:26873717
Craig, Orla F
EVALUATION OF: Villani AC, Lemire M, Thabane M et al. Genetic risk factors for post-infectious irritable bowel syndrome following a waterborne outbreak of gastroenteritis. Gastroenterology 138, 1502-1513 (2010). While the pathogenesis of irritable bowel syndrome (IBS) remains to be fully defined, two clinical observations - the occurrence, de novo, of IBS following bacterial gastroenteritis and the history, commonly obtained from IBS patients, of other instances of the syndrome within their families - have instigated investigations, in IBS, of the potential roles, on the one hand, of the gut microbiota and the host response and, on the other hand, of genetic factors. The study reviewed here relates to both of these factors by studying genetic predisposition to postinfective IBS in a large population of individuals who were exposed to a multimicrobial enteric infection, which resulted in a severe outbreak of gastroenteritis and was followed by the development of IBS in over a third. In this detailed study, the investigators identified a number of genes that were linked significantly to the development of postinfectious-IBS in the Toll-like receptor 9, IL-6 and cadherin 1 regions. These genes play important roles in bacterial recognition, the inflammatory response and epithelial integrity, respectively, and provide considerable support for the hypothesis that links IBS onset to disturbances in the microbiota and the host response.
Quigley, E M M
Irritable bowel syndrome affects approximately 10-15% of the European population, although prevalence rates vary depending on the classification used and the country surveyed. This may be due to differences in patterns of medical care and diagnosis of the condition. Up to 70% of individuals with irritable bowel syndrome may not have been formally diagnosed. The disorder affects 1.5-3 times as many women as men and poses a significant economic burden in Europe, estimated at euro 700-euro 1600 per person per year. It also reduces quality of life and is associated with psychological distress, disturbed work and sleep, and sexual dysfunction. It is a chronic disorder, which affects many individuals for more than 10 years. Most patients are managed in primary care, although some are referred to gastroenterologists and other specialists. Patients with irritable bowel syndrome undergo more abdomino-pelvic surgery than the general population. We propose that a positive diagnosis of the condition may avoid the delay in diagnosis many patients experience. We conclude that, in Europe, there are significant unmet needs including lack of familiarity with irritable bowel syndrome, difficulties in diagnosis and lack of effective treatments for the multiple symptoms of the disorder. The development of pan-European guidelines for irritable bowel syndrome will benefit patients with this condition in Europe.
Jeppesen, Palle B
Recently, the US Food and Drug Administration and the European Medicines Agency approved the glucagon-like peptide 2 analogue, teduglutide, for the treatment of short bowel syndrome (SBS), and this review describes the physiological basis for its clinical use.......Recently, the US Food and Drug Administration and the European Medicines Agency approved the glucagon-like peptide 2 analogue, teduglutide, for the treatment of short bowel syndrome (SBS), and this review describes the physiological basis for its clinical use....
Kang, Sun Hyung; Choi, Seong-Woo; Lee, Seung Jun; Chung, Woo Suk; Lee, Hye Ran; Chung, Ki-Young; Lee, Eaum Seok; Moon, Hee Seok; Kim, Seok Hyun; Sung, Jae Kyu; Lee, Byung Seok; Jeong, Hyun Yong
Background/Aims Although notably common, irritable bowel syndrome (IBS) has no specific cure. Lifestyle modification may be as important as medication; however, few studies support the effectiveness of such modifications. We performed this observational study of IBS patients to explore further the role of lifestyle changes in treatment. Methods This study included 831 men who enlisted in 2010 as armed surgeon cadets and 85 women who concurrently entered the Armed Forces Nursing Academy. Of th...
Undseth R; Jakobsdottir G; Nyman M; Berstad A; Valeur J
Ragnhild Undseth,1 Greta Jakobsdottir,2 Margareta Nyman,2 Arnold Berstad,3 Jørgen Valeur3 1Department of Radiology, Lovisenberg Diaconal Hospital, Oslo, Norway; 2Food for Health Science Centre, Lund University, Lund, Sweden; 3Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway Background: Ingestion of low-digestible carbohydrates triggers symptoms in patients with irritable bowel syndrome (IBS). These carbohydrates become substrates for microbial fermentation in ...
Dobbin, A; Dobbin, J; Ross, S C; Graham, C; Ford, M J
Irritable bowel syndrome (IBS) is a common disorder associated with profoundly impaired quality of life and emotional distress. The management of refractory IBS symptoms remains challenging and non-pharmacological therapeutic approaches have been shown to be effective. We compared brief interventions with biofeedback and hypnotherapy in women referred by their GP with refractory IBS symptoms. Patients were randomised to one of two treatment groups, biofeedback or hypnotherapy, delivered as three one-hour sessions over 12 weeks. Symptom assessments were undertaken using validated, self-administered questionnaires. Two of the 128 consecutive IBS patients suitable for the study declined to consider nonpharmacological therapy and 29 patients did not attend beyond the first session. Of the 97 patients randomised into the study, 21 failed to attend the therapy session; 15 of 76 patients who attended for therapy dropped out before week 12 post-therapy. The mean (SD) change in IBS symptom severity score 12 weeks post-treatment in the biofeedback group was -116.8 (99.3) and in the hypnotherapy group -58.0 (101.1), a statistically significant difference between groups (difference=-58.8, 95% confidence interval [CI] for difference [-111.6, -6.1], p=0.029). In 61 patients with refractory IBS, biofeedback and hypnotherapy were equally effective at improving IBS symptom severity scores, total non-gastrointestinal symptom scores and anxiety and depression ratings during 24 weeks follow-up. Biofeedback may prove to be the more cost-effective option as it requires less expertise. PMID:23516685
Limketkai, Berkeley N; Parian, Alyssa M; Shah, Neha D; Colombel, Jean-Frédéric
Crohn's disease is a chronic and progressive inflammatory disorder of the gastrointestinal tract. Despite the availability of powerful immunosuppressants, many patients with Crohn's disease still require one or more intestinal resections throughout the course of their disease. Multiple resections and a progressive reduction in bowel length can lead to the development of short bowel syndrome, a form of intestinal failure that compromises fluid, electrolyte, and nutrient absorption. The pathophysiology of short bowel syndrome involves a reduction in intestinal surface area, alteration in the enteric hormonal feedback, dysmotility, and related comorbidities. Most patients will initially require parenteral nutrition as a primary or supplemental source of nutrition, although several patients may eventually wean off nutrition support depending on the residual gut anatomy and adherence to medical and nutritional interventions. Available surgical treatments focus on reducing motility, lengthening the native small bowel, or small bowel transplantation. Care of these complex patients with short bowel syndrome requires a multidisciplinary approach of physicians, dietitians, and nurses to provide optimal intestinal rehabilitation, nutritional support, and improvement in quality of life. PMID:26818425
Javed Yakoob; Zaigham Abbas; Rustam Khan; Saeed Hamid; Safia Awan; Wasim Jafri
Background /Aim: The symptoms of irritable bowel syndrome resemble those of small intestinal bacterial overgrowth (SIBO). The aim of this study was to determine the frequency of SIBO and lactose intolerance (LI) occurrence in patients with diarrhea-predominant irritable bowel syndrome (IBS-D) according to Rome III criteria. Patients and Methods: In this retrospective case-control study, patients over 18 years of age with altered bowel habit, bloating, and patients who had lactose Hydrogen bre...
Bennett, William E
Probiotics have seen widespread use for a variety of gastrointestinal problems, especially in two common disorders: irritable bowel syndrome and inflammatory bowel disease. Since a wide variety of probiotic preparations has been used, and despite a large number of studies performed, a great deal of heterogeneity exists among them. Straightforward evidence-based recommendations for the use of probiotics in irritable bowel syndrome and inflammatory bowel disease have thus been difficult to formulate. In an effort to improve understanding of the risk-benefit balance of probiotics in these conditions, this study (1) queried the US FDA Adverse Event Reporting System (FAERS) database for all reported adverse drug events related to probiotics in 2013, and (2) constructed risk-benefit planes for both irritable bowel syndrome and inflammatory bowel disease using a geometric approximation of the confidence region between risk and benefit. The results show that adverse events from probiotics vary widely by disease, and when they occur, they are mild and may be difficult to distinguish from the natural history of the underlying disorders they are used to treat. The risk-benefit plane for irritable bowel syndrome straddles the risk-benefit threshold, so patients can expect a balance between a low chance of risk and also a low chance of benefit. The risk-benefit plane for inflammatory bowel disease largely lies above the risk-benefit threshold, so patients may expect more benefit than risk in most cases. More standardized and high-quality research is needed to improve our understanding of risk and benefit for these complex biopharmaceuticals. PMID:26467550
Shahabi, Leila; Naliboff, Bruce D; Shapiro, David
With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p maintenance of a self-regulated walking program may be more feasible and therefore more effective long term. PMID:26086986
Cashman, Michael D; Martin, Daniel K; Dhillon, Sonu; Puli, Srinivas R
Symptoms of irritable bowel syndrome (IBS) are common in population studies including chronic abdominal pain associated with altered bowel habits. Patients often have associated gastrointestinal and somatic symptoms suggesting a possible common contributing mechanism, but the heterogeneous symptom patterns of individual patients make generalizations difficult. The pathophysiology of IBS is incompletely understood but includes disturbances of the brain-gut axis. Central mechanisms are: the psychosocial history and environment, dysfunctional brain processing of peripheral signals attributed to the intestine including the enteric nervous system, the microbiome and the innate and adaptive immune system. As a result there is visceral hypersensitivity and disturbed intestinal secretory and motor activity. Some mechanisms of visceral pain hypersensitivity may overlap with other pain syndromes including fibromyalgia (FMS). Central Sensitization (CS) would offer a way to conceptualize an integration of life experience and psychologic response into a biopsychosocial framework of pathophysiology, diagnosis and treatment of IBS. Corticotropin-releasing factor, a principle regulator in the stress and pain response may contribute to a neuroendocrine mechanism for the brain-gut interaction. The positive diagnostic approach to IBS symptoms to avoid excess testing and enhance the patient-provider therapeutic relationship requires the recognition of the "cluster" of IBS symptoms while identifying "alarm" symptoms requiring specific attention. The severity of the symptoms and other individual psychosocial factors characterize patients who seek medical care. The presence of significant psychosocial comorbidities adds to the complexity of management which often requires a multidisciplinary approach. Several treatment options exist but no single method is effective for all the symptoms of IBS. The therapeutic benefit of the well-executed physician-patient relationship is considered
Ibarra, Catalina; Herrera, Valentina; Pérez de Arce, Edith; Gil, Luis Carlos; Madrid, Ana María; Valenzuela, Lucía; Beltrán, Caroll J
Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterised by multi-factorial aetiology. In IBS physiopathology are involved diverse factors between them biological, psychosocial, and environmental components which affect the immune activation status of gut mucosa. Among these factors is recognized the intestinal parasitosis. Post-infection IBS (PI-IBS) is recognised as a subgroup of functional disorders whose symptoms onset appear after a symptomatic intestinal infection caused by microbial agents. There are few studies regarding of relationship between IBS and intestinal parasitosis in Chile. However, is has been well described a positive association between IBS and Blastocystis hominis infections, one of prevalent parasites in Chile. In other countries, is also described a relationship between IBS and amebiasis and giardiasis. Both, characterized by a common mode of transmission through water as well as contaminated food. Because the high prevalence of parasitosis in our country it is necessary to expand the association studies to clarify the strength of the parasites ethiology in IBS. PMID:27598274
Nutritional factors relative to IBS include diagnostic and therapeutic considerations. Etiologically, foods do not cause IBS. A small percentage of patients with childhood allergic diatheses, usually in association with atopic dermatitis and asthma, may be intolerant to one or more of wheat, corn, dairy products, coffee, tea, or citrus fruits. Diagnostically, many patients labeled as IBS subjects are in fact intolerant to the ingestion of lactose-containing foods, sorbitol, fructose, or combinations of fructose and sorbitol. A precise dietary history will characterize this group. Taken in its broadest context, IBS involves the entire hollow tract inclusive of esophagus, stomach, small bowel, and colon. The symptomatic presentation relative to the hollow organ involved allows the selection of dietary manipulations that may help to reduce symptoms. Gastroesophageal reflux, a consequence of low LES pressure in some IBS patients, may be treated with the elimination of fatty foods, alcohol, chocolate, and peppermint. Delayed gastric emptying may be helped by the elimination of fatty foods and reduction of soluble fiber. Aberrant small bowel motor function may be ameliorated by reduction of lactose, sorbitol, and fructose and the addition of soluble fiber. Gas syndromes may be improved by reduced intake of beans, cabbage, lentils, legumes, apples, grapes, and raisins. Colonic motor dysfunction may be overcome by the gradual addition of combinations of soluble and insoluble fiber-containing foods and supplements. The selective use of activated charcoal and simethicone may be helpful. PMID:2553606
Thompson, John Richard
Irritable bowel syndrome (IBS) is the most common of all gastroenterological diseases. While many mechanisms have been postulated to explain its etiology, no single mechanism entirely explains the heterogeneity of symptoms seen with the various phenotypes of the disease. Recent data from both basic and clinical sciences suggest that underlying infectious disease may provide a unifying hypothesis that better explains the overall symptomatology. The presence of small intestinal bowel overgrowth (SIBO) has been documented in patients with IBS and reductions in SIBO as determined by breath testing correlate with IBS symptom improvement in clinical trials. The incidence of new onset IBS symptoms following acute infectious gastroenteritis also suggests an infectious cause. Alterations in microbiota-host interactions may compromise epithelial barrier integrity, immune function, and the development and function of both central and enteric nervous systems explaining alterations in the brain-gut axis. Clinical evidence from treatment trials with both probiotics and antibiotics also support this etiology. Probiotics appear to restore the imbalance in the microflora and improve IBS-specific quality of life. Antibiotic trials with both neomycin and rifaximin show improvement in global IBS symptoms that correlates with breath test normalization in diarrhea-predominant patients. The treatment response to two weeks of rifaximin is sustained for up to ten weeks and comparable results are seen in symptom reduction with retreatment in patients who develop recurrent symptoms. PMID:26819502
Marroon Thabane; John K Marshall
Post-infectious irritable bowel syndrome (PI-IBS) is a common disorder wherein symptoms of IBS begin after an episode of acute gastroenteritis. Published studies have reported incidence of PI-IBS to range between 5% and 32%. The mechanisms underlying the development of PI-IBS are not fully understood, but are believed to include persistent sub-clinical inflammation, changes in intestinal permeability and alteration of gut flora. Individual studies have suggested that risk factors for PI-IBS include patients' demographics, psychological disorders and the severity of enteric illness. However, PI-IBS remains a diagnosis of exclusion with no specific disease markers and, to date, no definitive therapy exists. The prognosis of PIIBS appears favorable with spontaneous and gradual resolution of symptoms in most patients.
Full Text Available Our objective was to understand the functional link between the composition of faecal microbiota and the clinical characteristics of adults with short bowel syndrome (SBS. Sixteen patients suffering from type II SBS were included in the study. They displayed a total oral intake of 2661±1005 Kcal/day with superior sugar absorption (83±12% than protein (42±13% or fat (39±26%. These patients displayed a marked dysbiosis in faecal microbiota, with a predominance of Lactobacillus/Leuconostoc group, while Clostridium and Bacteroides were under-represented. Each patient exhibited a diverse lactic acid bacteria composition (L. delbrueckii subsp. bulgaricus, L. crispatus, L. gasseri, L. johnsonii, L. reuteri, L. mucosae, displaying specific D and L-lactate production profiles in vitro. Of 16 patients, 9/16 (56% accumulated lactates in their faecal samples, from 2 to 110 mM of D-lactate and from 2 to 80 mM of L-lactate. The presence of lactates in faeces (56% patients was used to define the Lactate-accumulator group (LA, while absence of faecal lactates (44% patients defines the Non lactate-accumulator group (NLA. The LA group had a lower plasma HCO3(- concentration (17.1±2.8 mM than the NLA group (22.8±4.6 mM, indicating that LA and NLA groups are clinically relevant sub-types. Two patients, belonging to the LA group and who particularly accumulated faecal D-lactate, were at risk of D-encephalopathic reactions. Furthermore, all patients of the NLA group and those accumulating preferentially L isoform in the LA group had never developed D-acidosis. The D/L faecal lactate ratio seems to be the most relevant index for a higher D-encephalopathy risk, rather than D- and L-lactate faecal concentrations per se. Testing criteria that take into account HCO3(- value, total faecal lactate and the faecal D/L lactate ratio may become useful tools for identifying SBS patients at risk for D-encephalopathy.
Dajčman, Davorin; Potočnik Dajčman, Nataša
Irritable bowl syndrome is one of the most common medical condition diagnosed today. It is a chronic functional gastrointestinal disorder tha affects all aspects of the patient's daily life. It was recognized nearly two centuries ago, but it still remains widely misunderstood by both patients and physicians. Irritable bowel syndrome has been given a number of different names over the years, including nervous colitis, spastic colitis, mucous colitis, unstable colon and irritable colon. Today i...
Zamot, Alberto L; Torres, Esther A; González, Henry; Marcial, Manuel A
Recent medical literature agrees that celiac disease (CD) is much more prevalent in western civilization than it was thought to be in the past. Given the potential complications and consequences of untreated CD, screening programs have been considered. Symptoms of celiac disease may resemble those of Irritable Bowel Syndrome. A group of patients with IBS was screened for CE using the Tissue Transglutaminase Antibody IgA serum test. A total of 18 patients were screened. All of our patients tested negative for TTG IgA. This finding may indicate that the prevalence of CD may be low in our population. Further population studies are needed to confirm our finding. PMID:25856876
Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R
The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients ...
Mazzawi, Tarek; El-Salhy, Magdy
Chromogranin A (CgA) is a common marker for enteroendocrine cells in the gut, and CgA-immunoreactive cell densities are abnormal in patients with irritable bowel syndrome (IBS). The majority of patients with IBS report that their symptoms develop after consuming certain foodstuffs. In the present study, we investigated the effects of dietary guidance on the total enteroendocrine cell densities in the small intestine, as detected by CgA. A total of 14 patients with IBS underwent a gastroscopy with duodenal biopsies and 11 of them also underwent a colonoscopy, with biopsy samples obtained from the ileum. Fourteen control subjects were also included. Each patient received 3 sessions of dietary guidance. Gastroscopies and colonoscopies were performed on both the controls and patients with IBS (at baseline and at 3-9 months after receiving guidance). Biopsy samples obtained from the duodenum and ileum were immunostained for CgA using the avidin-biotin complex (ABC) method and were quantified using computerized image analysis. The density of CgA-immunoreactive cells in the duodenum (mean ± SEM values) in the control subjects was 235.9 ± 31.9 cells/mm2; in the patients with IBS, the density was 36.9 ± 9.8 and 103.7 ± 16.9 cells/mm2 before and after they received dietary guidance, respectively (P=0.007). The density of CgA-immunoreactive cells in the ileum in the control subjects was 47.4 ± 8.3 cells/mm2; in the patients with IBS, the density was 48.4 ± 8.1 and 17.9 ± 4.4 cells/mm2, before and after they received dietary guidance, respectively (P=0.0006). These data indicate that changes in CgA-immunoreactive cell densities in patients with IBS after receiving dietary guidance may reflect a change in the densities of the small intestinal enteroendocrine cells, which may contribute to an improvement in the IBS symptoms. PMID:26987104
Full Text Available Background: Irritable bowel syndrome (IBS is a functional gastrointestinal disorder with chronic abdominal pain, bowel habit variations, and lack of structural causes. Symptom intensity has a statistical relation with patients' quality of life (QOL and mental health. The first objective of the present study was to develop and provide a therapeutic plan based on cognitive behavioral therapy (CBT for IBS that was operated for the very first time in Iran. The second objective was to determine the effectiveness of these treatments on IBS symptoms intensity, health-related QOL, and psychological health among patients with IBS. Methods: The participants were 15 women with IBS. The participants were diagnosed on the basis of ROME-III diagnosis criteria. The data collection tools consisted of IBS Symptom Severity Scale (IBS-SSS, the Irritable Bowel Syndrome Quality of Life (IBS-QOL questionnaire, and the Symptom Checklist-90-Revised (SCL-90-R used to evaluate mental health. Data were collected during the weeks of 0, 4, 12, and 24, during the treatment process. The extracted data was examined statistically via repeated measures MANOVA in SPSS software. Results: CBT has a significant effect on IBS symptoms reduction, QOL improvement, and mental health promotion of the patients. The effect of the therapeutic plan persisted until the follow-up stage. Conclusion: According to the results, applied CBT can be specifically implemented as an effective treatment for IBS. Therefore, the use of this treatment is advised.
Makker, Jasbir; Chilimuri, Sridhar; Bella, Jonathan N
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder characterized by presence of abdominal pain or discomfort associated with altered bowel habits. It has three main subtypes - constipation predominant IBS (C-IBS), diarrhea predominant IBS (D-IBS) and IBS with mixed features of both diarrhea as well as constipation (M-IBS). Its pathophysiology and underlying mechanisms remain elusive. It is traditionally believed that IBS is a result of multiple factors incl...
Koo, Hoonmo L.; Saman Sabounchi; Huang, David B.; Herbert L. DuPont
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain and altered bowel habits in the absence of specific organic pathology. Although the underlying pathogenesis of IBS is not well-understood, small intestinal bacterial overgrowth (SIBO) or other abnormalities in the gut flora is believed to contribute to the development of a subset of IBS cases. Rifaximin is a poorly absorbed antimicrobial with activity against enteric pathogens. A number of stu...
Seidner, Douglas L; Schwartz, Lauren K; Winkler, Marion F; Jeejeebhoy, Khursheed; Boullata, Joseph I; Tappenden, Kelly A
Short bowel syndrome-associated intestinal failure (SBS-IF) as a consequence of extensive surgical resection of the gastrointestinal (GI) tract results in a chronic reduction in intestinal absorption. The ensuing malabsorption of a conventional diet with associated diarrhea and weight loss results in a dependency on parenteral nutrition and/or intravenous fluids (PN/IV). A natural compensatory process of intestinal adaptation occurs in the years after bowel resection as the body responds to a lack of sufficient functional nutrient-processing intestinal surface area. The adaptive process improves bowel function but is a highly variable process, yielding different levels of symptom control and PN/IV independence among patients. Intestinal rehabilitation is the strategy of maximizing the absorptive capacity of the remnant GI tract. The approaches for achieving this goal have been limited to dietary intervention, antidiarrheal and antisecretory medications, and surgical bowel reconstruction. A targeted pharmacotherapy has now been developed that improves intestinal absorption. Teduglutide is a human recombinant analogue of glucagon-like peptide 2 that promotes the expansion of the intestinal surface area and increases the intestinal absorptive capacity. Enhanced absorption has been shown in clinical trials by a reduction in PN/IV requirements in patients with SBS-IF. This article details the clinical considerations and best-practice recommendations for intestinal rehabilitation, including optimization of fluids, electrolytes, and nutrients; the integration of teduglutide therapy; and approaches to PN/IV weaning. PMID:23343999
Full Text Available Irritable bowel syndrome (IBS is a group of symptoms manifesting as a functional gastrointestinal (GI disorder in which patients experience abdominal pain, discomfort, and bloating that is often relieved with defecation. IBS is often associated with a host of secondary comorbidities such as anxiety, depression, headaches, and fatigue. In this review, we examined the basic principles of Pancha Kosha (five sheaths of human existence concept from an Indian scripture Taittiriya Upanishad and the pathophysiology of a disease from the Yoga approach, Yoga Vasistha’s Adhi (originated from mind and Vyadhi (ailment/disease concept. An analogy between the age old, the most profound concept of Adhi-Vyadhi, and modern scientific stress-induced dysregulation of brain-gut axis, as it relates to IBS that could pave way for impacting IBS, is emphasized. Based on these perspectives, a plausible Yoga module as a remedial therapy is provided to better manage the primary and secondary symptoms of IBS.
Gibson, Peter R; Varney, Jane; Malakar, Sreepurna; Muir, Jane G
Ingestion of food has long been linked with gut symptoms, and there is increasing interest in using diet in the management of patients with irritable bowel syndrome (IBS). The West has developed an intense interest in specialized, restrictive diets, such as those that target multiple food groups, avoid gluten, or reduce fermentable oligo-, di-, and mono-saccharides and polyols. However, most gastroenterologists are not well educated about diets or their effects on the gut. It is important to understand the various dietary approaches, their putative mechanisms, the evidence that supports their use, and the benefits or harm they might produce. The concepts behind, and delivery of, specialized diets differ from those of pharmacologic agents. High-quality research is needed to determine the efficacy of different dietary approaches and the place of specific strategies. PMID:25680668
Soldi, Sara; Vasileiadis, Sotirios; Uggeri, Francesca; Campanale, Mariachiara; Morelli, Lorenzo; Fogli, Maria Vittoria; Calanni, Fiorella; Grimaldi, Maria; Gasbarrini, Antonio
Rifaximin, with its low systemic absorption, may represent a treatment of choice for irritable bowel syndrome (IBS), mainly due to its ability to act on IBS pathogenesis, through the influence on gut microbiota. The aim of the present study was to assess, by biomolecular tools, the rifaximin active modulation exerted on gut microbiota of non-constipated IBS patients. Fifteen non-constipated IBS subjects were treated with 550 mg rifaximin three times a day for 14 days. Stool samples were collected before starting the treatment, at the end of it, and after a 6-week washout period. Real-time polymerase chain reaction, denaturing gradient gel electrophoresis, and next-generation sequencing were applied to all the samples to verify and quantify possible microbial fluctuations. Rifaximin treatment did not affect the overall composition of the microbiota of the treated subjects, inducing fluctuations in few bacterial groups, balanced by the replacement of homologs or complementary bacterial groups. Rifaximin appeared to influence mainly potentially detrimental bacteria, such as Clostridium, but increasing the presence of some species, such as Faecalibacterium prausnitzii. A decrease in the Firmicutes/Bacteroidetes ratio after 14 days of treatment and bacterial profiles with higher biodiversity were observed during the follow-up compared to baseline. Rifaximin treatment, although effective on IBS symptom relief and normalization of lactulose breath test, did not induce dramatic shifts in the microbiota composition of the subjects, stimulating microbial reorganization in some populations toward a more diverse composition. It was not possible to speculate on differences of fecal microbiota modification between responders vs nonresponders and to correlate the quali-/quantitative modification of upper gastrointestinal microbiota and clinical response. PMID:26673000
Teodora Surdea-Blaga; Adriana Bǎban; Dan L Dumitrascu
From a pure motor disorder of the bowel,in the past few years,irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity,alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system,alteration of the gut microflora,an increased intestinal permeability and minimum intestinal inflammation.Psychological and social factors can interfere with the communication between the central and enteric nervous systems,and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome.There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders.In order to explain clustering of IBS in families,genetic factors and social learning mechanisms have been proposed.The psychological features,such as anxiety,depression as well as the comorbid psychiatric disorders,health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.
Acute effects of continuous infusions of glucagon-like peptide (GLP)-1, GLP-2 and the combination (GLP-1+GLP-2) on intestinal absorption in short bowel syndrome (SBS) patients. A placebo-controlled study
Madsen, K B; Askov-Hansen, C; Naimi, R M;
The ileocolonic brake is impaired in short bowel syndrome (SBS) patients with distal bowel resections. An attenuated meal-stimulated hormone secretion may cause gastric hypersecretion, rapid gastric and intestinal transit and a poor adaptation. Attempting to restore this ileocolonic brake, this s...... study evaluated the acute effects of continuous intravenous administration of glucagon-like peptide (GLP) 1 and 2, alone or in combination, on gastrointestinal function in SBS patients....
Mahvi-Shirazi, Majid; Fathi-Ashtiani, Ali; Rasoolzade-Tabatabaei, Sayed-Kazem; Amini, Mohsen
Introduction The study aims to investigate two kinds of treatment in patients suffering from irritable bowel syndrome (IBS) and consequently compares its efficacy on improving the symptoms and mental health of patients; one with just medical treatment and another through a combination of psychotherapy and medical treatment. Material and methods Applying general sampling, 50 IBS patients were selected from among those who used to refer to a Gastroenterology Clinic. After physical and mental ev...
Nielsen, Lecia Møller; Olesen, Anne Estrup; Andresen, Trine; Simrén, Magnus; Törnblom, Hans; Drewes, Asbjørn Mohr
-blind, placebo-controlled, cross-over trial in patients with IBS, excluding females of child-bearing potential. The study consisted of a training visit, study visit 1 and 2 and a follow-up visit. Rectosigmoid electrical, thermal and mechanical stimulations were performed, pain perception was rated on a pain...... intensity scale and referred pain areas were assessed. All adverse events were registered. Twenty-five patients with IBS were enrolled and completed the study (9 women and 16 men; mean age 50.4 ± 12.7 years). No effects of the study drug were found on any of the rectal stimulations or for referred pain...... areas (all p > 0.05). No significant or clinically relevant treatment-related differences were seen for the laboratory safety variables or any other reported adverse event. In conclusion, in patients with IBS on rectal sensitivity to multi-modal stimulations, PPC-5650 did not produce efficacy relative...
Asare, Fredrick; Störsrud, Stine; Simrén, Magnus
Complimentary alternative treatment regimens are widely used in irritable bowel syndrome (IBS), but the evidence supporting their use varies. For psychological treatment options, such as cognitive behavioral therapy, mindfulness, gut-directed hypnotherapy, and psychodynamic therapy, the evidence supporting their use in IBS patients is strong, but the availability limits their use in clinical practice. Dietary interventions are commonly included in the management of IBS patients, but these are primarily based on studies assessing physiological function in relation to dietary components, and to a lesser degree upon research examining the role of dietary components in the therapeutic management of IBS. Several probiotic products improve a range of symptoms in IBS patients. Physical activity is of benefit for health in general and recent data implicates its usefulness also for IBS patients. Acupuncture does not seem to have an effect beyond placebo in IBS. A beneficial effect of some herbal treatments has been reported. PMID:22661301
Boltin, Doron; Perets, Tsachi Tsadok; Shporn, Einav; Aizic, Shoshana; LEVY, SIGAL; Niv, Yaron; Dickman, Ram
Background Rifaximin is a minimally absorbed antibiotic with high luminal activity, used to treat various gastrointestinal diseases. Although rifaximin has been proposed as first line treatment for small intestinal bacterial overgrowth (SIBO), few data are available regarding its efficacy in non-IBS subjects. We aimed to assess the ability of rifaximin to normalize lactulose-H2 breath tests in non-IBS subjects with symptoms suggestive of SIBO. Materials and methods Consecutive non-IBS patient...
Ringel, Yehuda; Ringel-Kulka, Tamar
Irritable bowel syndrome (IBS) is the most prevalent and the best studied functional gastrointestinal disorder. The etiology and the pathogenesis of IBS are still not clear; however, recent studies have implicated a role for alterations in the intestinal microbiota (dysbiosis) in the pathophysiology of the disorder. Epidemiological observations have demonstrated that the development of IBS symptoms is often preceded by a disruption of the individual's normal intestinal microbiota, and microbiological studies have demonstrated compositional differences in the intestinal microbiota between patients with IBS patients and healthy controls. In addition, animal studies and a few recent human clinical studies have demonstrated that compositional changes in the intestinal microbiota in IBS are associated with relevant abnormal gastrointestinal and brain-gut axis functions that are often observed in patients with IBS. This article discusses points of interest from the current research on the microbiota-gut-brain interactions in IBS and highlights the relevance of the emerging data to our understanding of the disorder and the clinical implications for patients' care. PMID:26447966
Rosa LS SOARES
Full Text Available Context The irritable bowel syndrome and primary headache are two chronic diseases characterized by symptoms of recurring pain and affect approximately 10%-20% of the general population. Objectives To study the prevalence of primary headache in volunteers with irritable bowel syndrome in a Brazilian urban community. Methods It was evaluated the prevalence of primary headache associated with irritable bowel syndrome in adult volunteers 330 no patients.The protocol included the Rome III criteria, international classification of Headaches, later divided into four groups: I- Irritable bowel syndrome (n = 52, II- Primary headache (n = 45, III-Irritable bowel syndrome (n = 26 and headache, and IV- Controls (207. Results We not found significant difference in the average age of the four groups and the diagnosis of irritable bowel syndrome, primary headache and their association was more frequent in females. The frequent use of analgesics was greater in groups II and III. Conclusion Our results suggest that irritable bowel syndrome and primary headache are also common in third world countries. The frequency in use of analgesics in association between the two entities was relevant. The identification of irritable bowel syndrome patients with different clinical sub-types could improve the therapeutics options and the prevention strategies.
Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder that considerably reduces the quality of life.It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients.The diagnosis of IBS is based on symptom assessment and the Rome Ⅲ criteria.A combination of the Rome Ⅲ criteria,a physical examination,blood tests,gastroscopy and colonoscopy with biopsies is believed to be necessary for diagnosis.Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS.The pathogenesis of IBS seems to be multifactorial,with the following factors playing a central role in the pathogenesis of IBS:heritability and genetics,dietary/intestinal microbiota,low-grade inflammation,and disturbances in the neuroendocrine system (NES) of the gut.One hypothesis proposes that the cause of IBS is an altered NES,which would cause abnormal GI motility,secretions and sensation.All of these abnormalities are characteristic of IBS.Alterations in the NES could be the result of one or more of the following:genetic factors,dietary intake,intestinal flora,or low-grade inflammation.Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases.Patients with PI-and IBD-IBS exhibit low-grade mucosal inflammation,as well as abnormalities in the NES of the gut.
Yarandi, Shadi Sadeghi; Nasseri-Moghaddam, Siavosh; Mostajabi, Pardis; Malekzadeh, Reza
AIM: To investigate the association of gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) in Iranian patients and examine the prevalence of functional symptoms of the gastrointestinal tract in patients presenting with either IBS, GERD or both.
Full Text Available Sara Soldi,1 Sotirios Vasileiadis,2 Francesca Uggeri,1 Mariachiara Campanale,3 Lorenzo Morelli,4 Maria Vittoria Fogli,5 Fiorella Calanni,5 Maria Grimaldi,5 Antonio Gasbarrini31AAT – Advanced Analytical Technologies Srl, Piacenza, Italy; 2Centre for Environmental Risk Assessment and Remediation, University of South Australia, Mawson Lakes, Australia; 3Internal Medicine and Gastroenterology Division, Catholic University of Rome, Rome, Italy; 4Microbiology Institute, Catholic University of Piacenza, Piacenza, Italy; 5Alfa Wassermann SpA, Bologna, ItalyAbstract: Rifaximin, with its low systemic absorption, may represent a treatment of choice for irritable bowel syndrome (IBS, mainly due to its ability to act on IBS pathogenesis, through the influence on gut microbiota. The aim of the present study was to assess, by biomolecular tools, the rifaximin active modulation exerted on gut microbiota of non-constipated IBS patients. Fifteen non-constipated IBS subjects were treated with 550 mg rifaximin three times a day for 14 days. Stool samples were collected before starting the treatment, at the end of it, and after a 6-week washout period. Real-time polymerase chain reaction, denaturing gradient gel electrophoresis, and next-generation sequencing were applied to all the samples to verify and quantify possible microbial fluctuations. Rifaximin treatment did not affect the overall composition of the microbiota of the treated subjects, inducing fluctuations in few bacterial groups, balanced by the replacement of homologs or complementary bacterial groups. Rifaximin appeared to influence mainly potentially detrimental bacteria, such as Clostridium, but increasing the presence of some species, such as Faecalibacterium prausnitzii. A decrease in the Firmicutes/Bacteroidetes ratio after 14 days of treatment and bacterial profiles with higher biodiversity were observed during the follow-up compared to baseline. Rifaximin treatment, although effective on IBS
Cuomo, Rosario; Andreozzi, Paolo; Zito, Francesco Paolo; Passananti, Valentina; De Carlo, Giovanni; Sarnelli, Giovanni
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders in Western countries. Despite the high prevalence of this disorders, the therapeutic management of these patients is often unsatisfactory. A number of factors have been suggested to be involved in the pathogenesis of IBS, including impaired motility and sensitivity, increased permeability, changes in the gut microbiome and alterations in the brain-gut axis. Also food seems to play a critical role: the most of IBS patients report the onset or the exacerbation of their symptoms after the meals. Recently, an increasing attention has been paid to the role of food in IBS. In this review we summarize the most recent evidences about the role of diet on IBS symptoms. A diet restricted in fermentable, poorly absorbed carbohydrates and sugar alcohols has beneficial effects on IBS symptoms. More studies are needed to improve our knowledge about the relationship between food and IBS. However, in the foreseeable future, dietary strategies will represent one of the key tools in the therapeutic management of patients with IBS. PMID:25083057
Full Text Available Congenital short bowel syndrome (SBS is a relatively rare condition as compared to acquired SBS. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. It is important to suspect and diagnose this condition promptly, as early initiation of parenteral nutrition or surgery, if necessary, may result in a favorable outcome. We discuss a case of an infant aged 26 days, who presented with failure to thrive, recurrent vomiting, and weight loss. A contrast study of the gastrointestinal tract revealed a short small bowel, with malrotation. The infant was started on parenteral nutrition, but succumbed shortly thereafter to severe disseminated sepsis.
It is known that irritable bowel syndrome (IBS) is a chronic disease of cyclic nature characterized by recurrent symptoms. IBS patients should receive, as initial therapeutic approach a short course of treatment which, if effective, has the additional value of confirming the diagnosis. Long-term treatment should be reserved to diagnosed IBS patients with recurrent symptoms. Clinical trials with stabilized therapies and new active treatments showed an improvement of the symptoms over placebo t...
Jizhong, Song; Qiaomin, Wang; Chao, Wang
The mechanism of low-grade inflammation in irritable bowel syndrome (IBS) is unclear; our research concentrates on the involvement of the corticotropin-releasing factor (CRF) and Toll-like receptor (TLR) gene expression in the process of low-grade inflammation in IBS patients with depression. This study suggests more IBS patients are presenting with the states of depression and anxiety. IBS patients with depression have shown a lower grade inflammatory response and an imbalance of the inflammatory response. CRF1, CRF2, TLR2, and TLR4 in IBS patients with depression are significantly higher than those without depression and controls. Thus, activation of the CRF-TLR associated pathways produces an inflammatory reaction, which can concurrently affect the digestive tract and the CNS and induce the corresponding digestive and psychiatric symptoms.
Full Text Available Introduction: Irritable bowel syndrome (IBS is a common gastrointestinal disorder in children that may lead to anxiety, frequent physician visits and school absenteeism. The aim of this study is to reviewe effects of probiotic for irritable bowel syndrome. Materials and Methods: This study review articles about probiotic for irritable bowel syndrome in pubmed and google scholar. Results: Multiple etiologic factors were suggested for IBS, including psychosocial factors, altered gastrointestinal motility, malfermentation of food residues and changes in the intestinal micro flora. It is reported that patients with IBS have a great homogeneity in the fecal flora with a decrease in lactobacilli, coliforms and bifidobacteria in comparison to healthy individuals. The beneficial effects of probiotics in IBS could be explained by increasing the mass of beneficial bacteria such as lactobacilli strains in the digestive tract, decreasing bacterial overgrowth in the small bowel. Recently it was also demonstrated that some lactobacilli strains may modulate intestinal pain attacks by inducing the expression of μ-opioid and cannabinoid receptors in the intestinal epithelial cells. Probiotics can also reinforce the intestinal mucosal barrier and normalize the motility of the digestive tract and its visceral sensitivity and reversing the imbalance between the pro- and anti-inflammatory cytokines so that suggested as a therapeutic option for IBS. Conclusion: Probiotic has been suggested as a therapeutic option for IBS by modulation pathophysiologic events in these patients. Keyword: Probiotic, IBS, Children.
Irritable Bowel Syndrome (IBS) is a functional bowel disease characterized by abdominal pain or discomfort associated with a disordered defecation. No unique pathophysiological mechanism has been identified. It is most likely a multifactorial disease involving alterations in intestinal microbiota co
Full Text Available Ragna Lind,1 Arnold Berstad,2 Jan Hatlebakk,1,3 Jørgen Valeur21Department of Medicine, Haukeland University Hospital, Bergen, 2Unger-Vetlesen Institute, Department of Medicine, Lovisenberg Diakonale Hospital, Oslo, 3Department of Clinical Medicine, University of Bergen, Bergen, NorwayBackground: Patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome (IBS suffer from several health complaints, including fatigue. The aim of the present study was to validate a Norwegian translation of the Fatigue Impact Scale (FIS, and to assess the impact of fatigue in patients with self-reported food hypersensitivity and IBS, as compared with healthy controls.Methods: Thirty-eight patients with unexplained self-reported food hypersensitivity and IBS, who participated in the validation of the FIS completed the following additional questionnaires: the Short Form of Nepean Dyspepsia Index for assessment of quality of life, the Subjective Health Complaint Inventory, and questionnaires for diagnosis and severity of IBS. Impact of fatigue was studied in 43 patients with unexplained self-reported food hypersensitivity, 70% diagnosed with IBS, and 42 healthy controls.Results: Cronbach's α for the FIS was 0.98, indicating excellent agreement between individual items. Scores on the FIS correlated with scores on the Short Form of Nepean Dyspepsia Index (r = 0.50, P = 0.001, indicating good convergent validity, and were higher in patients (median 85.0, interquartile range 36.8–105.3 than in controls (median 14.0, interquartile range 3.0–29.0, P ≤0.0001.Conclusion: The Norwegian translation of the FIS performed excellently in patients with unexplained self-reported food hypersensitivity and IBS, with patients reporting significantly more impact of chronic fatigue than healthy controls.Keywords: irritable bowel syndrome, fatigue, food hypersensitivity, quality of life
Full Text Available Ragnhild Undseth,1 Greta Jakobsdottir,2 Margareta Nyman,2 Arnold Berstad,3 Jørgen Valeur3 1Department of Radiology, Lovisenberg Diaconal Hospital, Oslo, Norway; 2Food for Health Science Centre, Lund University, Lund, Sweden; 3Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway Background: Ingestion of low-digestible carbohydrates triggers symptoms in patients with irritable bowel syndrome (IBS. These carbohydrates become substrates for microbial fermentation in the colon, yielding short-chain fatty acids (SCFAs that are readily absorbed. Aiming to compare colonic fermentation in patients with IBS and healthy controls, we analyzed the concentrations of SCFA in serum at fasting and 90 minutes following ingestion of an unabsorbable, but fermentable carbohydrate, lactulose. Methods: Patients with IBS according to Rome III criteria (n=22 and healthy controls (n=20 ingested 10 g lactulose dissolved in water. Symptoms were graded by questionnaires and SCFA were analyzed using hollow fiber-supported liquid membrane extraction coupled with gas chromatography. Results: Lactulose induced more symptoms in patients with IBS than in healthy controls (P=0.0001. Fasting serum levels of SCFA did not differ between patients with IBS and controls. However, the postprandial levels of total SCFA (P=0.0002, acetic acid (P=0.005, propionic acid (P=0.0001, and butyric acid (P=0.01 were significantly lower in patients with IBS compared with healthy controls. There was no correlation between the levels of serum SCFA and symptom severity. Conclusion: Low-serum levels of SCFA after lactulose ingestion may indicate impaired colonic fermentation in patients with IBS. Conceivably, this disturbance is related to symptom generation, but the mechanism is not clear. Keywords: fermentation, FODMAP, irritable bowel syndrome, microbiota, short-chain fatty acids
Ohlsson Bodil; Bengtsson Mariette; Ulander Kerstin
Abstract Background The aim of this study was to develop and psychometrically test a short, patient-reported questionnaire to be used in clinical practice for patients with Irritable Bowel Syndrome (IBS). The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) questionnaire was designed to measure the treatment response of symptoms and well-being in patients suffering from IBS. Methods The VAS-IBS was psychometrically tested for content and criterion validity, scale acceptability, it...
Rana, Satya Vati; Malik, Aastha
Breath tests are non-invasive tests and can detect H2 and CH4 gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in the breath. These tests are used in the diagnosis of carbohydrate malabsorption, small intestinal bacterial overgrowth, and for measuring the orocecal transit time. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome (IBS)-type symptoms such as diarrhea and/or constipation, bloating, excess flatulence...
Palle Lalitha; Reddy Balaji
Congenital short bowel syndrome (SBS) is a relatively rare condition as compared to acquired SBS. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. It is important to suspect and diagnose this condition promptly, as early initiation of parenteral nutrition or surgery, if necessary, may result in a favorable outcome. We discuss a case of an infant aged 26 days, who presented with failure to thrive, recur...
Full Text Available Irritable Bowel Syndrome (IBS is a chronic and disabling gastrointestinal problem that affects psychosocial functioning as well as the quality of life. This case study reports the utility of cognitive behavior therapy as a psychological intervention procedure in a chronic case of IBS. The use of psychological intervention was found to result in a reduction of anxiety; amelioration of the symptoms associated with IBS and improved functioning.
Hausteiner-Wiehle, Constanze; Henningsen, Peter
This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders. PMID:24876725
Naliboff, Bruce D.; Fresé, Michael P.; Lobsang Rapgay
Currently, the goal of treatment for those with irritable bowel syndrome (IBS) is to improve the quality of life through a reduction in symptoms. While the majority of treatment approaches involve the use of traditional medicine, more and more patients seek out a non-drug approach to managing their symptoms. Current forms of non-drug psychologic or mind/body treatment for IBS include hypnotherapy, cognitive behavioral therapy and brief psychodynamic psychotherapy, all of which have been prove...
Bennet, Sean M.P.; Öhman, Lena; Simrén, Magnus
Irritable bowel syndrome (IBS) is a multifactorial functional disorder with no clearly defined etiology or pathophysiology. Modern culture-independent techniques have improved the understanding of the gut microbiota’s composition and demonstrated that an altered gut microbiota profile might be found in at least some subgroups of IBS patients. Research on IBS from a microbial perspective is gaining momentum and advancing. This review will therefore highlight potential links between the gut mic...
Debora Duro; Daniel Kamin
Short bowel syndrome is at once a surgical, medical, and a disorder, with potential for life-threatening complications as well as eventual independence from artificial nutrition. Navigating through the diagnostic and therapeutic decisions is ideally accomplished by a multidisciplinary team comprised of nutrition, pharmacy, social work, medicine, and surgery. Early identification of patients at risk for long-term PN-dependency is the first step towards avoiding severe complications. Close mon...
Dianna Ramírez Prada; Gabriel del Castillo Calderón
Case: The objective is to present the successful experience of multidisciplinary management of a patient with short bowel syndrome and intestinal failure with progression to intestinal adaptation. This is a newly born premature with intestinal atresia type IV with multiple intestinal atresia who evolved to intestinal failure and required managed with prolonged parenteral nutritional support, multiple antibiotic schemes, prebiotics, multivitamins, enteral nutrition with elemental formula to ac...
Mouksassi, M S; Marier, J F; Cyran, J; Vinks, A A
Teduglutide, a synthetic glucagon-like peptide-2 (GLP-2) analog with activity relating to the regeneration, maintenance, and repair of the intestinal epithelium, is currently being evaluated for the treatment of short-bowel syndrome (SBS), Crohn's disease, and other gastrointestinal disorders. On the basis of promising results from teduglutide studies in adults with SBS and from studies in neonatal and juvenile animal models, a pediatric multiple-dose phase I clinical study was designed to determine the safety, efficacy, and pharmacokinetics of teduglutide in pediatric patients with SBS who have undergone resection for necrotizing enterocolitis, malrotation, or intestinal atresia. This report details the application of clinical trial simulations coupled with a novel approach using generalized additive modeling for location, scale, and shape (GAMLSS) that facilitates the simulation of demographic covariates specific to the targeted patient populations. The goal was to optimize phase I dosing strategies and the likelihood of achieving target exposure and therapeutic effect. PMID:19847163
Burgdorf, Stefan K; Qvist, Niels; Gögenur, Ismail
Short bowel syndrome is the result of extensive surgical resection, inherited defects or loss of functional absorbing intestine. Parenteral nutrition is associated with high economical expenses, increased morbidity and decreased quality of life. Intestinal transplantation is associated with high...... morbidity and mortality rates. Segmental reversal of the small bowel can prolong the transit time in the small bowel and in many cases permanently end parenteral nutrition dependency. Segmental reversal of the small bowel should be integrated in the surgical treatment of adults with short bowel syndrome....
Rana, Satya Vati; Malik, Aastha
Breath tests are non-invasive tests and can detect H₂ and CH₄ gases which are produced by bacterial fermentation of unabsorbed intestinal carbohydrate and are excreted in the breath. These tests are used in the diagnosis of carbohydrate malabsorption, small intestinal bacterial overgrowth, and for measuring the orocecal transit time. Malabsorption of carbohydrates is a key trigger of irritable bowel syndrome (IBS)-type symptoms such as diarrhea and/or constipation, bloating, excess flatulence, headaches and lack of energy. Abdominal bloating is a common nonspecific symptom which can negatively impact quality of life. It may reflect dietary imbalance, such as excess fiber intake, or may be a manifestation of IBS. However, bloating may also represent small intestinal bacterial overgrowth. Patients with persistent symptoms of abdominal bloating and distension despite dietary interventions should be referred for H₂ breath testing to determine the presence or absence of bacterial overgrowth. If bacterial overgrowth is identified, patients are typically treated with antibiotics. Evaluation of IBS generally includes testing of other disorders that cause similar symptoms. Carbohydrate malabsorption (lactose, fructose, sorbitol) can cause abdominal fullness, bloating, nausea, abdominal pain, flatulence, and diarrhea, which are similar to the symptoms of IBS. However, it is unclear if these digestive disorders contribute to or cause the symptoms of IBS. Research studies show that a proper diagnosis and effective dietary intervention significantly reduces the severity and frequency of gastrointestinal symptoms in IBS. Thus, diagnosis of malabsorption of these carbohydrates in IBS using a breath test is very important to guide the clinician in the proper treatment of IBS patients. PMID:24976698
Bijkerk, C.J.; de Wit, N J; Muris, J W M; Whorwell, P J; Knottnerus, J. A.; Hoes, A. W.
Objective To determine the effectiveness of increasing the dietary content of soluble fibre (psyllium) or insoluble fibre (bran) in patients with irritable bowel syndrome. Design Randomised controlled trial. Setting General practice. Participants 275 patients aged 18-65 years with irritable bowel syndrome. Interventions 12 weeks of treatment with 10 g psyllium (n=85), 10 g bran (n=97), or 10 g placebo (rice flour) (n=93). Main outcome measures The primary end point was adequate symptom relief...
Although diarrhea is the predominant bowel dysfunction in as many as one-third of patients with irritable bowel syndrome (IBS), it is unclear whether there is a specific disorder of intestinal fluid or electrolyte secretion in IBS. Diarrhea is generally considered a result of accelerated colonic transit in patients with IBS. Although a primary secretory diathesis has not been well-documented in patients with IBS with diarrhea (IBS-D), several mechanisms that could potentially contribute to intestinal secretion have been reported. Some of these mechanisms also influence motor and secretory dysfunctions that contribute to the pathophysiology of IBS-D. We review the evidence supporting secretion in IBS-D caused by peptides and amines produced by enteroendocrine cells or submucosal neurons, enterocyte secretory processes, and intraluminal factors (bile acids and short-chain fatty acids). Understanding these mechanisms and developing clinical methods for their identification could improve management of patients with IBS-D. PMID:25041862
Latimer, P; Campbell, D; Latimer, M; Sarna, S; Daniel, E; Waterfall, W
This study tested the hypothesis that, patients with irritable bowel syndrome (IBS), there is a primary hyperalgesia of the colon. Previous work, which examined these patients and normals, has not included subjects who provide a control for relevant psychological characteristics. We compared ratings of pain, following varying degrees of distension of the sigmoid colon, in normals, patients with IBS, and patients who were psychologically disturbed but without bowel symptoms. Psychological characteristics were assessed by a psychiatric interview and psychometric inventories; response to distension was tested by placing a tube in the rectosigmoid colon and successively inflating a nd deflating a balloon at its tip at 10 cm3 increments up to 50 cm3. Ratings of pain were recorded at each volume. The results indicated that the two patient groups were psychologically similar and both were more disturbed than normals. A linear relation was found between reports of pain and volume of distension in all three groups. There were no significant differences between the proportions of subjects experiencing pain in each group or the average of the ratings. There were no significant associations between the pain ratings and measures of anxiety, depression, neuroticism, and extraversion. The data do not support the hypothesis that colonic hyperalgesia is an important contributory factor in the etiology of the irritable bowel syndrome. PMID:537039
Full Text Available Abstract Background To investigate non-patient irritable bowel syndrome (IBS change to IBS and to determine factors predictive of the onset of IBS, individual biological factors, psychological factors, behavioral factors, and environmental factors were examined. Methods The subjects were 105 non-patient IBS (male = 59, female = 46, average age:21.49 ± 2.37, including 68 of the diarrhea-predominant type and 37 of the constipation-predominant type selected from 1,409 university and technical college students by use of a questionnaire based on the Rome II diagnostic criteria. The subjects were followed for three years, and various characteristics and IBS symptoms were serially observed (12 times. The IBS incidence rate was calculated. Results During the three years, 37 non-patient IBS (35.24% changed to IBS: 28 diarrhea-predominant type and 9 constipation-predominant type. All IBS symptoms disappeared in 26 non-patient IBS subjects (24.76%. According to quantification method II (discriminant analysis, seven factors (stressor, two kinds of stress coping styles, cognitive appraisal, eating habits, sleeping time, and psychologically abuse were adopted as a predictive model for IBS incidence and were confirmed as predictive of IBS. Conclusion The results of this research show that non-patient IBS is a changeable state that can change into IBS or persons without symptoms. Most of the non-patient IBS subjects who became asymptomatic had had symptoms for six months or less. Furthermore, the longer a non-patient IBS subject had symptoms, the higher the risk of a change to IBS became. The findings suggest the usefulness of identifying and approaching non-patient IBS as early as possible to prevent the onset of IBS. It must be noted that the persons surveyed in the present study had only the diarrhea-predominant and constipation-predominant types. Therefore, the findings of the present study are limited only these two types. Further study including the
Mª G. Guijarro de Armas
Full Text Available El Magnesio (Mg es el cuarto catión más abundante en el organismo y juega un papel fundamental en numerosas funciones celulares, como la glucólisis o el metabolismo energético¹. Su déficit puede originar alteraciones gastrointestinales, cardiovasculares y neurológicas. Dentro de estas últimas, la sintomatología puede oscilar desde debilidad muscular y parestesias, hasta letargo, hiperreflexia, ataxia, tetania, convulsiones y coma². Presentamos el caso de un varón de 65 años con intestino corto secundario a una amplia resección intestinal por neoplasia de sigma y peritonitis fecaloidea posterior, con ileostomía terminal, que presentó varios episodios de crisis convulsivas tónico-clónicas secundarias a déficit severo de magnesio, como consecuencia de una disminución en la absorción intestinal por pérdidas por una ileostomía de alto débito. Tras instaurar tratamiento con magnesio intravenoso (iv se consiguieron normalizar sus niveles plasmáticos. Posteriormente se instauraron recomendaciones dietéticas y tratamiento farmacológico, así como Magnesio oral a dosis altas y Calcitriol para incrementar su absorción, pudiendo ser dado de alta.Magnesium (Mg is the fourth most abundant cation in the body and plays a key role in numerous cellular functions such as glycolysis and energy metabolism. Its deficit may cause gastrointestinal disturbances, cardiovascular and neurological diseases. Among the latter, the symptoms may range from muscle weakness and numbness, to lethargy, hyperreflexia, ataxia, tetany, convulsions and coma. We report the case of a man of 65 with short bowel syndrome secondary to extensive bowel resection for sigma neoplasm and subsequent peritonitis, with end ileostomy, who presented several episodes of tonic-clonic seizures secondary to severe magnesium deficiency as a result a decrease in intestinal absorption of losses for high debit ileostomy. After beginning treatment with intravenous magnesium (iv
Carroll, Robert E; Benedetti, Enrico; Schowalter, Joseph P; Buchman, Alan L
Short bowel syndrome (SBS) is defined as loss of bowel mass from surgical resection, congenital defects, or disease. Intestinal failure (IF) includes the subset of SBS unable to meet nutrition needs with enteral supplements and requires parenteral nutrition (PN). The parenteral treatment of SBS is now a half-century old. Recent pharmacologic treatment (GLP-2 analogues) has begun to make a significant impact in the care and ultimate management of these patients such that the possibility of reducing PN requirements in formerly PN-dependent patients is a now a real possibility. Finally, newer understanding and possible treatment for some of the complications related to IF have more recently evolved and will be an emphasis of this report. This review will focus on developments over the last 10 years with the goal of updating the reader to new advances in our understanding of the care and feeding of the SBS patient. PMID:27324885
Hammerle, Christopher W; Crowe, Sheila E
Irritable bowel syndrome (IBS) is a highly prevalent disorder characterized by nonspecific symptoms that can mimic other common medical conditions. A careful history and physical examination may reveal clues that suggest a coexisting or alternative diagnosis, such as small intestinal bacterial overgrowth or celiac disease (CD). Testing for bacterial overgrowth has limitations, but emerging data suggest that antibiotics may be of some benefit in patients with IBS with diarrhea and bloating. CD seems to have a higher prevalence in patients with IBS. Some patients with IBS may have symptomatic improvement on gluten-restricted diets, without histologic or serologic evidence of CD. PMID:21601781
A dose-equivalent comparison of the effects of continuous subcutaneous glucagon-like peptide 2 (GLP-2) infusions versus meal related GLP-2 injections in the treatment of short bowel syndrome (SBS) patients
Naimi, R M; Madsen, K B; Askov-Hansen, C; Brandt, C F; Hartmann, B; Holst, Jens Juul; Mortensen, P B; Jeppesen, P B
Glucagon-like peptide 2 (GLP-2), secreted endogenously from L-cells in the distal bowel in relation to meals, modulates intestinal absorption by adjusting gastric emptying and secretion and intestinal growth. Short bowel syndrome (SBS) patients with distal intestinal resections have attenuated...... endogenous GLP-2 secretion, which may contribute to their rapid gastric emptying, gastric hypersecretion and poor intestinal adaptation, whereas SBS patients with preserved terminal ileum and colon, who have a constantly elevated GLP-2 secretion, seem to do better in these respects. This study compared...
M. Lo Gatto; C. Staffieri; Y. Macchitella; F. Varrone; G. Tamo Tamo; G. Marzocca
Introduction. The main complication of large bowel resection is the malabsorption syndrome, a rare form of which is the syndrome of Wernicke-Korsakoff. Patients and Methods. B.E. following gastro-entero anastomosis develops Syndrome Wernicke-Korsakoff characterized by progressive state of disorientation, fixity of gaze, dysphoria. Results. Syndrome Wernicke-Korsacoff is linked to a deficiency of thiamin (also known as vitamin B1). Conclusions. In the follow up of patients who underwent a larg...
Piero Portincasa; Antonio Moschetta; Giuseppe Baldassarre; Donato F. Altomare; Giuseppe Palasciano
AIM:Psychological factors, altered motility and sensation disorders of the intestine can be variably associated with irritable bowel syndrome (IBS). Such aspects have not been investigated simultaneously. The aim of this paper was to evaluate gastrointestinal motility and symptoms, psychological spectrum and quality of life in a large group of IBS patients in southern Italy.METHODS: One hundred IBS patients (F:M=73:27, age 48±2 years, mean±SE) fulfilling ROME Ⅱ criteria matched with 100 healthy subjects (F:M=70:30, 45±2 years). Dyspepsia,bowel habit, alexithymia, psycho-affective profile and quality of life were assessed using specific questionnaires. Basally and postprandially, changes in gallbladder volumes and antral areas after liquid meal and orocaecal transit time (OCTT)were measured respectively by ultrasonography and H2-breath test. Appetite, satiety, fullness, nausea, and epigastric pain/discomfort were monitored using visual-analogue scales.RESULTS: Compared with controls, IBS patients had increased dyspepsia (score 12.6±0.7 VS 5.1±0.2, P＜0.0001),weekly bowel movements (12.3±0.4 VS 5.5±0.2, P＜0.00001, comparable stool shape), alexithymia (score 59.11.1 VS40.5±1.0, P=0.001), poor quality of life and psychoaffective profile. IBS patients had normal gallbladderemptying, but delayed gastric emptying (T50:35.5±1.0 VS 26.1±0.6 min, P=0.00001) and OCTT (163.0±5.4 VS96.6±1.8min, P=0.00001). Fullness, nausea, and epigastric pain/discomfort were greater in IBS than in controls.CONCLUSION: ROME Ⅱ IBS patients have a pan-enteric dysmotility with frequent dyspepsia, associated with psychological morbidity and greatly impaired quality of life.The presence of alexithymia, a stable trait, is a novel finding of potential interest to detect subgroups of IBS patients with different patterns recoveed after therapy.
Full Text Available Objective. To assess histological changes of colonic mucosa in patients with clinically different types of irritable bowel syndrome (IBS before and after the treatment with tetracyclic antidepressant and selective serotonin reuptake inhibitor. Methods. Adult patients (over 18 years with confirmed diagnosis of IBS were examined. Biopsy specimens were taken from colon during colonoscopy for the next histological examination. One expert gastrointestinal pathologist assessed all tissue samples. We patent semi quantitative assessment of the severity of cell infiltration of colonic mucosa, which could be assessed as inflammatory (neutrophils, immune (lymphocytes, plasma cells, macrophages, or allergic (eosinophils response (0 to 3 degrees. All patients received treatment due to the clinical variant of IBS: 1 IBS-constipation – mirtazapinum 15 mg/night+lactulose 30ml/morning (+30ml/night if needed; 2 IBS-diarrhea – escitalopram 5mg/night+rifaximine 600mg/twice a day; 3 IBS-unspecified – mirtazapinum 15 mg/escitalopram 5mg/ night; 4 IBS-mixed – mirtazapinum 15 mg, lactulose 30ml/morning (+30ml/night if needed / escitalopram 5mg/night+rifaximine 600mg/twice a day. Results. 107 patients were examined, 36 of them had constipation (I group, 35 – diarrhea (II group, 22- unspecified variant (III group and 12 patients had mixed variant of IBS (IV group due to Rome III criteria (2006. 1st degree of lymphocyte infiltration was detected in 100% IBS-constipation patients and in 58,3% IBS-mixed variant (p0.05. No cases of 2nd or 3rd degree of colonic mucosa infiltration were found. Conclusion. After the treatment with tetracyclic antidepressant and selective serotonin reuptake inhibitor we found that the degree of inflammation of colonic mucosa was reduced or disappeared, due to the zero degree of infiltration according to our patented classification. Citation: Nagieva S, Svintsitskyy A, Kuryk O, Korendovych I. [Morphological changes of intestinal mucosa
Marier, Jean-Francois; Mouksassi, Mohamad-Samer; Gosselin, Nathalie H; Beliveau, Martin; Cyran, Jane; Wallens, John
Teduglutide is a GLP-2 analog currently evaluated for the treatment of short bowel syndrome, Crohn's disease, and other gastrointestinal disorders. The population pharmacokinetics (PK) of teduglutide were assessed following daily subcutaneous (SC) administrations of 2.5 to 80 mg doses in a total of 256 patients. A 1-compartment model with a site-specific rate constant of absorption in the abdomen, arm, and thigh was used to assess the PK of teduglutide. Apparent clearance (CL/F) of teduglutide in male participants was approximately 18% higher than that observed in female participants (12.4 vs 10.5 L/h, respectively). Body weight was detected as a significant covariate explaining the volume of distribution of teduglutide. The elimination half-life (t((1/2))) of teduglutide was also influenced by the body weight of participants. For a male patient weighing 50 and 90 kg, t((1/2)) of teduglutide was 0.897 and 2.99 hours, respectively. Renal and hepatic function of patients did not affect the PK of teduglutide. As a result, no dose adjustment was deemed necessary in patients with altered renal or liver function. The population PK model will help to support adequate drug labeling following SC administrations in patients and determine whether an individualized dosage is required. PMID:19773525
Full Text Available Blastocystis is a protistan parasite living in the digestive tract of many animals, including humans. This highly prevalent intestinal parasite is suspected to be linked to Irritable Bowel Syndrome (IBS, a chronic functional bowel disorder. Here, we first compared the prevalence of Blastocystis among 56 IBS patients (40 IBS with constipation (IBS-C, 9 IBS with diarrhea (IBS-D, 4 mixed IBS (IBS-M and 3 unsubtyped IBS (IBS-U according to the Rome III criteria and 56 control (i.e. without any diagnosed chronic or acute gastrointestinal disorder subjects. The highest prevalence of Blastocystis spp. was observed in the IBS group, but was only statistically significant in men (36.8% in the IBS group versus 4.8% in the control group. We then conducted a meta-analysis including epidemiological studies attempting to determine whether Blastocystis carriage could be linked to IBS, and highlighted that IBS patients had a relative risk of 2.34 to be infected by Blastocystis when compared to non-IBS subjects. We also looked for Dientamoeba fragilis, which is often associated with IBS, and identified this parasite only in some IBS patients (n = 6/56. Several studies provided evidence for a major role of the gut microbiota in the pathophysiology of IBS. Thus, we investigated the possible impact of Blastocystis carriage on the enteric bacterial community through quantification of 8 major bacterial groups from the enteric flora. Our data indicated that men with IBS-C had a significant decrease in Bifidobacterium sp. when infected by Blastocystis. Interestingly, in control subjects (i.e. without any gastrointestinal disorder positive for Blastocystis, Faecalibacterium prausnitzii, which is known for its anti-inflammatory properties, was significantly decreased in men. Our results support the hypothesis that Blastocystis might be linked to the pathophysiology of IBS-C and intestinal flora imbalance.
Nourrisson, Céline; Scanzi, Julien; Pereira, Bruno; NkoudMongo, Christina; Wawrzyniak, Ivan; Cian, Amandine; Viscogliosi, Eric; Livrelli, Valérie; Delbac, Frédéric; Dapoigny, Michel; Poirier, Philippe
Blastocystis is a protistan parasite living in the digestive tract of many animals, including humans. This highly prevalent intestinal parasite is suspected to be linked to Irritable Bowel Syndrome (IBS), a chronic functional bowel disorder. Here, we first compared the prevalence of Blastocystis among 56 IBS patients (40 IBS with constipation (IBS-C), 9 IBS with diarrhea (IBS-D), 4 mixed IBS (IBS-M) and 3 unsubtyped IBS (IBS-U) according to the Rome III criteria) and 56 control (i.e. without any diagnosed chronic or acute gastrointestinal disorder) subjects. The highest prevalence of Blastocystis spp. was observed in the IBS group, but was only statistically significant in men (36.8% in the IBS group versus 4.8% in the control group). We then conducted a meta-analysis including epidemiological studies attempting to determine whether Blastocystis carriage could be linked to IBS, and highlighted that IBS patients had a relative risk of 2.34 to be infected by Blastocystis when compared to non-IBS subjects. We also looked for Dientamoeba fragilis, which is often associated with IBS, and identified this parasite only in some IBS patients (n = 6/56). Several studies provided evidence for a major role of the gut microbiota in the pathophysiology of IBS. Thus, we investigated the possible impact of Blastocystis carriage on the enteric bacterial community through quantification of 8 major bacterial groups from the enteric flora. Our data indicated that men with IBS-C had a significant decrease in Bifidobacterium sp. when infected by Blastocystis. Interestingly, in control subjects (i.e. without any gastrointestinal disorder) positive for Blastocystis, Faecalibacterium prausnitzii, which is known for its anti-inflammatory properties, was significantly decreased in men. Our results support the hypothesis that Blastocystis might be linked to the pathophysiology of IBS-C and intestinal flora imbalance. PMID:25365580
Van Der Werf, Christine S.; Wabbersen, Tara D.; Hsiao, Nai-Hua; Paredes, Joana; Etchevers, Heather C.; Kroisel, Peter M.; Tibboel, Dick; Babarit, Candice; Schreiber, Richard A.; Hoffenberg, Edward J.; Vekemans, Michel; Zeder, Sirkka L.; Ceccherini, Isabella; Lyonnet, Stanislas; Ribeiro, Ana S.; Seruca, Raquel; Meerman, Gerard J. Te; van Ijzendoorn, Sven C. D.; Shepherd, Iain T.; Verheij, Joke B. G. M.; Hofstra, Robert M. W.
BACKGROUND & AIMS: Short-bowel syndrome usually results from surgical resection of the small intestine for diseases such as intestinal atresias, volvulus, and necrotizing enterocolitis. Patients with congenital short-bowel syndrome (CSBS) are born with a substantial shortening of the small intestine
Cukier Celso; Waitzberg Dan L.; Borges Viviane Chaer; Silva Maria de Lourdes T.; Gama-Rodrigues Joaquim; Pinotti Henrique Walter
Growth hormone (GH) and glutamine (GLN) are considered bowel trophic factors and are used experimentally after bowel resection. Their clinical uses in short bowel syndrome (SBS) are still not standardized. It is of interest to verify metabolic, nutritional and side effects of the association of GH and GLN in SBS. Three patients, 39 (A), 33 (B), and 01 years old (C) underwent bowel resection with jejunum anastomosis 15 cm (A) and 60 cm (B) distant from the Treitz angle, and 40 cm (C) preservin...
Gastroenterologists and general practitioners see many patients that have abdominal symptoms which are not explained when the patients are investigated for celiac disease, inflammatory bowel disease, peptic ulcer or tumours. The diagnosis is irritable bowel syndrome (IBS). Many of these patients report intolerance to certain foods including milk, and some develop symptoms after ingestion of lactose during the lactose tolerance test. In Northern European populations, lactose malabsorption is, ...
Posserud, Iris; Ersryd, Amanda; Simrén, Magnus
The pathophysiology of IBS is complex and still incompletely known. Both central and peripheral factors, including psychosocial factors, abnormal GI motility and secretion, and visceral hypersensitivity, are thought to contribute to the symptoms of IBS. Several studies have demonstrated altered GI motor function in IBS patients and the pattern differs between IBS subgroups based on the predominant bowel pattern. Few studies have so far addressed GI secretion in IBS, but there are some evidenc...
BACKGROUND: Complementary and alternative medical therapies and practices are widely employed in the treatment of the irritable bowel syndrome. AIM: To review the usage of complementary and alternative medicine in the irritable bowel syndrome, and to assess critically the basis and evidence for its use. METHODS: A systematic review of complementary and alternative medical therapies and practices in the irritable bowel syndrome was performed based on literature obtained through a Medline search. RESULTS: A wide variety of complementary and alternative medical practices and therapies are commonly employed by irritable bowel syndrome patients both in conjunction with and in lieu of conventional therapies. As many of these therapies have not been subjected to controlled clinical trials, some, at least, of their efficacy may reflect the high-placebo response rate that is characteristic of irritable bowel syndrome. Of those that have been subjected to clinical trials most have involved small poor quality studies. There is, however, evidence to support efficacy for hypnotherapy, some forms of herbal therapy and certain probiotics in irritable bowel syndrome. CONCLUSIONS: Doctors caring for irritable bowel syndrome patients need to recognize the near ubiquity of complementary and alternative medical use among this population and the basis for its use. All complementary and alternative medicine is not the same and some, such as hypnotherapy, forms of herbal therapy, specific diets and probiotics, may well have efficacy in irritable bowel syndrome. Above all, we need more science and more controlled studies; the absence of truly randomized placebo-controlled trials for many of these therapies has limited meaningful progress in this area.
Sansone, Randy A.; Sansone, Lori A.
Irritable bowel syndrome is allegedly the most common gastrointestinal diagnosis in the United States. The etiology of this syndrome appears to entail the interaction of both genes and the environment. One potential environmental contributory factor to irritable bowel syndrome is abuse in childhood. Of the various forms of abuses previously examined, sexual abuse in childhood appears to be the most patent contributor. However, both emotional and physical abuses may also contribute to irritabl...
Zhang, Shuang; Jiao, Taiwei; Chen, Yushuai; Gao, Nan; Zhang, Lili; Jiang, Min
Patients with irritable bowel syndrome (IBS) show a wide range of symptoms including diarrhea, abdominal pain, changes in bowel habits, nausea, vomiting, headache, anxiety, depression and cognitive impairment. Methylglyoxal has been proved to be a potential toxic metabolite produced by intestinal bacteria. The present study was aimed at investigating the correlation between methylglyoxal and irritable bowel syndrome. Rats were treated with an enema infusion of methylglyoxal. Fecal water content, visceral sensitivity, behavioral tests and serum 5-hydroxytryptamine (5-HT) were assessed after methylglyoxal exposure. Our data showed that fecal water content was significantly higher than controls after methylglyoxal exposure except that of 30 mM group. Threshold volumes on balloon distension decreased in the treatment groups. All exposed rats showed obvious head scratching and grooming behavior and a decrease in sucrose preference. The serum 5-HT values were increased in 30, 60, 90 mM groups and decreased in 150 mM group. Our findings suggested that methylglyoxal could induce diarrhea, visceral hypersensitivity, headache as well as depression-like behaviors in rats, and might be the key role in triggering systemic symptoms of IBS. PMID:25157984
Full Text Available Patients with irritable bowel syndrome (IBS show a wide range of symptoms including diarrhea, abdominal pain, changes in bowel habits, nausea, vomiting, headache, anxiety, depression and cognitive impairment. Methylglyoxal has been proved to be a potential toxic metabolite produced by intestinal bacteria. The present study was aimed at investigating the correlation between methylglyoxal and irritable bowel syndrome. Rats were treated with an enema infusion of methylglyoxal. Fecal water content, visceral sensitivity, behavioral tests and serum 5-hydroxytryptamine (5-HT were assessed after methylglyoxal exposure. Our data showed that fecal water content was significantly higher than controls after methylglyoxal exposure except that of 30 mM group. Threshold volumes on balloon distension decreased in the treatment groups. All exposed rats showed obvious head scratching and grooming behavior and a decrease in sucrose preference. The serum 5-HT values were increased in 30, 60, 90 mM groups and decreased in 150 mM group. Our findings suggested that methylglyoxal could induce diarrhea, visceral hypersensitivity, headache as well as depression-like behaviors in rats, and might be the key role in triggering systemic symptoms of IBS.
Hani Abu Zeid* Magdi Abdel Karim* Mahmoud M. Bazid*
Full Text Available A clinically distinct subset of Irritable Bowel syndrome (IBS could be induced or exaggerated by bowel infection that is called post-infective IBS (PI-IBS which is characterized by diarrhea predominant symptoms with less psychiatric illness. The purpose of this work was to study whether some bowel infections contribute to the pathogenesis of IBS and whether the treatment of such infections reduces IBS symptoms. 100 patients with symptoms suggestive of IBS according to Rome II Criteria were chosen from Internal Medicine outpatient clinic-Al Hussein university hospital. They were 64 females and 36 males, aged 18-52 years old with mean age 38,2 3,6 years. They were submitted to: full clinical examination and frequent stool examinations (direct smear and culture before, soon after and six months after administration of drug therapies for common stool-positive associated bowel infections (diloxanide for E. histolytica, metronidazole for Giardia lamblia, Ketoconazole for Candida, ciprofloxacin for Salmonella and neomycin for Pseudomonas. Results obtained showed that 24% of patients had diarrhea predominant symptoms, 13 patients (54% out of them had history suggestive of acute gastroenteritis. 80 patients had initial positive stool examination and continued the post treatment six months follow up study. Out of them, 13 patients had stool positive for Salmonella typhi mixed with E. histolytica; ten of them (76.9% showed a statistically significant persistent clinical and laboratory improvement after ciprofloxacin therapy (P 0.05. This finding makes the correlation between E. histolytica infection and IBS is unlikely. 20 patients had isolated Candida overgrowth on stool examination; eight of them (40% showed a statistically significant clinical and laboratory improvement after Ketoconazole therapy (P < 0.05. Therefore Candida overgrowth may induce or exaggerate IBS symptoms. Finally, no growth was noticed for shigella sp. or E. coli, this may exclude the
M. Lo Gatto
Full Text Available Introduction. The main complication of large bowel resection is the malabsorption syndrome, a rare form of which is the syndrome of Wernicke-Korsakoff. Patients and Methods. B.E. following gastro-entero anastomosis develops Syndrome Wernicke-Korsakoff characterized by progressive state of disorientation, fixity of gaze, dysphoria. Results. Syndrome Wernicke-Korsacoff is linked to a deficiency of thiamin (also known as vitamin B1. Conclusions. In the follow up of patients who underwent a large bowel resection will be important to carry out systematic blood tests that can detect any frameworks-megaloblastic anemia macrocytosis deficiency vit. B12, iron deficiency, hypomagnesaemia, hypocalcemia, ipodisprotidemy. In the follow up of patients who underwent a large bowel resection will be important to carry out systematic blood tests that can detect any frameworks-megaloblastic anemia macrocytosis deficiency vit. B12, iron deficiency, hypomagnesaemia, hypocalcemia,ipodisprotidemy.
John Samuel Leeds; Mark Edward McAlindon; Eleanor Lorenz; Asha Kumari Dube; David Surendran Sanders
Sarcoidosis is a systemic disease of unknown aetiology that may affect any organ in the body. The gastrointestinal tract however is only rarely affected outside the liver. Symptoms may be non-specific.Irritable bowel syndrome (IBS) is a common diagnosis.The recognition of TBS is aided by the use of the Rome Ⅱ criteria - in the absence of organic disease. We describe the first case of a patient with gastric sarcoidosis who presented with IBS symptoms but subsequently responded to immunosuppressive therapy.
Coletta, Riccardo; Khalil, Basem A; Morabito, Antonino
The main cause of intestinal failure in children is due to short bowel syndrome (SBS) resulting from congenital or acquired intestinal lesions. From the first lengthening procedure introduced by Bianchi, the last three decades have seen lengthening procedures established as fundamental components of multidisciplinary intestinal rehabilitation programs. Debate on indications and timing of the procedures is still open leaving SBS surgical treatment a great challenge. However, enteral autonomy is possible only with an individualized approach remembering that each SBS patient is unique. Current literature on autologous gastrointestinal reconstruction technique was reviewed aiming to assess a comprehensive pathway in SBS non-transplant management. PMID:25459014
Kim, Jeong Hwan; Sung, In-Kyung
Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders. It is a multifactorial disorder with its pathogenesis attributed to abnormal gastrointestinal motility, low-grade inflammation, visceral hypersensitivity, communication in the gut-brain axis, and so on. Traditionally, IBS has been treated with diet and lifestyle modification, fiber supplementation, psychological therapy, and pharmacological treatment. Carbohydrates are intermingled with a wide range of regularly consumed food including grains such as rye and wheat, vegetables, fruits, and legumes. Short-chain carbohydrates that are poorly absorbed exert osmotic effects in the intestinal lumen increasing its water volume, and are rapidly fermented by bacteria with consequent gas production. These effects may be the basis for the induction of most of the gastrointestinal symptoms. This has led to the use of lactose-free diets in those with lactose intolerance and of fructose-reduced diets for fructose malabsorption. As all poorly absorbed short-chain carbohydrates have similar and additive effects in the intestine, a concept has been developed to regard them collectively as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) and to evaluate a dietary approach that restricts them all. Based on the observational and comparative studies, and randomized-controlled trials, FODMAPs have been shown to trigger gastrointestinal symptoms in patients with IBS. Food choice via the low FODMAPs and potentially other dietary strategies is now a realistic and efficacious therapeutic approach for managing symptoms of IBS. PMID:25252862
Orr, W; Crowell, M; Lin, B.; Harnish, M; J. Chen
Background—Recently, several studies have shown an alteration in bowel function during sleep in patients with irritable bowel syndrome (IBS), and a recent study also suggests a remarkable increase in rapid eye movement (REM) sleep. These studies have suggested that an alteration in CNS function may play an important role in the pathogenesis of IBS. Aims—To confirm the presence of an alteration in REM sleep in patients with IBS and to assess the relation between sleep and a non...
Lee, Kang Nyeong; Lee, Oh Young
Irritable bowel syndrome (IBS) is a functional bowel disorder without any structural or metabolic abnormalities that sufficiently explain the symptoms, which include abdominal pain and discomfort, and bowel habit changes such as diarrhea and constipation. Its pathogenesis is multifactorial: visceral hypersensitivity, dysmotility, psychosocial factors, genetic or environmental factors, dysregulation of the brain-gut axis, and altered intestinal microbiota have all been proposed as possible cau...
Kellow, J E; Phillips, S F; Miller, L J; Zinsmeister, A R
Though the pathophysiology of the irritable bowel syndrome (IBS) is commonly attributed to dysfunction of the large intestine, evidence exists to incriminate the small bowel. In order to further explore the role of the small bowel in IBS several stimuli were applied, in an attempt to unmask the dysmotility of the jejunum and ileum. These included infusions of cholecystokinin-octapeptide (CCK-OP), a high fat meal, neostigmine and balloon distension of the ileum. Three groups (n = 8) each of ag...
Eamonn MM Quigley
Recent years have witnessed tremendous progress in our understanding of irritable bowel syndrome (IBS). It is evident that this is a truly global disease associated with significant symptoms and impairments in personal and social functioning for afflicted individuals. Advances in our understanding of gut flora-mucosal interactions, the enteric nervous system and the brain-gut axis have led to substantial progress in the pathogenesis of symptoms in IBS and have provided some hints towards the basic etiology of this disorder, in some subpopulations, at the very least. We look forward to a time when therapy will be addressed to pathophysiology and perhaps, even to primary etiology. In the meantime, a model based on a primary role for intestinal inflammation serves to integrate the various strands, which contribute to the presentation of IBS
Moraru, Ioana G; Moraru, A G; Dumitraşcu, D L
Irritable bowel syndrome, one of the most common functional gastro intestinal disorders all over the world is considered to have a multi factorial pathogenesis. Recently more and more studies are focusing on the changes that take place in the microbiota of patients with irritable bowel syndrome, underlining the bacterial role in this pathogenesis. As a consequence, bacterial overgrowth, along with intestinal dysmotility, altered brain-gut axis and genetic factors are considered part of this pathophysiology. This report intends to summarize the actual knowledge on irritable bowel syndrome and small intestinal bacterial overgrowth syndrome, from details on the epidemiology, clinical manifestation, pathophysiology, diagnosis, treatment to details on the relationship between these two syndromes. PMID:26076568
Calculating Total Health Service Utilisation and Costs from Routinely Collected Electronic Health Records Using the Example of Patients with Irritable Bowel Syndrome Before and After Their First Gastroenterology Appointment
Canavan,Caroline; West, Joe; Card, Timothy
Introduction Health economic models are increasingly important in funding decisions but most are based on data, which may therefore not represent the general population. We sought to establish the potential of real-world data available within the Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES) to determine comprehensive healthcare utilisation and costs as input variables for economic modelling. Methods A cohort of patients with irritable bowel syndrome ...
Uday C. Ghoshal
Full Text Available Progress in the understanding of the pathophysiology of irritable bowel syndrome (IBS, once thought to be a purely psychosomatic disease, has advanced considerably and low-grade inflammation and changes in the gut microbiota now feature as potentially important. The human gut harbours a huge microbial ecosystem, which is equipped to perform a variety of functions such as digestion of food, metabolism of drugs, detoxification of toxic compounds, production of essential vitamins, prevention of attachment of pathogenic bacteria to the gut wall, and maintenance of homeostasis in the gastrointestinal tract. A subset of patients with IBS may have a quantitative increase in bacteria in the small bowel (small intestinal bacterial overgrowth. Qualitative changes in gut microbiota have also been associated with IBS. Targeting the gut microbiota using probiotics and antibiotics has emerged as a potentially effective approach to the treatment of this, hitherto enigmatic, functional bowel disorder. The gut microbiota in health, quantitative and qualitative microbiota changes, and therapeutic manipulations targeting the microbiota in patients with IBS are reviewed in this paper.
Full Text Available Context Health-related quality of life (HRQoL is increasingly important in the assessment of chronic conditions, especially for irritable bowel syndrome (IBS, which has no associated mortality, but is prevalent and significantly impacts patient’s lives. Disease-specific instruments such as the irritable bowel syndrome quality of life instrument (IBS-QOL, in addition to generic instruments such as the short form (SF-36, are useful in measuring health-related quality of life, and have been shown to be reliable in assessing disease severity and as an endpoint to monitor treatment response. We reviewed the impact of IBS on patients’ HRQoL, the factors causing HRQoL impairments, and the utility of HRQoL instruments in the assessment of IBS. Evidence Acquisition We performed electronic literature searches in Medline, the Cochrane library, and digestive disease week (DDW meeting abstracts. Across all databases searched, common keywords included “Irritable bowel syndrome”, “Quality of life” and “Health related quality of life”. For databases that accommodated Boolean searches, terms specifically related to QOL and military were added. Results We summarized the data available in the literature to show that HRQoL is poorer in patients with IBS compared to healthy controls, and compared to most serious chronic conditions. There are several factors that contribute to HRQoL impairments in IBS, of which gastrointestinal symptoms, physical co-morbidities, psychosocial factors and demographics all play significant roles. Conclusions It is crucial for clinicians to be aware of the importance of measuring HRQoL. Understanding the factors causing impairment of HRQoL is also important for clinicians seeing these patients as it helps to individualise treatment and treat the patient more holistically, to achieve greater patient satisfaction.
Irritable Bowel Syndrome (IBS) is a functional bowel disease characterized by abdominal pain or discomfort associated with a disordered defecation. No unique pathophysiological mechanism has been identified. It is most likely a multifactorial disease involving alterations in intestinal microbiota composition, intestinal mucosal barrier, serine protease and serotonergic signalling components which may play a role in the visceral hypersensitivity. We showed alterations in microbiota composition...
textabstractInfantile short bowel syndrome is a condition which is characterized by malabsorption of nutrients, as a result of congenital intestinal shortening or massive small bowel resection. Survival rates have improved over the years, but morbidity remains high and clinical management of these p
Full Text Available Brian E Lacy Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA Abstract: Irritable bowel syndrome (IBS is one of the most common gastrointestinal disorders worldwide. The economic impact of IBS on the health care system is substantial, as is the personal impact on patients. Patients with diarrhea-predominant IBS (IBS-D comprise a substantial proportion of the overall IBS population. Primary care providers are often the first point of contact for patients with IBS-D and can accurately diagnose IBS after a careful history and examination without extensive diagnostic tests. Several pharmacologic treatments (eg, loperamide, alosetron, and antidepressants and non-pharmacologic treatments (eg, dietary modification and probiotics are available for IBS-D, but restrictions on use (eg, alosetron or the lack of controlled trial data showing reductions in both global and individual IBS-D symptoms (eg, bloating, pain and stool frequency emphasize the need for alternative treatment options. Two newer medications (eluxadoline and rifaximin were approved in May 2015 for the treatment of IBS-D, and represent new treatment options for this common gastrointestinal condition. Keywords: abdominal pain, antibiotic, bloating, diarrhea, irritable bowel syndrome
Dianna Ramírez Prada
Full Text Available Case: The objective is to present the successful experience of multidisciplinary management of a patient with short bowel syndrome and intestinal failure with progression to intestinal adaptation. This is a newly born premature with intestinal atresia type IV with multiple intestinal atresia who evolved to intestinal failure and required managed with prolonged parenteral nutritional support, multiple antibiotic schemes, prebiotics, multivitamins, enteral nutrition with elemental formula to achieve their adaptation intestinal until lead to a normal diet. The evolution of these patients intestinal failure is a challenge for the health team, as it not only involves the surgical management of your condition if not basic nutritional support, fluid and electrolyte balance, hepatic dysfunction cholestasis associated infections etc. Discussion: Short bowel syndrome with progression to intestinal failure in children is a condition whose prevalence is increasing worldwide, thanks to advances in neonatal intensive care, neonatal surgery, and nutritional support of patients with conditions such as gastroschisis, omphalocele and necrotizing enterocolitis. Despite the limitations of our health system, it is possible to offer a multidisciplinary and integrated to lead to intestinal adaptation treatment.
Differential Activation in Amygdala and Plasma Noradrenaline during Colorectal Distention by Administration of Corticotropin-Releasing Hormone between Healthy Individuals and Patients with Irritable Bowel Syndrome
Tanaka, Yukari; Kanazawa, Motoyori; Kano, Michiko; Morishita, Joe; Hamaguchi, Toyohiro; Van Oudenhove, Lukas; Ly, Huynh Giao; Dupont, Patrick; Tack, Jan; Yamaguchi, Takuhiro; Yanai, Kazuhiko; Tashiro, Manabu; Fukudo, Shin
Irritable bowel syndrome (IBS) often comorbids mood and anxiety disorders. Corticotropin-releasing hormone (CRH) is a major mediator of the stress response in the brain-gut axis, but it is not clear how CRH agonists change human brain responses to interoceptive stimuli. We tested the hypothesis that brain activation in response to colorectal distention is enhanced after CRH injection in IBS patients compared to healthy controls. Brain H215O- positron emission tomography (PET) was performed in 16 male IBS patients and 16 age-matched male controls during baseline, no distention, mild and intense distention of the colorectum using barostat bag inflation. Either CRH (2 μg/kg) or saline (1:1) was then injected intravenously and the same distention protocol was repeated. Plasma adrenocorticotropic hormone (ACTH), serum cortisol and plasma noradrenaline levels were measured at each stimulation. At baseline, CRH without colorectal distention induced more activation in the right amygdala in IBS patients than in controls. During intense distention after CRH injection, controls showed significantly greater activation than IBS patients in the right amygdala. Plasma ACTH and serum cortisol secretion showed a significant interaction between drug (CRH, saline) and distention. Plasma noradrenaline at baseline significantly increased after CRH injection compared to before injection in IBS. Further, plasma noradrenaline showed a significant group (IBS, controls) by drug by distention interaction. Exogenous CRH differentially sensitizes brain regions of the emotional-arousal circuitry within the visceral pain matrix to colorectal distention and synergetic activation of noradrenergic function in IBS patients and healthy individuals. PMID:27448273
Full Text Available Objective: to study the psychological characteristics of patients with irritable bowel syndrome (IBS, ulcerative colitis (UC, Crohn's disease (CD. Material and methods. The study group included 98 patients with IBD (inflammatory bowel disease and IBS, the control group included 30 healthy individuals. Set of psychological tests included questionnaire (multifactorial systemic examination of the person, the Luscher color test, Beck Depression Inventory, a test on health, activity, mood. Results. Premorbid personality traits, communication disorders with stress have been revieled. According to the nosology different types of emotional response to the disease, changes in health and activity have been marked. There is a high level of frustration needs, increased frequency of anxiety and depression in all patients. Conclusion. Psychological mechanisms of pathology are similar in functional and organic bowel diseases with the greatest influence on the course of functional disorders.