WorldWideScience

Sample records for bowel cancer syndrome

  1. Small-bowel cancer in Lynch syndrome : is it time for surveillance?

    NARCIS (Netherlands)

    Koornstra, Jan J.; Kleibeuker, Jan H.; Vasen, Hans F. A.

    Small-bowel cancer is part of the tumour spectrum of Lynch syndrome. Lynch syndrome, or hereditary non-polyposis colorectal cancer, is caused by germline mutations in one of the mismatch repair genes. Mutation carriers have an estimated lifetime risk for the development of small-bowel cancer of

  2. Late radiation-induced bowel syndromes, tobacco smoking, age at treatment and time since treatment - gynecological cancer survivors.

    Science.gov (United States)

    Steineck, Gunnar; Sjöberg, Fei; Skokic, Viktor; Bull, Cecilia; Wilderäng, Ulrica; Alevronta, Eleftheria; Dunberger, Gail; Bergmark, Karin; Jörnsten, Rebecka

    2017-05-01

    It is unknown whether smoking; age at time of radiotherapy or time since radiotherapy influence the intensity of late radiation-induced bowel syndromes. We have previously identified 28 symptoms decreasing bowel health among 623 gynecological-cancer survivors (three to twelve years after radiotherapy) and 344 matched population-based controls. The 28 symptoms were grouped into five separate late bowel syndromes through factor analysis. Here, we related possible predictors of bowel health to syndrome intensity, by combining factor analysis weights and symptom frequency on a person-incidence scale. A strong (p bowel health among gynecological-cancer survivors. Furthermore, by understanding the mechanism for the decline in urgency-syndrome intensity over time, we may identify new strategies for prevention and alleviation.

  3. Short bowel syndrome

    International Nuclear Information System (INIS)

    Engels, L.G.J.B.

    1983-01-01

    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.)

  4. Irritable Bowel Syndrome

    Science.gov (United States)

    ... your belly area), constipation (when you can't poop), and diarrhea (when you poop too much). If you have irritable bowel syndrome, ... food particles are also known as stool, a bowel movement, or poop. Here's why an intestine gets "irritable." ...

  5. Diagnosis of Irritable Bowel Syndrome

    Science.gov (United States)

    ... of digestive diseases, such as celiac disease , colon cancer , or inflammatory bowel disease medicines you take recent infections stressful events ... of digestive diseases, such as celiac disease, colon cancer, or inflammatory bowel disease whether you have symptoms that could be ...

  6. Bowel Endometriosis Syndrome

    DEFF Research Database (Denmark)

    Riiskjær, M; Egekvist, A G; Hartwell, D

    2017-01-01

    STUDY QUESTION: Is it possible to develop a validated score that can identify women with Bowel Endometriosis Syndrome (BENS) and be used to monitor the effect of medical and surgical treatment? SUMMARY ANSWER: The BENS score can be used to identify women with BENS and to monitor the effect...... of medical and surgical treatment of women suffering from bowel endometriosis. WHAT IS KNOWN ALREADY: Endometriosis is a heterogeneous disease with extensive variation in anatomical and clinical presentation, and symptoms do not always correspond to the disease burden. Current endometriosis scoring systems...... are mainly based on anatomical and surgical findings. STUDY DESIGN, SIZE, DURATION: The score was developed and validated from a cohort of 525 women with medically or surgically treated bowel endometriosis from Aarhus and Copenhagen University Hospitals, Denmark. PARTICIPANTS/MATERIALS, SETTING AND METHODS...

  7. Short bowel syndrome.

    LENUS (Irish Health Repository)

    Donohoe, Claire L

    2012-02-01

    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.

  8. Irritable bowel syndrome

    Science.gov (United States)

    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.

    2016-01-01

    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

  9. Intestinal Failure (Short Bowel Syndrome)

    Science.gov (United States)

    Intestinal Failure (Short Bowel Syndrome) What is intestinal failure? Intestinal failure occurs when a significant portion of the small ... intestine does. Who is at risk for intestinal failure? N Babies (usually premature) who have had surgery ...

  10. Diet in irritable bowel syndrome

    OpenAIRE

    El-Salhy, Magdy; Gundersen, Doris Irene

    2015-01-01

    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...

  11. Treatment of irritable bowel syndrome.

    Science.gov (United States)

    Hadley, Susan K; Gaarder, Stephen M

    2005-12-15

    Irritable bowel syndrome affects 10 to 15 percent of the U.S. population to some degree. This condition is defined as abdominal pain and discomfort with altered bowel habits in the absence of any other mechanical, inflammatory, or biochemical explanation for these symptoms. Irritable bowel syndrome is more likely to affect women than men and is most common in patients 30 to 50 years of age. Symptoms are improved equally by diets supplemented with fiber or hydrolyzed guar gum, but more patients prefer hydrolyzed guar gum. Antispasmodic agents may be used as needed, but anticholinergic and other side effects limit their use in some patients. Loperamide is an option for treatment of moderately severe diarrhea. Antidepressants have been shown to relieve pain and may be effective in low doses. Trials using alosetron showed a clinically significant, although modest, gain over placebo, but it is indicated only for women with severe diarrhea-predominant symptoms or for those in whom conventional treatment has failed. Tegaserod has an advantage over placebo in constipation-predominant irritable bowel syndrome; it is indicated for up to 12 weeks of treatment in women. However, postmarketing reports of severe diarrhea and ischemic colitis further limit its use. Herbal therapies such as peppermint oil also may be effective in the treatment of irritable bowel syndrome. Therapies should focus on specific gastrointestinal dysfunctions (e.g., constipation, diarrhea, pain), and medications only should be used when nonprescription remedies do not work or when symptoms are severe.

  12. Irritable Bowel Syndrome

    Science.gov (United States)

    ... quality of life. Research indicates that people with IBS miss three times as many days from work as do those without bowel symptoms. Mood disorders. Experiencing the signs and symptoms of IBS can ...

  13. Definition and Facts for Irritable Bowel Syndrome

    Science.gov (United States)

    ... For Health Professionals Diabetes Discoveries & Practice Blog Health Communication Programs FAQs ... Syndrome (IBS) Definition & Facts Related Topics Section Navigation Irritable Bowel Syndrome ( ...

  14. Irritable Bowel Syndrome

    Science.gov (United States)

    ... Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Diverticular Disease Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Dumping Syndrome ...

  15. Bombesin in short bowel syndrome.

    Science.gov (United States)

    Uluutku, Ahmet Haldun; Akin, Mehmet Levhi; Kurt, Yavuz; Yucel, Ergun; Cermik, Hakan; Avsar, Kadir; Celenk, Tuncay

    2004-01-01

    Short bowel syndrome comprises the sequel of nutrient, fluid, and weight loss that occurs subsequent to greatly reduced functional surface area of the small intestine. The aim of this study is to investigate the trophic and functional effects of bombesin on remaining gut in rats with experimentally induced short bowel syndrome. Thirty-two rats were allocated randomly and experimental short bowel syndrome was induced by 80% bowel resection in all rats. A regular enteral diet and isocaloric elemental enteral nutrition for 12 days were given in the control group and the elemental nutrition group, respectively. In the bombesin group 10 microg/kg subcutaneous bombesin (t.i.d.) for 10 days with regular enteral diet for 12 days was given. In the elemental nutrition and bombesin group the diet consisted of 10 microg/kg subcutaneous bombesin (t.i.d.) for 10 days with isocaloric elemental enteral nutrition for 12 days was given. All rats underwent physical, histological, and biochemical evaluation. Reduction in weight loss, bowel diameter, fecal fat content, and glycemia, increase in cellularity, and d-xylose absorption were observed in all treatment groups. These changes were more evident in the bombesin treatment groups. Increases in serum protein and albumin levels were seen with bombesin treatment with or without elemental diet, whereas reductions in villous height and crypt depth were observed only with bombesin treatment without elemental diet. Serum calcium, iron, and vitamin B(12) levels were not affected with any treatment. It is concluded that bombesin may be a useful trophic agent contributing to increased absorptive capacity and improved biochemical values even in the absence of elemental nutrition.

  16. Irritable bowel syndrome

    Science.gov (United States)

    ... stimulate the intestines (such as caffeine, tea, or colas) Eating smaller meals Increasing fiber in the diet ( ... not lead to a serious disease, such as cancer. When to Contact a Medical Professional Call your ...

  17. Irritable bowel syndrome: contemporary nutrition management strategies.

    Science.gov (United States)

    Mullin, Gerard E; Shepherd, Sue J; Chander Roland, Bani; Ireton-Jones, Carol; Matarese, Laura E

    2014-09-01

    Irritable bowel syndrome is a complex disorder whose pathophysiology involves alterations in the enteric microbiota, visceral hypersensitivity, gut immune/barrier function, hypothalamic-pituitary-adrenal axis regulation, neurotransmitters, stress response, psychological factors, and more. The importance of diet in the management of irritable bowel syndrome has taken center stage in recent times as the literature validates the relationship of certain foods with the provocation of symptoms. Likewise, a number of elimination dietary programs have been successful in alleviating irritable bowel syndrome symptoms. Knowledge of the dietary management strategies for irritable bowel syndrome will help guide nutritionists and healthcare practitioners to deliver optimal outcomes. This tutorial reviews the nutrition management strategies for irritable bowel syndrome. © 2014 American Society for Parenteral and Enteral Nutrition.

  18. Mesenteric ischemia after capecitabine treatment in rectal cancer and resultant short bowel syndrome is not an absolute contraindication for radical oncological treatment

    International Nuclear Information System (INIS)

    Perpar, Ana; Brecelj, Erik; Kozjek, Nada Rotovnik; Anderluh, Franc; Oblak, Irena; Vidmar, Marija Skoblar; Velenik, Vaneja

    2015-01-01

    Thrombotic events, arterial or venous in origin, still remain a source of substantial morbidity and mortality in cancer patients. The propensity for their development in oncology patients is partially a consequence of the disease itself and partially a result of our attempts to treat it. One of the rarest and deadliest thromboembolic complications is arterial mesenteric ischemia. The high mortality rate is caused by its rarity and by its non-specific clinical presentation, both of which make early diagnosis and treatment difficult. Hence, most diagnoses and treatments occur late in the course of the disease. The issue survivors of arterial mesenteric ischemia may face is short bowel syndrome, which has become a chronic condition after the introduction of parenteral nutrition at home. We present a 73-year-old rectal cancer patient who developed acute arterial mesenteric thrombosis at the beginning of the pre-operative radiochemotherapy. Almost the entire length of his small intestine, except for the proximal 50 cm of it, and the ascending colon had to be resected. After multiorgan failure his condition improved, and he was able to successfully complete radical treatment (preoperative radiotherapy and surgery) for the rectal carcinoma, despite developing short bowel syndrome (SBS) and being dependent upon home-based parenteral nutrition to fully cover his nutritional needs. Mesenteric ischemia and resultant short bowel syndrome are not absolute contraindications for radical oncological treatment since such patients can still achieve long-term remission

  19. Probiotics and irritable bowel syndrome.

    Science.gov (United States)

    Dai, Cong; Zheng, Chang-Qing; Jiang, Min; Ma, Xiao-Yu; Jiang, Li-Juan

    2013-09-28

    Irritable bowel syndrome (IBS) is common gastrointestinal problems. It is characterized by abdominal pain or discomfort, and is associated with changes in stool frequency and/or consistency. The etiopathogenesis of IBS may be multifactorial, as is the pathophysiology, which is attributed to alterations in gastrointestinal motility, visceral hypersensitivity, intestinal microbiota, gut epithelium and immune function, dysfunction of the brain-gut axis or certain psychosocial factors. Current therapeutic strategies are often unsatisfactory. There is now increasing evidence linking alterations in the gastrointestinal microbiota and IBS. Probiotics are living organisms which, when ingested in certain numbers, exert health benefits beyond inherent basic nutrition. Probiotics have numerous positive effects in the gastrointestinal tract. Recently, many studies have suggested that probiotics are effective in the treatment of IBS. The mechanisms of probiotics in IBS are very complex. The purpose of this review is to summarize the evidence and mechanisms for the use of probiotics in the treatment of IBS.

  20. Irritable Bowel Syndrome and Complementary Health Practices

    Science.gov (United States)

    ... may decrease the severity of IBS symptoms, including psychological distress, compared to attending a support group. The ... management of irritable bowel syndrome: a comprehensive review. World Journal of Gastroenterology . 2012;18(7):589–600. ...

  1. Modern treatment of short bowel syndrome

    DEFF Research Database (Denmark)

    Jeppesen, Palle B

    2013-01-01

    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....

  2. Small bowel endoscopy in familial adenomatous polyposis and Lynch syndrome

    NARCIS (Netherlands)

    Koornstra, Jan Jacob

    Patients with familial adenomatous polyposis (FAP) and patients with Lynch syndrome have an increased risk of developing small intestinal neoplasia. In both conditions, the lifetime risk to develop small bowel cancer is estimated to be around 5%. In FAP, this risk is associated with the degree of

  3. Treatment of postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome with mesalazine

    Directory of Open Access Journals (Sweden)

    Mauro Bafutto

    2011-03-01

    Full Text Available CONTEXT: Recent studies support the hypothesis that postinfectious irritable bowel syndrome and some irritable bowel syndrome patients display persistent signs of minor mucosal inflammation. Mesalazine has intestinal anti-inflammatory properties including cyclooxygenase and prostaglandin inhibition. The effects of mesalazine on postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome patients are still unknown. OBJECTIVE: To observe the effects of mesalazine on postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome with diarrhea patients. METHODS: Based on Rome III criteria, 61 irritable bowel syndrome with diarrhea patients (18 years old or more were included in the evaluation. Patients were divided into two groups: postinfectious irritable bowel syndrome group, with 18 patients medicated with mesalazine 800 mg 3 times a day for 30 days; noninfective irritable bowel syndrome group, with 43 patients medicated with mesalazine 800 mg 3 times a day for 30 days. Symptom evaluations at baseline and after treatment were performed by means of a four-point Likert scale including stool frequency, stool form and consistency (Bristol Stool Scale, abdominal pain and distension (maximum score: 16; minimum score: 4. RESULTS: Postinfectious irritable bowel syndrome group presented a statistically significant reduction of the total symptom score (P<0.0001. The stool frequency was significantly reduced (P<0.0001, and stool consistency, improved (P<0.0001. Abdominal pain (P<0.0001 and abdominal distension were significantly reduced (P<0.0001. Noninfective irritable bowel syndrome group presented a statistically significant reduction of total symptom score (P<0.0001. Also, the stool frequency was significantly reduced (P<0.0001 and stool consistency, improved (P<0.0001. Abdominal pain (P<0.0001 and abdominal distention were significantly reduced (P<0.0001. There was no statistical difference between

  4. Intestino Corto Short bowel syndrome

    Directory of Open Access Journals (Sweden)

    María Matilde Socarrás Suárez

    2004-06-01

    Full Text Available El intestino corto está asociado a pérdida o disfunción del intestino delgado por resección del mismo, que causa diarreas, tránsito intestinal acelerado, malabsorción intestinal, y eventualmente la pérdida de peso y el desgaste muscular. El objetivo de este trabajo fue actualizar el conocimiento acerca de este síndrome. Se realiza una revisión del tema de intestino corto donde se refiere a su definición, causas fundamentales frecuentes e infrecuentes en el niño y en el adulto, cómo se adapta el intestino a la resección de diferentes extensiones, las funciones del íleon terminal. Se hacen una valoración clínica inicial, con el interrogatorio médico, revisión minuciosa de la historia clínica para cuantificar la capacidad de absorción. Se habla de los síntomas y signos de deficiencia nutricional. Se explican las estrategias del tratamiento, que tienen 3 etapas de evolución clínica. Se concluye que se indica la dietoterapia adecuada según el estado nutricional del paciente y la resección intestinal realizada, evitando las complicaciones para lograr una calidad máxima de vidaShort bowel is associated with loss or dysfunction of the small bowel due to its resection, which causes diarrheas, accelerated intestinal transit, intestinal malabsorption and, eventually, weight loss ansd muscular waste. The objective of this paper was to update knowledge about this syndrome. A review of the short intestine topic is made, making reference to its definition, common and uncommon main cuases in the child and adult, how the bowel adapts itslef to resection of different extensions, and the functions of the terminal ileum. An initial clinical assessment is made with the medical questionnaire and a detailed review of the medical history to quantify the absorption capacity. The symptoms and signs of nutritional deficiency are dealt with. The strategies of the treatment consisting of 3 stages of clinical evolution are explained. It is concluded

  5. [Parasitosis and irritable bowel syndrome].

    Science.gov (United States)

    Ibarra, Catalina; Herrera, Valentina; Pérez de Arce, Edith; Gil, Luis Carlos; Madrid, Ana María; Valenzuela, Lucía; Beltrán, Caroll J

    2016-06-01

    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.

  6. Irritable bowel syndrome: Is it "irritable brain" or "irritable bowel"?

    Directory of Open Access Journals (Sweden)

    Susanta Kumar Padhy

    2015-01-01

    Full Text Available Irritable bowel syndrome (IBS has been recognized as one of the most common and best studied disorders among the group of functional gastrointestinal disorders. It is a functional bowel disorder in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. In the Western world, IBS appears to affect up to 20% of the population at any given time but in Asian countries, the median value of IBS prevalence defined by various criteria ranges between 6.5% and 10.1%, and community prevalence of 4% is found in North India. Those attending gastroenterology clinics represent only the tip of the iceberg. The disorder substantially impairs the quality of life, and the overall health-care costs are high. IBS has therefore gained increased attention from clinicians, researchers, and pharmaceutical industries. It is often frustrating to both patients and physicians as the disease is usually chronic in nature and difficult to treat. However, the understanding of IBS has been changing from time to time and still most of its concepts are unknown. In this review we have discussed, debated, and synthesized the evidence base, focusing on underlying mechanisms in the brain and bowel. We conclude that it is both brain and bowel mechanisms that are responsible. The clinical implication of such mechanisms is discussed.

  7. Towards an integrated psychoneurophysiological approach of irritable bowel syndrome

    NARCIS (Netherlands)

    Veek, Patrick Petrus Johannes van der

    2009-01-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by recurrent abdominal pain or discomfort accompanied by disturbed bowel habits. It is among the most frequently occurring functional bowel syndromes, but the pathophysiology is poorly understood. A variety of mechanisms

  8. Bowel-associated dermatosis-arthritis syndrome in an adolescent with short bowel syndrome.

    Science.gov (United States)

    Pereira, Ester; Estanqueiro, Paula; Almeida, Susana; Ferreira, Ricardo; Tellechea, Oscar; Salgado, Manuel

    2014-09-01

    Bowel-associated dermatosis-arthritis syndrome (BADAS) is a neutrophilic dermatosis, characterized by the occurrence of arthritis and skin lesions related to bowel disease with or without bowel bypass. We report an unusual case of BADAS in a 15-year-old white male with congenital aganglionosis of the colon and hypoganglionosis of the small intestine and multiple bowel surgeries in childhood complicated by short bowel syndrome. He presented with recurrent peripheral polyarthritis, tenosynovitis, and painful erythematous subcutaneous nodules located on the dorsolateral regions of the legs and on the dorsa of the feet. Histological examination disclosed a neutrophilic dermatosis confirming the diagnosis of BADAS.Although an uncommon disease, especially at pediatric age, it is important to evoke the diagnosis of BADAS in children and adolescents with bowel disease, because treatment options and prognosis are distinct from other rheumatologic conditions.

  9. Role of alimentation in irritable bowel syndrome

    NARCIS (Netherlands)

    Dapoigny, M.; Stockbrügger, R. W.; Azpiroz, F.; Collins, S.; Coremans, G.; Müller-Lissner, S.; Oberndorff, A.; Pace, F.; Smout, A.; Vatn, M.; Whorwell, P.

    2003-01-01

    BACKGROUND: Different food items are made responsible for irritable bowel syndrome (IBS) symptoms, but the physiopathology of IBS remains unclear. AIMS: During a meeting in Nice, France, experts of the European Working Team of the IBiS Club discussed selected data regarding the relationships between

  10. Review of Irritable Bowel Syndrome Treatment

    Directory of Open Access Journals (Sweden)

    Ghadir M.R.

    2010-06-01

    Full Text Available Background and Objectives: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders striking 10-20% of the world population. Although most patients do not take medical assistance, this disease enforces significant cost on the patient and health systems and has negative effects on quality of life of the individual. After diagnosis ,treatment of this disease is the next step. Many pathways of treatment has been introduced and the efficacy of each other has been established in one way or another. The first step in the path of treatment is education and confidence of patients that might also be the most important step. Fiber diet, probiotic, anti-cholinergic and anti antispasmodics, laxatives, anti-diarrhea, the drugs affecting serotonin receptors, antidepressants and anti-anxiety, the chloride channel activator and non-drug methods such as cognitive-behavior therapy, hypnotherapy, acupuncture and herbal medicine each of which has been tested on irritable bowel syndrome and efficacy of each one has been indicated in one way or another. This paper tried to outline new treatments available in addition to categorization and discussion of various treatments for irritable bowel syndrome.Keywords: Irritable Bowel Syndrome; Probiotics; Parasmpatholytics; Laxatives.

  11. Visceral hypersensitivity in Irritable Bowel Syndrome:pathophysiological mechanisms

    NARCIS (Netherlands)

    Kerckhoffs, A.P.M.

    2009-01-01

    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

  12. Dietary fiber in irritable bowel syndrome (Review)

    OpenAIRE

    El-Salhy, Magdy; Ystad, Synne Otterasen; Mazzawi, Tarek; Gundersen, Doris

    2017-01-01

    Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. It is widely believed that IBS is caused by a deficient intake of dietary fiber, and most physicians recommend that patients with IBS increase their intake of dietary fiber in order to relieve their symptoms. However, different types of dietary fiber exhibit marked differences in physical and chemical properties, and the associated health benefits are specific for each fiber type. Short-chain soluble and highly ferm...

  13. Irritable bowel syndrome and its psychological management

    Directory of Open Access Journals (Sweden)

    Ravikesh Tripathi

    2015-01-01

    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.

  14. Inflammatory bowel disease and irritable bowel syndrome: similarities and differences.

    Science.gov (United States)

    Barbara, Giovanni; Cremon, Cesare; Stanghellini, Vincenzo

    2014-07-01

    Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are classically viewed as dichotomous conditions. The former is perceived as a typical organic disease, and the latter is regarded as a disorder of gut function driven by mood. Recent research identified some shared contributing factors, which will be discussed here. Mounting evidence shows the importance in both IBD and IBS of genetic, microbiological, epithelial, and immunological factors. In some instances, these factors overlap in the two conditions as shown by: involvement of brain-gut axis dysfunction in IBD, implication of TNFSF gene in Crohn's disease and IBS, evidence of abnormal microbiota and its impact on host functions, identification of low-grade inflammation in subsets of IBS patients, and development of IBS symptoms in patients with IBD in remission. IBD and IBS remain separate conditions although there are some overlapping mechanisms. Both research and clinical management would benefit from considering a functional approach for certain manifestations of IBD and accepting an organic view in subsets of IBS patients.

  15. Psychological factors in the irritable bowel syndrome.

    Science.gov (United States)

    Solmaz, M; Kavuk, I; Sayar, K

    2003-12-09

    The role of psychological factors in the irritable bowel syndrome (IBS) is a matter of debate. The prevalence of psychiatric disorders is high in IBS patients. Positive response to antidepressant therapy and presence of family history of depression in IBS patients have led speculations whether this syndrome might be regarded as an affective spectrum disorder. In this study we tried to examine the possible association of IBS with affective spectrum disorders. Forty IBS patients from gastroenterology outpatient clinics of a university hospital and state hospital, 32 controls with inflammatory bowel disease and 34 healthy hospital workers were included in the study. Psychiatric interviews were done using SCID-NP (Structured Clinical Interview for DSM-Non-patients) and psychological factors were assessed by the SCL-90-R (Symptom Checklist-90-Revised), the Beck Depression Inventory, the Beck Anxiety Scale and the Hamilton Rating Scale for Depression. Family histories were obtained by FH-RDC (Family History Research Diagnostic Criteria). All groups were matched for sociodemographic variables. The prevalence of psychiatric disorders and mood disorders was higher in the IBS group than the control groups. Also IBS group rated higher on anxiety and depression scales than the other groups, where the differences were statistically significant. Presence of positive family history for mood disorders was higher in the IBS group. These results support the hypothesis that IBS might be linked to affective spectrum disorder. Psychiatric assessment and therapy might be useful in the course of irritable bowel syndrome.

  16. Review of Irritable Bowel Syndrome Treatment

    Directory of Open Access Journals (Sweden)

    M.R Ghadir

    2012-05-01

    Full Text Available

    Background and Objectives: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders striking 10-20% of the world population. Although most patients do not take medical assistance, this disease enforces significant cost on the patient and health systems and has negative effects on quality of life of the individual. After diagnosis ,treatment of this disease is the next step. Many pathways of treatment has been introduced and the efficacy of each other has been established in one way or another. The first step in the path of treatment is education and confidence of patients that might also be the most important step. Fiber diet, probiotic, anti-cholinergic and anti antispasmodics, laxatives, anti-diarrhea, the drugs affecting serotonin receptors, antidepressants and anti-anxiety, the chloride channel activator and non-drug methods such as cognitive-behavior therapy, hypnotherapy, acupuncture and herbal medicine each of which has been tested on irritable bowel syndrome and efficacy of each one has been indicated in one way or another. This paper tried to outline new treatments available in addition to categorization and discussion of various treatments for irritable bowel syndrome.

  17. The epidemiology of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Canavan C

    2014-02-01

    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

  18. Bacteria, genetics and irritable bowel syndrome.

    LENUS (Irish Health Repository)

    Craig, Orla F

    2010-06-01

    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.

  19. Rapunzel Syndrome: a rare cause of acute small bowel obstruction ...

    African Journals Online (AJOL)

    The Rapunzel syndrome is a very rare condition where trichobezoar has extended up to the small bowel. Here we are reporting a rare case of Rapunzel syndrome in an adolescent girl with history of trichophagia who presented with small bowel obstruction. Patient underwent exploratory laparotomy and bezoar was ...

  20. Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome

    Science.gov (United States)

    Ross, Colin A.

    2005-01-01

    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…

  1. Familial Breast and Bowel Cancer: Does It Exist?

    Directory of Open Access Journals (Sweden)

    Scott Rodney J

    2004-02-01

    Full Text Available Abstract There is much debate in the literature about familial predispositions to breast and bowel cancers yet little evidence is forthcoming to suggest that there are susceptibility genes that can account for such kindreds. Within the context of known susceptibility genes the most controversial syndrome is hereditary non-polyposis colorectal cancer (HNPCC. In HNPCC, breast cancers do occur yet their incidence overall is no different to that of the general population yet when studied at the molecular level these tumours often display DNA microsatellite instability suggesting that they do indeed belong to this genetic entity. In this review we examine the relationship between breast and bowel cancer and suggest a possible explanation for the diverse points of view described in the literature.

  2. [Intelligence and irritable bowel syndrome].

    Science.gov (United States)

    Díaz-Rubio García, Manuel

    2006-01-01

    The Syndrome of Irritable Intestine (SII) is a chronic functional dysfunction that it is characterized by abdominal pain and changes of intestinal rhythm without demonstrable organic alteration. It is avery prevelent dysfunction in the developed countries, there being involved in its physiopathology, among other, the psychosocial factors (illness behavior, social situation, stress, vital events, neuroticism, anxiety and somatization). However no study has been carried out on the Rational Intelligence and Experiential Intelligence or Constructive Thought in patient with SII in spite of knowing that the cognitive processes participate in its genesis. On the hypothesis that the patients with SII would have an experiencial intelligence smaller that the fellows controls, 100 cases of SII and 100 controls have been studied, being excluded of both patients groups with intellectual deficit or psychiatric illness in the last year. The cases of SII were distributed in two groups, one of 50 cases that habitually consulted with the doctor and other 50 that didn't make it. All the participants completed specific tests to evaluate all the psychological factors and Rational Intelligence and the Constructive Thought. The results show an alteration of the psychological factors in the SII, expressed by the antecedents of vital events, m even significant of anxiety feature and anxiety and a neuroticism statistically significant. As for Rational Intelligence and Experiential Intelligence in the SII, it was observed that to Rational Intelligence is same in the patients with SII that in the controls. Only in the group of SII that habitually consulted with the doctor a slightly significant decrease of the intellectual coefficient it was observed. As for the Experiential Intelligence a significant decrease of the Constructive Thought was observed in the patients with SII in comparison with the group control. Of their components a decrease of the emotionality exists and of the

  3. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R

    1985-01-01

    with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were......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...

  4. [Pain therapy in irritable bowel syndrome].

    Science.gov (United States)

    de Greck, M; Layer, P; Andresen, V

    2014-06-01

    Irritable bowel syndrome (IBS) is one of the most common gastrointestinal diseases. It is characterized by chronic abdominal pain, typically associated with altered bowel habits that cannot be explained by structural abnormalities in routine diagnostic workup. Based on the predominant symptom, IBS can be divided into different subtypes: IBS with predominant constipation, diarrhea, bloating, or pain. Knowledge about the complex and multifactorial IBS pathophysiology has increased tremendously in recent years, e.g., IBS may be related to alterations in gastrointestinal motility, visceral sensitivity, and the mucosal immune system. It is important, both for the patient and the physician, that IBS diagnosis is made quickly and thoroughly based on the typical symptom complex and exclusion of relevant differential diagnoses and to reassure the patient that IBS is a chronic, but benign disease. These components are the fundamental basis for a good patient-physician relationship and for a successful long-term management of this potentially very compromising disorder. IBS therapy is based on general measures as well as symptom-oriented medical therapy, where improvement of abdominal pain is one of the main goals in treating IBS patients. Several pain treatment options are available, which may be used long-term or on demand and which may be combined with other therapies. General medical approaches include antispasmodics, improvement of bowel function, phytotherapy, and probiotics. Especially in patients with psychological comorbidities, antidepressants may be used. Modern drug treatments include the GC-C agonist linaclotide in IBS with predominant constipation, the locally acting antibiotic rifaximin in IBS with bloating, and 5-HT3 antagonists in IBS with predominant diarrhea. Psychotherapy should be included in an interdisciplinary approach in refractory cases or in psychological comorbidity.

  5. Sensory dysfunction and the irritable bowel syndrome.

    Science.gov (United States)

    Houghton, L A

    1999-10-01

    Dysfunction of the sensory system of the gut is now generally believed to be important in the pathophysiology of irritable bowel syndrome (IBS). This disturbance may well account for some of the symptoms of the disorder, such as abdominal pain, by virtue of the fact that intra-lumenal events (e.g. contractions) may be 'sensed' more easily. It can be assessed in the laboratory by a variety of techniques, but usually involves measuring the patient's response to distension of any site of the gut, most commonly the rectum. Hypersensitivity is the most frequent finding, but hyposensitivity can also occur--hypersensitivity does not appear to be specific to any particular pattern of bowel habit, but hyposensitivity does tend to be generally only seen in patients with constipation, especially those with the 'no urge' type. Although there is some evidence to support hypersensitivity being related to enhanced vigilance in some patients, other data suggest that there may be a true alteration in sensory processing. The mechanisms underlying this sensory dysfunction remain to be elucidated, but could involve changes in either the enteric, spinal and/or central nervous systems. Finally, factors such as gender, stress, emotion and infection can all influence the sensitivity of the gut and may therefore play a role in IBS.

  6. Is irritable bowel syndrome an infectious disease?

    Science.gov (United States)

    Thompson, John Richard

    2016-01-28

    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.

  7. Irritable bowel syndrome: Diagnosis and pathogenesis

    Science.gov (United States)

    El-Salhy, Magdy

    2012-01-01

    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. PMID:23066308

  8. [Importance of diet in irritable bowel syndrome].

    Science.gov (United States)

    Mearin, Fermín; Peña, Enrique; Balboa, Agustín

    2014-05-01

    About two-thirds of irritable bowel syndrome (IBS) patients associate their symptoms with certain foods. We reviewed food-related factors putatively associated with manifestations of IBS. Soluble fiber may improve constipation but frequently increases bloating and abdominal pain. Carbohydrate malabsorption seems to be more frequent in IBS. A low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet significantly reduces IBS symptoms and has been suggested as a therapeutic option. Serological screening for celiac disease should be done in patients without constipation. Moreover, non-celiac disease gluten sensitivity, defined as gluten intolerance once celiac disease and wheat allergy have been ruled out, should be considered in these patients. There is no specific diet for IBS patients but small and frequent meals, avoiding greasy foods, dairy products, many carbohydrates, caffeine and alcohol, is recommended. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  9. Irritable Bowel Syndrome: Yoga as Remedial Therapy

    Directory of Open Access Journals (Sweden)

    Vijaya Kavuri

    2015-01-01

    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.

  10. Infantile Short Bowel Syndrome: short and long term evaluation

    NARCIS (Netherlands)

    J.F. Olieman (Joanne)

    2009-01-01

    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

  11. Evaluation Of Irritable Bowel Syndrome Symptoms Amongst Warsaw University Students

    OpenAIRE

    Niemyjska Sylwia; Ukleja Anna; Ławiński Michał

    2015-01-01

    Irritable bowel syndrome (IBS) belongs to functional gastrointestinal disorders and is characterized by abdominal pain and change in stool consistency and/or bowel habits. Etiological factors include gastrointestinal peristalsis disturbances, visceral hypersensitivity, chronic inflammation of the mucous membrane, dysbacteremia, intestinal infections, psychosomatic and nutritional factors. Gastrointestinal motility disturbances in case of IBS are manifested by the inhibition of the intestinal ...

  12. Malignant bowel obstruction in advanced ovarian cancer.

    Science.gov (United States)

    Dean, Emma; Khoja, Leila; Clamp, Andrew; Jayson, Gordon C; Goonetilleke, Dilly; Conway, Alicia M; Hasan, Jurjees

    2017-03-01

    Malignant bowel obstruction (MBO) in ovarian cancer is poorly understood. This retrospective cohort study analyzed 129 patients with ovarian cancer and MBO. At presentation, 69 (53%) had platinum-resistant, 37 (29%) platinum-sensitive and 23 (18%) chemotherapy-naive disease. In patients receiving chemotherapy following the MBO episode, median overall survival (OS) was 107 days for chemotherapy-naive patients compared with 83 and 86 for platinum-sensitive or platinum-resistant patients (p = 0.98). OS was inferior for best supportive care (45 days) compared with chemotherapy (152 days) or surgery (124 days; p Bowel Obstruction Score using Eastern Cooperative Oncology Group and obstruction level discriminated patients by median OS of 181 days (neither) versus 98 days (one) versus 42 days (both; p Bowel Obstruction Score may aide treatment stratification.

  13. Irritable Bowel Syndrome in a Population of African Patients

    Directory of Open Access Journals (Sweden)

    Sylvester Chuks Nwokediuko

    2012-01-01

    Full Text Available Background. Functional dyspepsia is the prototype functional gastrointestinal disorder. This study was designed to determine its prevalence, subtypes, and risk factors associated with the subtypes. Method. Patients with upper gastrointestinal symptoms who presented for endoscopy were administered a questionnaire containing the functional dyspepsia and irritable bowel syndrome modules of the Rome III diagnostic criteria. Results. Of 192 patients who had functional dyspepsia, epigastric pain syndrome, postprandial distress syndrome, and combination of the two subtypes accounted for 79.2%, 62.5%, and 50%, respectively. Multivariate analysis of the risk factors showed that independent predictors of postprandial distress syndrome were alcohol and irritable bowel syndrome while irritable bowel syndrome was independent predictor of epigastric pain syndrome. Alcohol, smoking, and use of nonsteroidal anti-inflammatory drugs were independent predictors of cooccurrence of postprandial distress syndrome and epigastric pain syndrome. Conclusion. Functional dyspepsia accounts for 62.5% of dyspepsia in a population of black African patients. Regarding symptomatology, epigastric pain syndrome, postprandial distress syndrome, and combination of the two subtypes account for 79.2%, 62.5%, and 50%, respectively. Risk factors for functional dyspepsia are irritable bowel syndrome, alcohol, smoking, and use of nonsteroidal anti-inflammatory drugs.

  14. Surgical management and autologous intestinal reconstruction in short bowel syndrome

    NARCIS (Netherlands)

    Hommel, Matthijs J.; van Baren, Robertine; Haveman, Jan Willem

    Short bowel syndrome (SBS) is a serious condition with considerable morbidity and mortality. When treatment with parenteral nutrition fails and life-threatening complications occur, autologous intestinal reconstruction (AIR) should be considered before intestinal transplantation (ITx). Single or

  15. Case Study: The dietary management of irritable bowel syndrome ...

    African Journals Online (AJOL)

    , Dianne Ivison. Abstract. Keywords: irritable bowel syndrome, functional gastrointestinal disorders, FODMAPs, probiotics. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  16. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, J H; Munck, Lars K; Andersen, J R

    1985-01-01

    with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...

  17. Is surveillance of the small bowel indicated for Lynch syndrome families?

    NARCIS (Netherlands)

    ten Kate, G. L.; Kleibeuker, J. H.; Nagengast, F. M.; Craanen, M.; Cats, A.; Menko, F. H.; Vasen, H. F. A.

    Background: Small bowel cancer (SBC) is one of the tumours associated with Lynch syndrome (LS). To advise on screening for this tumour it is paramount to be informed about the lifetime risk. The aim of this study was to calculate the lifetime risk of SBC in LS and to identify possible risk factors.

  18. Altered gastric emptying in patients with irritable bowel syndrome

    Energy Technology Data Exchange (ETDEWEB)

    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)

    1999-04-29

    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.

  19. Altered gastric emptying in patients with irritable bowel syndrome

    International Nuclear Information System (INIS)

    Caballero-Plasencia, A.M.; Valenzuela-Barranco, M.; Herrerias-Gutierrez, J.M.; Esteban-Carretero, J.M.

    1999-01-01

    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.)

  20. The Immune System in Irritable Bowel Syndrome

    Science.gov (United States)

    Cremon, Cesare; Carini, Giovanni; Bellacosa, Lara; Zecchi, Lisa; De Giorgio, Roberto; Corinaldesi, Roberto; Stanghellini, Vincenzo

    2011-01-01

    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 small and large intestine of patients with IBS is increased in a large proportion of patients with IBS over healthy controls. Mediators released by immune cells and likely from other non-immune competent cells impact on the function of enteric and sensory afferent nerves as well as on epithelial tight junctions controlling mucosal barrier of recipient animals, isolated human gut tissues or cell culture systems. Antibodies against microbiota antigens (bacterial flagellin), and increased levels of cytokines have been detected systemically in the peripheral blood advocating the existence of abnormal host-microbial interactions and systemic immune responses. Nonetheless, there is wide overlap of data obtained in healthy controls; in addition, the subsets of patients showing immune activation have yet to be clearly identified. Gender, age, geographic differences, genetic predisposition, diet and differences in the intestinal microbiota likely play a role and further research has to be done to clarify their relevance as potential mechanisms in the described immune system dysregulation. Immune activation has stimulated interest for the potential identification of biomarkers useful for clinical and research purposes and the development of novel therapeutic approaches. PMID:22148103

  1. Irritable bowel syndrome and food interaction

    Science.gov (United States)

    Cuomo, Rosario; Andreozzi, Paolo; Zito, Francesco Paolo; Passananti, Valentina; De Carlo, Giovanni; Sarnelli, Giovanni

    2014-01-01

    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

  2. Dietary fiber in irritable bowel syndrome (Review)

    Science.gov (United States)

    El-Salhy, Magdy; Ystad, Synne Otterasen; Mazzawi, Tarek; Gundersen, Doris

    2017-01-01

    Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. It is widely believed that IBS is caused by a deficient intake of dietary fiber, and most physicians recommend that patients with IBS increase their intake of dietary fiber in order to relieve their symptoms. However, different types of dietary fiber exhibit marked differences in physical and chemical properties, and the associated health benefits are specific for each fiber type. Short-chain soluble and highly fermentable dietary fiber, such as oligosaccharides results in rapid gas production that can cause abdominal pain/discomfort, abdominal bloating/distension and flatulence in patients with IBS. By contrast, long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber, such as psyllium results in a low gas production and the absence of the symptoms related to excessive gas production. The effects of type of fiber have been documented in the management of IBS, and it is known to improve the overall symptoms in patients with IBS. Dietary fiber acts on the gastrointestinal tract through several mechanisms, including increased fecal mass with mechanical stimulation/irritation of the colonic mucosa with increasing secretion and peristalsis, and the actions of fermentation byproducts, particularly short-chain fatty acids, on the intestinal microbiota, immune system and the neuroendocrine system of the gastrointestinal tract. Fiber supplementation, particularly psyllium, is both safe and effective in improving IBS symptoms globally. Dietary fiber also has other health benefits, such as lowering blood cholesterol levels, improving glycemic control and body weight management. PMID:28731144

  3. Dietary fiber in irritable bowel syndrome (Review).

    Science.gov (United States)

    El-Salhy, Magdy; Ystad, Synne Otterasen; Mazzawi, Tarek; Gundersen, Doris

    2017-09-01

    Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. It is widely believed that IBS is caused by a deficient intake of dietary fiber, and most physicians recommend that patients with IBS increase their intake of dietary fiber in order to relieve their symptoms. However, different types of dietary fiber exhibit marked differences in physical and chemical properties, and the associated health benefits are specific for each fiber type. Short-chain soluble and highly fermentable dietary fiber, such as oligosaccharides results in rapid gas production that can cause abdominal pain/discomfort, abdominal bloating/distension and flatulence in patients with IBS. By contrast, long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber, such as psyllium results in a low gas production and the absence of the symptoms related to excessive gas production. The effects of type of fiber have been documented in the management of IBS, and it is known to improve the overall symptoms in patients with IBS. Dietary fiber acts on the gastrointestinal tract through several mechanisms, including increased fecal mass with mechanical stimulation/irritation of the colonic mucosa with increasing secretion and peristalsis, and the actions of fermentation byproducts, particularly short-chain fatty acids, on the intestinal microbiota, immune system and the neuroendocrine system of the gastrointestinal tract. Fiber supplementation, particularly psyllium, is both safe and effective in improving IBS symptoms globally. Dietary fiber also has other health benefits, such as lowering blood cholesterol levels, improving glycemic control and body weight management.

  4. Dysplasia and Cancer in Inflammatory Bowel Disease.

    Science.gov (United States)

    Huang, Lyen C; Merchea, Amit

    2017-06-01

    Inflammatory bowel disease is associated with an increased risk of dysplasia and cancer. Improvements in medical management and endoscopic surveillance have reduced these risks. Patients can develop cancer even in the absence of dysplasia or with indefinite or low-grade dysplasia. Most guidelines recommend starting surveillance colonoscopy 6 to 10 years after initial diagnosis with interval surveillance afterward every 1 to 5 years depending on risk and/or individual characteristics. Most patients should undergo total proctocolectomy with end ileostomy or reconstruction with ileal pouch anal anastomosis because segmental and subtotal resections carry a higher risk of metachronous cancers. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Inflammatory bowel disease and colorectal cancer

    Directory of Open Access Journals (Sweden)

    Andreja Ocepek

    2006-12-01

    Full Text Available Background: Colorectal cancer is one of the most frequent cancers in developed countries and Slovenia, and the incidence is still rising. Groups of people with higher risk for colorectal cancer are well defined. Among them are patients with inflammatory bowel disease. The risk is highest in patients in whom whole large bowel is affected by inflammation, it rises after 8 to 10 years and increases with the duration of the disease. Precancerous lesion is a displastic, chronically inflammed mucosa and not an adenoma as in cases of sporadic colorectal carcinoma.Conclusions: Many studies suggest that the influence of genetic factors differs between sporadic and inflammatory bowel disease related colorectal cancer. Symptomatic patients at the time of diagnosis have a much worse prognosis. The goal of prevention programes is therefore discovering early precancerous lesions. Established screening protocols are based on relatively frequent colonoscopies which are inconvinient for the patient as well as the endoscopist. Use of specific genetic markers, mutations of candidate genes, as a screening method and a prognostic predictor could greatly lighten therapeutic decisions.

  6. Irritable bowel syndrome: the burden and unmet needs in Europe.

    LENUS (Irish Health Repository)

    Quigley, E M M

    2012-02-03

    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.

  7. Effects of Hypericum perforatum extract on rat irritable bowel syndrome

    OpenAIRE

    Mozaffari, Shilan; Esmaily, Hadi; Rahimi, Roja; Baeeri, Maryam; Sanei, Yara; Asadi-Shahmirzadi, Azar; Salehi-Surmaghi, Mohammad-Hossein; Abdollahi, Mohammad

    2011-01-01

    Context: In irritable bowel syndrome (IBS), disturbance of bowel motility is associated with infiltration of inflammatory mediators and cytokines into the intestine, such as neutrophils, myeloperoxidase (MPO), tumor necrosis factor alfa (TNF-?), and lipid peroxide. Aims: Regarding promising anti-inflammatory and anti-oxidative effects of Hypericum perforatum (HP) extract, besides its anti-depressant effect, this study was designed to evaluate the effects of HP in an experimental model of IBS....

  8. Targeted therapies for diarrhea-predominant irritable bowel syndrome

    OpenAIRE

    Olden, Kevin W

    2012-01-01

    Kevin W OldenDepartment of Medicine, St Joseph's Hospital and Medical Center, Phoenix, AZ, USAAbstract: Irritable bowel syndrome (IBS) causes gastrointestinal symptoms such as abdominal pain, bloating, and bowel pattern abnormalities, which compromise patients' daily functioning. Common therapies address one or two IBS symptoms, while others offer wider symptom control, presumably by targeting pathophysiologic mechanisms of IBS. The aim of this targeted literature review was t...

  9. Immunomodulation of enteric neural function in irritable bowel syndrome

    OpenAIRE

    O’Malley, Dervla

    2015-01-01

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder which is characterised by symptoms such as bloating, altered bowel habit and visceral pain. It’s generally accepted that miscommunication between the brain and gut underlies the changes in motility, absorpto-secretory function and pain sensitivity associated with IBS. However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusi...

  10. Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome

    OpenAIRE

    Magge, Suma; Lembo, Anthony

    2012-01-01

    Functional bowel disorders, including irritable bowel syndrome (IBS), are common disorders that have a significant impact on patients’ quality of life. These disorders present major challenges to healthcare providers, as few effective medical therapies are currently available. Recently, there has been increasing interest in dietary therapies for IBS, particularly a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Since ingestion of FODMAPs incre...

  11. Role of alimentation in irritable bowel syndrome.

    Science.gov (United States)

    Dapoigny, M; Stockbrügger, R W; Azpiroz, F; Collins, S; Coremans, G; Müller-Lissner, S; Oberndorff, A; Pace, F; Smout, A; Vatn, M; Whorwell, P

    2003-01-01

    Different food items are made responsible for irritable bowel syndrome (IBS) symptoms, but the physiopathology of IBS remains unclear. During a meeting in Nice, France, experts of the European Working Team of the IBiS Club discussed selected data regarding the relationships between alimentation, food items (including fibers) and IBS symptoms. Food allergy remains a difficult diagnosis, but medical and general history, presence of general symptoms such as skin rash, and hypersensitivity tests may help in achieving a positive diagnosis. On the other hand, food intolerance is more confusing because of the subjectivity of the relationship between ingestion of certain foods and the appearance of clinical symptoms. Different food items which are commonly implicated in adverse reactions mimicking IBS were found to be stimulants for the gut, suggesting that patients with predominant diarrhea IBS have to be carefully questioned about consumption of different kinds of food (i.e., coffee, alcohol, chewing gum, soft drinks) and not only on lactose ingestion. Gas production is discussed on the basis of retention of intestinal gas as well as on malabsorption of fermentable substrates. The role of a large amount of this kind of substrate reaching the colon is suggested as a potential mechanism of IBS-type symptoms in overeating patients. Regarding the role of fiber in IBS, the expert group concluded that fibers are not inert substances and that they could trigger pain or bloating in some IBS patients. Despite numerous reviews on this subject, it is very difficult to give general dietary advice to IBS patients, but dieteticians may have a positive role in managing such patients. Copyright 2003 S. Karger AG, Basel

  12. The Mexican consensus on irritable bowel syndrome.

    Science.gov (United States)

    Carmona-Sánchez, R; Icaza-Chávez, M E; Bielsa-Fernández, M V; Gómez-Escudero, O; Bosques-Padilla, F; Coss-Adame, E; Esquivel-Ayanegui, F; Flores-Rendón, Á R; González-Martínez, M A; Huerta-Iga, F; López-Colombo, A; Méndez-Gutiérrez, T H; Noble-Lugo, A; Nogueira-de Rojas, J R; Raña-Garibay, R H; Remes-Troche, J M; Roesch-Dietlen, F; Schmulson, M J; Soto-Pérez, J C; Tamayo, J L; Uscanga, L F; Valdovinos, M Á; Valerio-Ureña, J; Zavala-Solares, M R

    2016-01-01

    Since the publication in 2009 of the Guidelines on the Diagnosis and Treatment of Irritable Bowel Syndrome of the Asociación Mexicana de Gastroenterología (2009 Guidelines), there have been significant advances in our knowledge of the epidemiology, pathophysiology, diagnosis, and treatment of this disease. To present a consensus review of the most current knowledge of IBS, updating the 2009 Guidelines by incorporating new internationally published scientific evidence, with a special interest in Mexican studies. The PubMed literature from January 2009 to March 2015 was reviewed and complemented through a manual search. Articles in English and Spanish were included and preference was given to consensuses, guidelines, systematic reviews, and meta-analyses. Statements referring to the different aspects of the disease were formulated and voted upon by 24 gastroenterologists employing the Delphi method. Once a consensus on each statement was reached, the quality of evidence and strength of recommendation were determined through the GRADE system. Forty-eight statements were formulated, updating the information on IBS and adding the complementary data that did not appear in the 2009 Guidelines regarding the importance of exercise and diet, diagnostic strategies, and current therapy alternatives that were analyzed with more stringent scientific vigor or that emerged within the last 5 years. We present herein a consensus review of the most relevant advances in the study of IBS, updating and complementing the 2009 Guidelines. Several studies conducted in Mexico were included. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  13. Breath tests and irritable bowel syndrome.

    Science.gov (United States)

    Rana, Satya Vati; Malik, Aastha

    2014-06-28

    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.

  14. Irritable bowel syndrome is positively related to metabolic syndrome: a population-based cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Yinting Guo

    Full Text Available Irritable bowel syndrome is a common gastrointestinal disorder that may affect dietary pattern, food digestion, and nutrient absorption. The nutrition-related factors are closely related to metabolic syndrome, implying that irritable bowel syndrome may be a potential risk factor for metabolic syndrome. However, few epidemiological studies are available which are related to this potential link. The purpose of this study is to determine whether irritable bowel syndrome is related to metabolic syndrome among middle-aged people. We designed a cross-sectional study of 1,096 subjects to evaluate the relationship between irritable bowel syndrome and metabolic syndrome and its components. Diagnosis of irritable bowel syndrome was based on the Japanese version of the Rome III Questionnaire. Metabolic syndrome was defined according to the criteria of the American Heart Association scientific statements of 2009. Dietary consumption was assessed via a validated food frequency questionnaire. Principal-components analysis was used to derive 3 major dietary patterns: "Japanese", "sweets-fruits", and "Izakaya (Japanese Pub "from 39 food groups. The prevalence of irritable bowel syndrome and metabolic syndrome were 19.4% and 14.6%, respectively. No significant relationship was found between the dietary pattern factor score tertiles and irritable bowel syndrome. After adjustment for potential confounders (including dietary pattern, the odds ratio (95% confidence interval of having metabolic syndrome and elevated triglycerides for subjects with irritable bowel syndrome as compared with non-irritable bowel syndrome are 2.01(1.13-3.55 and 1.50(1.03-2.18, respectively. Irritable bowel syndrome is significantly related to metabolic syndrome and it components. This study is the first to show that irritable bowel syndrome was significantly related to a higher prevalence of metabolic syndrome and elevated triglycerides among an adult population. The findings suggest that

  15. Risk of Intestinal Malignancy in Patients With Short Bowel Syndrome.

    Science.gov (United States)

    Thompson, Jon S; Weseman, Rebecca A; Mercer, David F; Rochling, Fedja A; Vargas, Luciano M; Grant, Wendy J; Langnas, Alan N

    2017-05-01

    Postresection intestinal adaptation is an augmented self-renewal process that might increase the risk of malignant transformation in the intestine. Furthermore, patients with short bowel syndrome (SBS) have other characteristics that might increase this risk. Our aim was to determine the incidence of new intestinal malignancy in SBS patients. We reviewed the records of 500 adult SBS patients identified from 1982-2013. There were 199 men and 301 women ranging in age from 19-91 years. Follow-up from the time of diagnosis of SBS ranged from 12-484 months. A total of 186 (37%) patients were followed >5 years. The cause of SBS was postoperative in 35% of patients, malignancy/radiation in 19%, mesenteric vascular disease in 17%, Crohn's disease in 16%, and other in 13%. Twenty-eight (6%) patients received growth stimulatory medications. Fifteen percent of patients had a prior total colectomy. Twenty-eight (6%) patients underwent intestinal transplantation, and 115 (23%) patients had a previous abdominal malignancy, including colorectal cancer in 43 patients. Thirty-six (7%) received radiation therapy. Recurrent colon cancer was found in 2 patients, one at a stoma and the other with lung metastases. New colon cancer was found in 1 patient (0.2%), a 62-year-old woman with long-standing Crohn's disease. The incidence of colon cancer in this heterogenous group of patients with SBS was similar to that of the normal population. This suggests that the risk of developing a new colon cancer in patients with SBS is not increased.

  16. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    DEFF Research Database (Denmark)

    Svendsen, J H; Munck, Lars K; Andersen, J R

    1985-01-01

    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...... with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...... available for the follow-up study. Three diagnostic failures were found (gallbladder stones, kidney stone, thyrotoxicosis). The diagnostic failure rate was accordingly 4.5% (5/110). Half of the patients had unchanged or aggravated symptoms at the follow-up study, independent of treatment. The only predictor...

  17. Clinical peculiarities of antibiotic associated bowels impairment and its significance in irritable bowel syndrome appearance

    Directory of Open Access Journals (Sweden)

    І. O. Pasichna

    2016-06-01

    Full Text Available Aim: the main objective of this study was to investigate bowels impairment due to treatment with antibiotics, its incidence and clinical peculiarities; to evaluate its role in appearance of in irritable bowel syndrome. Material and Methods. We studied 110 patients (33 males and 77 females, age range 16-83 years, who received treatment with antibiotic. We evaluated the function of the intestine before treatment with antibiotic, then in 1 week, 3 months after treatment finish (1, 2, 3, 4 visits respectively. Control group included 20 healthy persons, who haven't had antibiotics administered during recent two years. Results. We revealed that the signs of bowel function impairment took place at the first visit in 18.2% of patients, at the second visit – in 60.0% of patients, at the third visit – in 45.5% of patients and at the fourth visit – in 41.1% of patients. At the second, third and fourth visits the signs of bowels function impairment were observed reliably more often then at the first visit (before antibiotic administration, p<0.001. At the second visit the signs bowels function disorders were the most prominent: abdominal pain – in 44.5%, distention – in 46.4%, diarrhea – in 29.1%, constipation – in 18.2%, presence of both (diarrhea and periodically constipation manifestations – in 2.7%; and extraintestinal manifestations (depression. depressed mood, sorrow, apathy, decreased stamina, sleep disturbances – in 29.1% of patients. Clinical manifestations of irritable bowel syndrome occured in 6 months of observation in 32.2% of patients. Conclusions. The signs of bowel function impairment were observed in 60.0% of patients after finishing treatment with antibiotic. This incidence is much higher than in control group (р<0.001. Bowel disorders mostly manifested as the changes in quantity and consistency of feaces, pain, abdominal distention and extraintestinal manifestations. In 32.2% of patients clinical manifestations of

  18. Surgical management and autologous intestinal reconstruction in short bowel syndrome.

    Science.gov (United States)

    Hommel, Matthijs J; van Baren, Robertine; Haveman, Jan Willem

    2016-04-01

    Short bowel syndrome (SBS) is a serious condition with considerable morbidity and mortality. When treatment with parenteral nutrition fails and life-threatening complications occur, autologous intestinal reconstruction (AIR) should be considered before intestinal transplantation (ITx). Single or combined ITx should be reserved for patients with severe liver disease and as last resort in the treatment of SBS. Longitudinal intestinal lengthening and tailoring (LILT) has proven its value in AIR, but its availability depends on the expertise of the surgeons. Serial transverse enteroplasty (STEP) has similar success rates as LILT and fewer patients progress to ITx. STEP is also applicable at small bowel dilatation in ultra-short bowel syndrome. The scope may be widened when duodenal dilatation can be treated as well. Spiral intestinal lengthening and tailoring (SILT) is a promising alternative. More research is needed to confirm these findings. Therefore we suggest an international data registry for all intestinal lengthening procedures. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Irritable Bowel Syndrome and Migraine: Bystanders or Partners?

    OpenAIRE

    Chang, Full-Young; Lu, Ching-Liang

    2013-01-01

    Irritable bowel syndrome (IBS) and migraine are distinct clinical disorders. Apart from the characteristics of chronic and recurrent pain in nature, these pain-related disorders apparently share many similarities. For example, IBS is female predominant with community prevalence about 5-10%, whereas that of migraine is 1-3% also showing female predominance. They are often associated with many somatic and psychiatric comorbidities in terms of fibromyaglia, chronic fatigue syndrome, interstitial...

  20. Irritable bowel syndrome and chronic constipation in patients with endometriosis

    NARCIS (Netherlands)

    Szojda, M.M.; Mijatovic, V.; Bersma, R.J.F.; Hompes, P.G.A.

    2011-01-01

    Aim The aim of this study was to evaluate how many patients with endometriosis have concomitant irritable bowel syndrome (IBS) and/or constipation according to the Rome III criteria. Furthermore, the value of an additional gastroenterological consultation with therapeutic advice was evaluated.

  1. Subtypes of irritable bowel syndrome in children and adolescents

    Science.gov (United States)

    Pharmacologic treatments for irritable bowel syndrome (IBS) and medical management of symptoms are increasingly based on IBS subtype, so it is important to accurately differentiate patients. Few studies have classified subtypes of pediatric IBS, and conclusions have been challenged by methodologic l...

  2. Food avoidance in irritable bowel syndrome leads to a nutrition ...

    African Journals Online (AJOL)

    2013-03-26

    Mar 26, 2013 ... Original Research: Food avoidance in irritable bowel syndrome leads to a nutrition-deficient diet. 2014;27(1) ... foods play a part in symptom generation may lead to an unbalanced dietary intake. Design: This was a ..... Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin.

  3. A holistic approach to the treatment of irritable bowel syndrome ...

    African Journals Online (AJOL)

    The purpose of this study is to investigate the effects of a holistic intervention approach to the management of Irritable Bowel Syndrome (IBS). The sample consisted of 70 South African women who were diagnosed with IBS. The sample was divided into four groups. Group 1 (n = 13) received IBS medication and holistic ...

  4. Irritable bowel syndrome as a biopsychosocial disease (review

    Directory of Open Access Journals (Sweden)

    Kozlova I.V.

    2012-06-01

    Full Text Available The research work is devoted to irritable bowel syndrome (IBS as an independent nosological unity of modern gas-troenterology. Risk factors, clinical manifestations and diagnostic methods of IBS have been analyzed. Psychological and social characteristics in the development of IBS have been examined

  5. Ectopic decidual reaction mimicking irritable bowel syndrome: a case report.

    Directory of Open Access Journals (Sweden)

    Soraya Salehgargari

    2014-01-01

    Full Text Available Ectopic decidualization with gross involvement of the peritoneum is one of the rare findings in pregnant women particularly when ectopic decidualization disseminated as an asymptomatic intra-abdominal nodule. We present here a case of an ectopic decidualization in a 33-year-old pregnant woman with symptoms of irritable bowel syndrome during pregnancy.

  6. Treatment of abdominal pain in irritable bowel syndrome

    NARCIS (Netherlands)

    Vanuytsel, Tim; Tack, Jan F.; Boeckxstaens, Guy E.

    2014-01-01

    Functional abdominal pain in the context of irritable bowel syndrome (IBS) is a challenging problem for primary care physicians, gastroenterologists and pain specialists. We review the evidence for the current and future non-pharmacological and pharmacological treatment options targeting the central

  7. Teduglutide for the treatment of short bowel syndrome

    DEFF Research Database (Denmark)

    Jeppesen, P B

    2013-01-01

    Glucagon-like peptide 2 (GLP-2) decreases gastric and intestinal motility, reduces gastric secretions, promotes intestinal growth and improves post-resection structural and functional adaptation in short bowel syndrome (SBS). Teduglutide, an analogue of GLP-2, has a prolonged half-life and provides...

  8. The Role of Mast Cells in Irritable Bowel Syndrome

    OpenAIRE

    Lee, Kang Nyeong; Lee, Oh Young

    2016-01-01

    Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, but its treatment is unsatisfactory as its pathophysiology is multifactorial. The putative factors of IBS pathophysiology are visceral hypersensitivity and intestinal dysmotility, also including psychological factors, dysregulated gut-brain axis, intestinal microbiota alterations, impaired intestinal permeability, and mucosal immune alterations. Recently, mucosal immune alterations have received mu...

  9. Diagnosis and Treatment of the Irritable Bowel Syndrome

    African Journals Online (AJOL)

    Introduction. Irritable bowel syndrome (IBS) is one of the most common conditions encountered in family practice, accounting for about 12% of general practice visits. The incidence of IBS in western communities varies from 10-. 15%, with a female to male ratio of 2:1.1. The incidence of IBS varies minimally with age.

  10. Frequency of irritable bowel syndrome diagnosis made by ...

    African Journals Online (AJOL)

    Background/aim: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. Despite the high prevalence of this disease, it is not known how frequently this diagnosis is made by physicians in. Nigeria. The purpose of the study was to determine the frequency with which the diagnosis of IBS is made by physicians ...

  11. Health problems associated with irritable bowel syndrome: analysis of a primary care registry.

    Science.gov (United States)

    Clevers, E; Vaes, B; Henrard, S; Goderis, G; Tack, J; Törnblom, H; Simrén, M; Van Oudenhove, L

    2018-03-24

    Associations between irritable bowel syndrome and other health problems have been described, but comprehensive reports are missing, especially in primary care. To investigate which health problems are associated with irritable bowel syndrome, how they cluster together and when they are typically diagnosed relative to irritable bowel syndrome. We used Intego, a general practice registry in Flanders, Belgium. Patients with an irritable bowel syndrome diagnosis (n = 13 701) were matched with controls without gastrointestinal diagnosis and controls with organic gastrointestinal disease. Long-term prevalences of 680 symptoms and diagnoses were compared between patients and controls. Results were summarised using functional enrichment analysis and visualised in a network and we calculated incidence rate ratios in the 10 years before and after the irritable bowel syndrome diagnosis for the network's key components. Various symptoms and infections, but not neoplasms, were enriched in irritable bowel syndrome patients compared to both control groups. We characterised the comorbidities of irritable bowel syndrome as psychosocial health problems, urogenital symptoms and infections, musculoskeletal symptoms and other somatic symptoms. These had a uniform incidence in the years around the irritable bowel syndrome diagnosis, and did not structurally precede or follow irritable bowel syndrome. Irritable bowel syndrome shares long-term associations with psychosocial health problems, urogenital symptoms and infections, musculoskeletal symptoms and other somatic symptoms in primary care. Clinicians are encouraged to take comorbidities into account when diagnosing and managing irritable bowel syndrome, as this may have important treatment implications. © 2018 John Wiley & Sons Ltd.

  12. Irritable bowel syndrome | Watermeyer | Continuing Medical Education

    African Journals Online (AJOL)

    functional diseases' such as fibromyalgia, interstitial cystitis and non-ulcer ... On the basis of the predominant bowel habit IBS can be categorised into the following subgroups: IBS with constipation (IBS-C) – more commom in women, IBS with ...

  13. How Probiotic Reduce Symptoms of Irritable Bowel Syndrome?

    Directory of Open Access Journals (Sweden)

    M Khalesi

    2014-04-01

    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.

  14. [Current issues on irritable bowel syndrome: diet and irritable bowel syndrome].

    Science.gov (United States)

    Kim, Jeong Hwan; Sung, In-Kyung

    2014-09-25

    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.

  15. Malignant Bowel Obstruction in Patients With Recurrent Ovarian Cancer.

    Science.gov (United States)

    Tran, Elizabeth; Spiceland, Clayton; Sandhu, Nicole P; Jatoi, Aminah

    2016-04-01

    We sought to report incidence, risk factors, and survival related to bowel obstruction in 311 ovarian cancer patients with recurrent disease. A total of 68 (22%) had a documented bowel obstruction during their cancer course, and 49 (16%) developed it after cancer recurrence. Surprisingly, 142 (45%) fit into an "unknown" category (3+ months of data lacking from last contact/death). No risk factors were identified; management included surgery (n = 21), conservative measures (n = 21), and other (n = 7). Documented bowel obstruction was not associated with a statistically significant reduction in survival after cancer recurrence. In conclusion, although bowel obstruction occurs in only a subgroup of patients with ovarian cancer and does not appear to detract from survival after cancer recurrence, limited end-of-life information may be resulting in an underestimation of incidence. © The Author(s) 2014.

  16. Acupuncture for treatment of irritable bowel syndrome

    Science.gov (United States)

    Manheimer, Eric; Cheng, Ke; Wieland, L. Susan; Min, Li Shih; Shen, Xueyong; Berman, Brian M; Lao, Lixing

    2013-01-01

    Background Irritable bowel syndrome (IBS) is a common, costly, and difficult to treat disorder that impairs health-related quality of life and work productivity. Evidence-based treatment guidelines have been unable to provide guidance on the effects of acupuncture for IBS because the only previous systematic review included only small, heterogeneous and methodologically unsound trials. Objectives The primary objectives were to assess the efficacy and safety of acupuncture for treating IBS. Search methods MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the Cumulative Index to Nursing and Allied Health, and the Chinese databases Sino-Med, CNKI, and VIP were searched through November 2011. Selection criteria Randomized controlled trials (RCTs) that compared acupuncture with sham acupuncture, other active treatments, or no (specific) treatment, and RCTs that evaluated acupuncture as an adjuvant to another treatment, in adults with IBS were included. Data collection and analysis Two authors independently assessed the risk of bias and extracted data. We extracted data for the outcomes overall IBS symptom severity and health-related quality of life. For dichotomous data (e.g. the IBS Adequate Relief Question), we calculated a pooled relative risk (RR) and 95% confidence interval (CI) for substantial improvement in symptom severity after treatment. For continuous data (e.g. the IBS Severity Scoring System), we calculated the standardized mean difference (SMD) and 95% CI in post-treatment scores between groups. Main results Seventeen RCTs (1806 participants) were included. Five RCTs compared acupuncture versus sham acupuncture. The risk of bias in these studies was low.We found no evidence of an improvement with acupuncture relative to sham (placebo) acupuncture for symptom severity (SMD-0.11, 95%CI −0.35 to 0.13; 4 RCTs; 281 patients) or quality of life (SMD = −0.03, 95%CI −0.27 to 0.22; 3 RCTs; 253 patients). Sensitivity analyses based on study

  17. Homeopathy for treatment of irritable bowel syndrome.

    Science.gov (United States)

    Peckham, Emily J; Nelson, E Andrea; Greenhalgh, Joanne; Cooper, Katy; Roberts, E Rachel; Agrawal, Anurag

    2013-11-13

    Irritable bowel syndrome (IBS) is a common, chronic disorder that leads to decreased health-related quality of life and work productivity. Evidence-based treatment guidelines have not been able to give guidance on the effects of homeopathic treatment for IBS because no systematic reviews have been carried out to assess the effectiveness of homeopathic treatment for IBS. Two types of homeopathic treatment were evaluated in this systematic review. In clinical homeopathy a specific remedy is prescribed for a specific condition. This differs from individualised homeopathic treatment, where a homeopathic remedy based on a person's individual symptoms is prescribed after a detailed consultation. To assess the effectiveness and safety of homeopathic treatment for treating IBS. We searched MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), Cochrane IBD/FBD Group Specialised Register, Cochrane Complementary Medicine Field Specialised Register and the database of the Homeopathic Library (Hom-inform) from inception to February 2013. Randomised controlled trials (RCTs), cohort and case-control studies that compared homeopathic treatment with placebo, other control treatments, or usual care, in adults with IBS were considered for inclusion. Two authors independently assessed the risk of bias and extracted data. The primary outcome was global improvement in IBS. The overall quality of the evidence supporting this outcome was assessed using the GRADE criteria. We calculated the mean difference (MD) and 95% confidence interval (CI) for continuous outcomes and the risk ratio (RR) and 95% CI for dichotomous outcomes. Three RCTs (213 participants) were included. No cohort or case-control studies were identified. Two studies published in 1976 and 1979 compared clinical homeopathy (homeopathic remedy) to placebo for constipation-predominant IBS

  18. Increased risk for irritable bowel syndrome after acute diverticulitis.

    Science.gov (United States)

    Cohen, Erica; Fuller, Garth; Bolus, Roger; Modi, Rusha; Vu, Michelle; Shahedi, Kamyar; Shah, Rena; Atia, Mary; Kurzbard, Nicole; Sheen, Victoria; Agarwal, Nikhil; Kaneshiro, Marc; Yen, Linnette; Hodgkins, Paul; Erder, M Haim; Spiegel, Brennan

    2013-12-01

    Individuals with diverticulosis frequently also have irritable bowel syndrome (IBS), but there are no longitudinal data to associate acute diverticulitis with subsequent IBS, functional bowel disorders, or related emotional distress. In patients with postinfectious IBS, gastrointestinal disorders cause long-term symptoms, so we investigated whether diverticulitis might lead to IBS. We compared the incidence of IBS and functional bowel and related affective disorders among patients with diverticulitis. We performed a retrospective study of patients followed up for an average of 6.3 years at a Veteran's Administration medical center. Patients with diverticulitis were identified based on International Classification of Diseases, 9th revision codes, selected for the analysis based on chart review (cases, n = 1102), and matched with patients without diverticulosis (controls, n = 1102). We excluded patients with prior IBS, functional bowel, or mood disorders. We then identified patients who were diagnosed with IBS or functional bowel disorders after the diverticulitis attack, and controls who developed these disorders during the study period. We also collected information on mood disorders, analyzed survival times, and calculated adjusted hazard ratios. Cases were 4.7-fold more likely to be diagnosed later with IBS (95% confidence interval [CI], 1.6-14.0; P = .006), 2.4-fold more likely to be diagnosed later with a functional bowel disorder (95% CI, 1.6-3.6; P mood disorder (CI, 1.4-3.5; P IBS and functional bowel disorders. We propose calling this disorder postdiverticulitis IBS. Diverticulitis appears to predispose patients to long-term gastrointestinal and emotional symptoms after resolution of inflammation; in this way, postdiverticulitis IBS is similar to postinfectious IBS. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  19. Spectrum of short bowel syndrome in adults

    DEFF Research Database (Denmark)

    Jeppesen, Palle B

    2014-01-01

    to diminished health-related quality of life because of its many physical and psychological effects on patients. SBS is associated with decreased survival; risk factors for SBS-related mortality include very short remnant small bowel, end-jejunal remnant anatomy, and arterial mesenteric infarction as primary...... severity and resection type; thus, each patient should be individually managed. This review discusses the spectrum of disease in patients with SBS and presents common complications encountered by these patients to highlight the importance of individualized management and treatment....

  20. Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment

    OpenAIRE

    Mahvi-Shirazi, Majid; Fathi-Ashtiani, Ali; Rasoolzade-Tabatabaei, Sayed-Kazem; Amini, Mohsen

    2012-01-01

    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...

  1. Is Fructose Malabsorption a Cause of Irritable Bowel Syndrome?

    OpenAIRE

    DiNicolantonio, James J.; Lucan, Sean C.

    2015-01-01

    Irritable Bowel Syndrome (IBS) is a condition that may be marked by abdominal pain, bloating, fullness, indigestion, belching, constipation and/or diarrhea. IBS symptoms can result from malabsorption of fructose. Fructose is a monosaccharide found naturally in small quantities in fruits and some vegetables, and in much larger quantities in industrially manufactured sweeteners and a dded sugars (e.g. sucrose and high fructose corn syrup). Fructose malabsorption leads to osmotic diarrhea as wel...

  2. Management patterns and predictors of mortality among US patients with cancer hospitalized for malignant bowel obstruction.

    Science.gov (United States)

    Alese, Olatunji B; Kim, Sungjin; Chen, Zhengjia; Owonikoko, Taofeek K; El-Rayes, Bassel F

    2015-06-01

    Malignant bowel obstruction affects an estimated 3% to 15% of patients with cancer, with a mean survival of bowel obstruction. In the current study, the authors assessed predictors of survival and the influence of treatment modality in US patients with cancer who were hospitalized for malignant bowel obstruction. All the US cancer patients hospitalized with malignant bowel obstruction in 2006 and 2010 were included. Data were obtained from the Nationwide Inpatient Sample provided by the Agency for Healthcare Research and Quality. Malignant bowel obstruction diagnoses and treatment variables were identified using Clinical Classifications Software codes based on International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes. Univariate and multivariate analyses were performed with a logistic model, weighted chi-square test, and a generalized linear model. The authors identified 942,014 and 1,103,528 hospitalizations for malignant bowel obstruction in 2006 and 2010, respectively. Medical management, upper gastrointestinal obstruction, health insurance coverage, and obesity were found to be significantly associated with better hospital survival. Multivariate analysis also demonstrated significantly increased odds of death with male sex, advanced age, AJCC stage IV disease, multiple comorbid conditions (except acquired immunodeficiency syndrome), and weight loss. There were no significant differences with stratification based on the location and etiology of the obstruction (primary tumor vs metastatic). Malignant bowel obstruction is a common cause of death in hospitalized patients with advanced cancer in the United States. The odds of death are especially high in older patients and those with concurrent medical illnesses. Lack of insurance coverage, significant weight loss, and surgical management also appear to be associated with higher mortality in this population. © 2015 American Cancer Society.

  3. Irritable bowel syndrome, the microbiota and the gut-brain axis

    DEFF Research Database (Denmark)

    Raskov, Hans; Burcharth, Jakob; Pommergaard, Hans-Christian

    2016-01-01

    nervous system is called the gut-brain-axis, which integrates brain and GI functions, such as gut motility, appetite and weight. The gut-brain-axis has a central function in the perpetuation of irritable bowel syndrome and the microbiota plays a critical role. The purpose of this article is to review...... recent research concerning the epidemiology of irritable bowel syndrome, influence of microbiota, probiota, gut-brain-axis, and possible treatment modalities on irritable bowel syndrome....

  4. Effects of Hypericum perforatum extract on rat irritable bowel syndrome

    Science.gov (United States)

    Mozaffari, Shilan; Esmaily, Hadi; Rahimi, Roja; Baeeri, Maryam; Sanei, Yara; Asadi-Shahmirzadi, Azar; Salehi-Surmaghi, Mohammad-Hossein; Abdollahi, Mohammad

    2011-01-01

    Context: In irritable bowel syndrome (IBS), disturbance of bowel motility is associated with infiltration of inflammatory mediators and cytokines into the intestine, such as neutrophils, myeloperoxidase (MPO), tumor necrosis factor alfa (TNF-α), and lipid peroxide. Aims: Regarding promising anti-inflammatory and anti-oxidative effects of Hypericum perforatum (HP) extract, besides its anti-depressant effect, this study was designed to evaluate the effects of HP in an experimental model of IBS. Settings and Design: IBS was induced by a 5-day restraint stress in rats. The HP extract was administered by gavage in doses of 150, 300, and 450 mg/kg for 26 days. Fluoxetine and loperamide were used as positive controls. Gastric emptying and small bowel and colon transit, besides the levels of TNF-α, MPO, lipid peroxidation, and antioxidant power, were determined in colon homogenates. Statistical Analysis Used: Data were analyzed by one-way ANOVA followed by Tukey's post hoc test for multiple comparisons. Results: A significant reduction in small bowel and colonic transit (450 mg/kg), TNF-α, MPO, and lipid peroxidation and an increase in antioxidant power in all HP-treated groups (150, 300, and 450 mg/kg) were seen as compared with the control group. Gastric emptying did not alter significantly when compared with the control group. Treatment with loperamide (10 mg/kg) significantly inhibited gastric emptying and small bowel and colonic transit, while flouxetine (10 mg/kg) decreased gastric emptying, TNF-α, MPO, and lipid peroxidation and increased the antioxidant power of the samples in comparison with the control group. Conclusions: HP diminished the recruitment of inflammatory cells and TNF-α following restraint stress not in a dose-dependent manner, possibly via inhibition of MPO activity and increasing colon antioxidant power, without any difference with fluoxetine. The HP extract inhibits small bowel and colonic transit acceleration like loperamide but has minimal

  5. Colon cancer and large bowel function in Denmark and Finland

    DEFF Research Database (Denmark)

    Cummings, J H; Branch, W J; Bjerrum, L

    1982-01-01

    for large bowel cancer. Mean transit time (37 +/- 1 hours, Copenhagen; 43 +/- 1 hours, Helsinki; 40 +/- 1 hours, Them; 37 +/- 1 hours, Parikkala) was not significantly different among populations, but average 24-hour stool weights (136 +/- 13 g, Copenhagen; 176 +/- 17 g, Helsinki; 169 +/- 16 g, Them; 196...... +/- 15 g, Parikkala) were different and had a significant inverse relationship to total large bowel cancer incidence, with larger stool weights being found in the low-risk population. A high proportion of study subjects, especially in Finland, were found to be taking medication or to have a history...... of gastrointestinal illness, but neither of these variables related to bowel habit....

  6. The current treatment landscape of irritable bowel syndrome in adults in Hong Kong: consensus statements.

    Science.gov (United States)

    Wu, J Cy; Chan, A Oo; Chan, Y W; Cheung, G Cl; Cheung, T K; Kwan, A Cp; Leung, V Ks; Mak, A Dp; Sze, W C; Wong, R

    2017-12-01

    The estimated prevalence of irritable bowel syndrome in Hong Kong is 6.6%. With the increasing availability of pharmacological and non-pharmacological treatments, the Hong Kong Advisory Council on Irritable Bowel Syndrome has developed a set of consensus statements intended to serve as local recommendations for clinicians about diagnosis and management of irritable bowel syndrome. A multidisciplinary group of clinicians constituting the Hong Kong Advisory Council on Irritable Bowel Syndrome-seven gastroenterologists, one clinical psychologist, one psychiatrist, and one nutritionist-convened on 20 April 2017 in Hong Kong. Published primary research articles, meta-analyses, and guidelines and consensus statements issued by different regional and international societies on the diagnosis and management of irritable bowel syndrome were reviewed. An outline of consensus statements was drafted prior to the meeting. All consensus statements were finalised by the participants during the meeting, with 100% consensus. Twenty-four consensus statements were generated at the meeting. The statements were divided into four parts covering: (1) patient assessment; (2) patient's psychological distress; (3) dietary and alternative approaches to managing irritable bowel syndrome; and (4) evidence to support pharmacological management of irritable bowel syndrome. It is recommended that primary care physicians assume the role of principal care provider for patients with irritable bowel syndrome. The current statements are intended to guide primary care physicians in diagnosing and managing patients with irritable bowel syndrome in Hong Kong.

  7. Declining Bowel Cancer Incidence and Mortality in Germany.

    Science.gov (United States)

    Brenner, Hermann; Schrotz-King, Petra; Holleczek, Bernd; Katalinic, Alexander; Hoffmeister, Michael

    2016-02-19

    In October 2002, screening colonoscopy from age 55 onward was introduced as part of the German national statutory cancer screening program. Screening colonoscopy is intended to lower both the mortality and the incidence of bowel cancer by enabling the detection and removal of precursor lesions. The authors studied trends in bowel cancer incidence and mortality in Germany from 2003 to 2012 on the basis of data from the epidemiological cancer registries and from cause-of-death statistics. Over the period of investigation, the age-standardized incidence of bowel cancer (with the European population as a standard) fell from 66.1 to 57.0 cases per 100 000 persons per year (-13.8%) in men and from 42.6 to 36.5 per 100 000 persons per year (-14.3%) in women. In parallel with these changes, the age-standardized mortality from bowel cancer fell by 20.8% in men and by 26.5% in women. In the age groups 55-64, 65-74, and 75-84 years, the cumulative risk of receiving a diagnosis of bowel cancer fell by 17-26%; in persons under age 55, this risk fell by only 3% in men, but increased by 14% in women. Long-term data from the cancer registry in the German federal state of Saarland revealed that the incidence of bowel cancer, but not its mortality, had risen over the decades preceding the study; it was only during the period of investigation that the trend reversed itself. Within 10 years of the introduction of screening colonoscopy in Germany, the incidence of bowel cancer in persons over age 55 fell by 17-26%, after having risen steadily over the preceding decades.

  8. Methylglyoxal induces systemic symptoms of irritable bowel syndrome.

    Science.gov (United States)

    Zhang, Shuang; Jiao, Taiwei; Chen, Yushuai; Gao, Nan; Zhang, Lili; Jiang, Min

    2014-01-01

    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.

  9. Optimising the expansion of the National Bowel Cancer Screening Program.

    Science.gov (United States)

    Cenin, Dayna R; St John, D James B; Ledger, Melissa J N; Slevin, Terry; Lansdorp-Vogelaar, Iris

    2014-10-20

    To estimate the impact of various expansion scenarios of the National Bowel Cancer Screening Program (NBCSP) on the number of bowel cancer deaths prevented; and to investigate the impact of the expansion scenarios on colonoscopy demand. MISCAN-Colon, a well established, validated computer simulation model for bowel cancer screening, was adjusted to reflect the Australian situation. In July 2013, we simulated the effects of screening over a 50-year period, starting in 2006. The model parameters included rates of participation in screening and follow-up, rates of identification of cancerous and precancerous lesions, bowel cancer incidence, mortality and the outcomes of the NBCSP. Five implementation scenarios, based on biennial screening using an immunochemical faecal occult blood test, were developed and modelled. A sensitivity analysis that increased screening participation to 60% was also conducted. Australian residents aged 50 to 74 years. Comparison of the impact of five implementation scenarios on the number of bowel cancer deaths prevented and demand for colonoscopy. MISCAN-Colon calculated that in its current state, the NBCSP should prevent 35 169 bowel cancer deaths in the coming 40 years. Accelerating the expansion of the program to achieve biennial screening by 2020 would prevent more than 70 000 deaths. If complete implementation of biennial screening results in a corresponding increase in participation to 60%, the number of deaths prevented will increase across all scenarios. The findings strongly support the need for rapid implementation of the NBCSP. Compared with the current situation, achieving biennial screening by 2020 could result in 100% more bowel cancer deaths (about 35 000) being prevented in the coming 40 years.

  10. Octreotide as Palliative Therapy for Cancer-Related Bowel Obstruction That Cannot Be Removed by Surgery

    Science.gov (United States)

    2012-05-31

    Colorectal Cancer; Constipation, Impaction, and Bowel Obstruction; Extrahepatic Bile Duct Cancer; Gastric Cancer; Gastrointestinal Stromal Tumor; Nausea and Vomiting; Ovarian Cancer; Pancreatic Cancer; Peritoneal Cavity Cancer; Small Intestine Cancer

  11. Role of environmental pollution in irritable bowel syndrome

    Science.gov (United States)

    Marynowski, Mateusz; Likońska, Aleksandra; Zatorski, Hubert; Fichna, Jakub

    2015-01-01

    Irritable bowel syndrome (IBS), with the prevalence of 10%-20 % of the population has become an emerging problem worldwide. IBS is a functional gastrointestinal (GI) disorder characterized by abdominal pain or discomfort and altered bowel habits. The etiology of IBS contains genetic, psychological, and immunological factors, and has not been fully elucidated; of note, recent studies also point at environmental pollution and its role in the development of functional GI diseases. In this review we focus on several environmental factors, such as bacterial contamination, air pollution, radiation and even stress as potential triggers of IBS. We discuss associated disturbances in homeostasis, such as changes in intestinal microbiome and related pathophysiological mechanisms. Based on the effect of environmental factors on the GI tract, we also propose novel targets in IBS treatment. PMID:26523104

  12. Role of environmental pollution in irritable bowel syndrome.

    Science.gov (United States)

    Marynowski, Mateusz; Likońska, Aleksandra; Zatorski, Hubert; Fichna, Jakub

    2015-10-28

    Irritable bowel syndrome (IBS), with the prevalence of 10%-20 % of the population has become an emerging problem worldwide. IBS is a functional gastrointestinal (GI) disorder characterized by abdominal pain or discomfort and altered bowel habits. The etiology of IBS contains genetic, psychological, and immunological factors, and has not been fully elucidated; of note, recent studies also point at environmental pollution and its role in the development of functional GI diseases. In this review we focus on several environmental factors, such as bacterial contamination, air pollution, radiation and even stress as potential triggers of IBS. We discuss associated disturbances in homeostasis, such as changes in intestinal microbiome and related pathophysiological mechanisms. Based on the effect of environmental factors on the GI tract, we also propose novel targets in IBS treatment.

  13. Five personality dimensions in patients with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Alireza Farnam

    2008-08-01

    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

  14. CT findings of small bowel metastases from primary lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Wook; Ha, Hyun Kwon; Kim, Ah Young; Kim, Gab Choul; Kim, Tae Kyoung; Kim, Pyo Nyun; Lee, Moon Gyu [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2002-11-01

    To evaluate the CT findings of small bowel metastases from primary lung cancer. Of the 1468 patients with primary lung cancer between 1990 and 2000, 13 patients who had metastasis to the small intestine were collected. Of these 13 patients, nine who underwent CT scan were included for analysis. The pathologic diagnoses of primary lung cancer in these nine patients were squamous cell carcinoma in six, adenocarcinoma in two, and large cell carcinoma in one. CT scans were analyzed with regard to the site and patterns (intraluminal mass/bowel wall thickening/bowel implants) of metastatic masses, and the presence or absence of complication such as intussusception, obstruction, or perforation of the small bowel. The medical records of the patients were also reviewed retrospectively for evaluation of presenting abdominal symptom and time interval of metastases from initial diagnosis of lung cancer. Metastatic lesions were distributed throughout the small intestine: the duodenum in five, the jejunum in four, the ileum in six, and both jejunum and ileum in one patient. The size of metastatic masses of small bowel ranged from 1.3 cm to 5.0 cm (mean size, 2.6 cm) On CT, the small bowel was involved with intraluminal masses (mean size, 3.4 cm) in eight patients, diffuse wall thickening (mean thickness, 1.6 cm) in five, and bowel implants (mean size, 2.2 cm) in two. Complications occurred in seven patients, including intussusceptions without obstruction in two patients and with obstruction in two, obstruction without intussusceptions in two, and bowel perforation in one. Of 9 patients, 6 had at least one symptom referable to the small bowel including abdominal pain in 4, anemia in 3, vomiting in 1, and jaundice in 1. Lung cancer and small bowel lesions were detected simultaneously in four patients and the time interval of metastases from initial diagnosis of lung cancer ranged from 10 days to 30 months (median interval, 54 days) in patients. CT helps in defining the extent and

  15. [Depressive and anxiety symptoms, coping strategies in patients with irritable bowel syndrome and inflammatory bowel disease].

    Science.gov (United States)

    Kovács, Zoltán; Kovács, Ferencs

    2007-01-01

    Psychological factors play an important role in the etiopathogenesis of functional gastrointestinal disorders, like irritable bowel syndrome. In our study we compared certain psychological characteristics of patients suffering from functional and organic gastrointestinal disorders and healthy subjects. Age and gender matched irritable bowel syndrome and inflammatory bowel disease patients and healthy subjects were compared on their depressive symptoms (Beck Depression Inventory), anxiety symptoms (Spielberger State-Trait Anxiety Inventory) and coping strategies (Folkman-Lazarus Ways of Coping Questionnaire). GI patients groups were characterized by significantly more severe depressive and anxiety symptoms and by the prevalence of passive coping strategies. On the Beck Depression Inventory "Performance Difficulty" and "Somatic Symptoms" subscales, significant differences were observed between patients and healthy subjects, while on the "Negative affect" subscale, only IBS patients but not IBD patients scored significantly higher compared to healthy subjects. The functional GI group showed significantly more severe depressive and also more severe anxiety symptoms, but this latter did not reach statistical significance. No differences were detected regarding the use of coping strategies. Psychological screening and psychological and/or pharmacological interventions are recommended for GI patients, at least in the most severe and treatment resistant cases. Differences between IBS and IBD groups underline the importance of the increased psychic vulnerability of functional GI patients and emphasize the role of affective components in the etiopathogenesis of the disorder. Future studies should be directed toward the assessment of disease-specific psychic characteristics (e.g. pain-coping strategies, cognitive schemas), subjective symptom experience and illness-behavior.

  16. THE PREVALENCE AND CLINICAL CHARACTERISTICS OF PRIMARY HEADACHE IN IRRITABLE BOWEL SYNDROME: a subgroup of the functional somatic syndromes

    Directory of Open Access Journals (Sweden)

    Rosa LS SOARES

    2013-12-01

    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.

  17. Motiliteit van het sigmoïd bij 'irritable bowel syndrome' en diverticulosis coli

    NARCIS (Netherlands)

    Ritsema, G. H.; Thijn, C. J.; Smout, A. J.

    1990-01-01

    The results of pressure recording in patients with irritable bowel syndrome, diverticulosis and diverticulosis with pain were compared with the results in control subjects. The motility showed variable higher values in patients with irritable bowel syndrome. The motility was clearly higher in

  18. Stem Cells in the Intestine: Possible Roles in Pathogenesis of Irritable Bowel Syndrome.

    Science.gov (United States)

    Ratanasirintrawoot, Sutheera; Israsena, Nipan

    2016-07-30

    Irritable bowel syndrome is one of the most common functional gastrointestinal (GI) disorders that significantly impair quality of life in patients. Current available treatments are still not effective and the pathophysiology of this condition remains unclearly defined. Recently, research on intestinal stem cells has greatly advanced our understanding of various GI disorders. Alterations in conserved stem cell regulatory pathways such as Notch, Wnt, and bone morphogenic protein/TGF- β have been well documented in diseases such as inflammatory bowel diseases and cancer. Interaction between intestinal stem cells and various signals from their environment is important for the control of stem cell self-renewal, regulation of number and function of specific intestinal cell types, and maintenance of the mucosal barrier. Besides their roles in stem cell regulation, these signals are also known to have potent effects on immune cells, enteric nervous system and secretory cells in the gut, and may be responsible for various aspects of pathogenesis of functional GI disorders, including visceral hypersensitivity, altered gut motility and low grade gut inflammation. In this article, we briefly summarize the components of these signaling pathways, how they can be modified by extrinsic factors and novel treatments, and provide evidenced support of their roles in the inflammation processes. Furthermore, we propose how changes in these signals may contribute to the symptom development and pathogenesis of irritable bowel syndrome.

  19. Treatment of adult short bowel syndrome patients with teduglutide

    DEFF Research Database (Denmark)

    Nørholk, Lærke Marijke; Holst, Jens Juul; Jeppesen, Palle Bekker

    2012-01-01

    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 parenteral support may cause impairment of the quality of life of SBS-IF patients. Conventional treatments include dietary manipulations, oral rehydration solutions, antidiarrheal and antisecretory treatments. However, the evidence base for these interventions is limited, and treatments improving structural...

  20. The Gut Microbiota and Irritable Bowel Syndrome: Friend or Foe?

    Directory of Open Access Journals (Sweden)

    Uday C. Ghoshal

    2012-01-01

    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.

  1. Intestinal microbiota in pathophysiology and management of irritable bowel syndrome.

    Science.gov (United States)

    Lee, Kang Nyeong; Lee, Oh Young

    2014-07-21

    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 causes. The human intestinal microbiota are composed of more than 1000 different bacterial species and 10(14) cells, and are essential for the development, function, and homeostasis of the intestine, and for individual health. The putative mechanisms that explain the role of microbiota in the development of IBS include altered composition or metabolic activity of the microbiota, mucosal immune activation and inflammation, increased intestinal permeability and impaired mucosal barrier function, sensory-motor disturbances provoked by the microbiota, and a disturbed gut-microbiota-brain axis. Therefore, modulation of the intestinal microbiota through dietary changes, and use of antibiotics, probiotics, and anti-inflammatory agents has been suggested as strategies for managing IBS symptoms. This review summarizes and discusses the accumulating evidence that intestinal microbiota play a role in the pathophysiology and management of IBS.

  2. Irritable bowel syndrome, the microbiota and the gut-brain axis.

    Science.gov (United States)

    Raskov, Hans; Burcharth, Jakob; Pommergaard, Hans-Christian; Rosenberg, Jacob

    2016-09-02

    Irritable bowel syndrome is a common functional gastrointestinal disorder and it is now evident that irritable bowel syndrome is a multi-factorial complex of changes in microbiota and immunology. The bidirectional neurohumoral integrated communication between the microbiota and the autonomous nervous system is called the gut-brain-axis, which integrates brain and GI functions, such as gut motility, appetite and weight. The gut-brain-axis has a central function in the perpetuation of irritable bowel syndrome and the microbiota plays a critical role. The purpose of this article is to review recent research concerning the epidemiology of irritable bowel syndrome, influence of microbiota, probiota, gut-brain-axis, and possible treatment modalities on irritable bowel syndrome.

  3. Diagnosis and treatment of diarrhea-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Lacy BE

    2016-02-01

    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

  4. Lubiprostone: chronic constipation and irritable bowel syndrome with constipation.

    Science.gov (United States)

    Lacy, Brian E; Chey, William D

    2009-01-01

    Lubiprostone is a bicyclic fatty acid metabolite analogue of prostaglandin E1. The FDA has approved lubiprostone for the treatment of chronic constipation in men and women and the treatment of women with irritable bowel syndrome with constipation (IBS-C). Lubiprostone specifically activates type-2-chloride channels on the apical membrane of epithelial cells. Lubiprostone acts locally within the intestinal tract, is rapidly metabolized and has very low systemic bioavailability. Animal studies have demonstrated that lubiprostone increases gastrointestinal fluid secretion in a dose-dependent manner. Clinical studies performed in men and women with chronic constipation using 24 microg of lubiprostone twice-daily demonstrated objective improvement in stool frequency and consistency, as well as symptoms of straining and incomplete evacuation. A multi-center study of patients with IBS-C found that 8 microg of lubiprostone twice-daily improved both global and individual symptoms of irritable bowel syndrome. Lubiprostone is generally well tolerated and serious adverse events are rare. The most common reported side effects are nausea, headache and diarrhea. This monograph provides a brief overview on chloride channel function in the gastrointestinal tract, describes the structure, function, and pharmacokinetics of lubiprostone, and discusses the safety and efficacy of this new medication for the treatment of chronic constipation and IBS-C.

  5. Pharmacological treatment of bowel obstruction in cancer patients.

    LENUS (Irish Health Repository)

    O'Connor, Brenda

    2012-02-01

    INTRODUCTION: Malignant bowel obstruction (MBO) is a common complication of advanced cancer, occurring most frequently in gynaecological and colorectal cancer. Its management remains complex and variable. This is in part due to the lack of evidence-based guidelines for the clinicians involved. Although surgery should be considered the primary treatment, this may not be feasible in patients with a poor performance status or advanced disease. Advances have been made in the medical management of MBO which can lead to a considerable improvement in symptom management and overall quality of life. AREAS COVERED: This review emphasizes the importance of a prompt diagnosis of MBO with early introduction of pharmacological agents to optimize symptom control. The authors summarize the treatment options available for bowel obstruction in those patients for whom surgical intervention is not a feasible option. The authors also explore the complexities involved in the introduction of parenteral hydration and total parenteral nutrition in this group of patients. EXPERT OPINION: It is not always easy to distinguish reversible from irreversible bowel obstruction. Early and aggressive management with the introduction of pharmacological agents including corticosteroids, octreotide and anti-cholinergic agents have the potential to maintain bowel patency, and allow for more rapid recovery of bowel transit. A combination of analgesics, anti-emetics and anti-cholinergics with or without anti-secretory agents can successfully improve symptom control in patients with irreversible bowel obstruction.

  6. Incidence and predictive factors of irritable bowel syndrome after acute diverticulitis in Korea.

    Science.gov (United States)

    Jung, Sungmo; Lee, Hyuk; Chung, Hyunsoo; Park, Jun Chul; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan

    2014-11-01

    Evidence indicates that irritable bowel syndrome can occur after gastroenteritis. However, little is known about its incidence after diverticulitis. This study was designed to identify the incidence and risk factors of irritable bowel syndrome after diverticulitis in Korea. A survey regarding irritable bowel syndrome was performed in patients allocated to the cases hospitalized for acute diverticulitis and controls hospitalized for non-gastrointestinal disorders between January 2007 and June 2012. Patients meeting criteria for irritable bowel syndrome before hospitalization or with a history of bowel resection were excluded for analysis. Response rate of telephone interviews was 28.1 % (139 of 494) and 73.3 % (220 of 300) in cases and controls, respectively. After exclusion, 102 patients in the cases and 205 patients in the controls were analyzed. At 31 months median follow-up, irritable bowel syndrome had developed in 13 patients (12.8 %) in the cases and 11 patients (5.4 %) in the controls with significant statistical difference (p = 0.02). No clinical difference was seen between the two groups. No clinical factor was significant for the development of irritable bowel syndrome after diverticulitis, and no independent factor was associated with the development of irritable bowel syndrome. Among the 13 patients who developed post-diverticulitis irritable bowel syndrome, the diarrhea-predominant type (53.9 %) was most common. A higher incidence of irritable bowel syndrome after diverticulitis was evident in this study. However, no clinical feature for prediction of its development after diverticulitis was found. Further large-scale analysis will be needed to generalize this result.

  7. An observational study of cognitive function in patients with irritable bowel syndrome and inflammatory bowel disease.

    Science.gov (United States)

    Berrill, J W; Gallacher, J; Hood, K; Green, J T; Matthews, S B; Campbell, A K; Smith, A

    2013-11-01

    Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are associated with several risk factors for developing cognitive impairment. These include altered cytokine levels, concurrent mood disorders, and the presence of chronic pain. This observational study aimed to explore the cognitive profile of patients with these conditions. Participants completed the Cardiff Cognitive Battery, a series of computerized neuropsychological performance tests that examine a range of cognitive function including psychomotor speed, memory, and intelligence. A progressive analysis of covariance model was used with demographic details, anxiety and depression scores entered as covariates. Fecal calprotectin levels were measured in IBD patients to determine disease activity. In total 231 participants were recruited (150 IBD patients, 40 IBS patients, and 41 healthy controls). IBD patients had significantly lower scores on fluid (p = 0.01) and crystalline intelligence tests (p = 0.028) compared to healthy volunteers, however, this reflected differences in concurrent mood disorder and level of education. When these factors were added as covariates, there was no significant difference between the groups. Duration and activity of disease did not affect cognitive function in IBD patients. Severity of symptoms had no impact on cognition in patients with IBS. The results of this observational study do not support the hypothesis that IBS or IBD have an intrinsic disease process that is associated with cognitive dysfunction. It is possible that concurrent mood disorders, in particular depression, may affect the cognitive performance of patients with IBD in specific tasks. © 2013 John Wiley & Sons Ltd.

  8. Colon cancer and large bowel function in Denmark and Finland

    DEFF Research Database (Denmark)

    Cummings, J H; Branch, W J; Bjerrum, L

    1982-01-01

    for large bowel cancer. Mean transit time (37 +/- 1 hours, Copenhagen; 43 +/- 1 hours, Helsinki; 40 +/- 1 hours, Them; 37 +/- 1 hours, Parikkala) was not significantly different among populations, but average 24-hour stool weights (136 +/- 13 g, Copenhagen; 176 +/- 17 g, Helsinki; 169 +/- 16 g, Them; 196...... +/- 15 g, Parikkala) were different and had a significant inverse relationship to total large bowel cancer incidence, with larger stool weights being found in the low-risk population. A high proportion of study subjects, especially in Finland, were found to be taking medication or to have a history...

  9. Childhood bladder and bowel dysfunction predicts irritable bowel syndrome phenotype in adult interstitial cystitis/bladder pain syndrome patients.

    Science.gov (United States)

    Doiron, R Christopher; Kogan, Barry A; Tolls, Victoria; Irvine-Bird, Karen; Nickel, J Curtis

    2017-08-01

    Many clinicians have suggested that a history of bladder and bowel dysfunction (BBD) in childhood predisposes to the development of interstitial cystitis/bladder pain syndrome (IC/BPS) or irritable bowel syndrome (IBS) in adulthood. We hypothesized that BBD symptoms in childhood would predict the IBS-associated phenotype in adult IC/BPS patients. Consecutive female patients (n=190) with a diagnosis of IC/BPS were administered a modified form of a clinical BBD questionnaire (BBDQ) to capture childhood BBD-like symptoms, as well as Interstitial Cystitis Symptoms Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Pelvic Pain and Urgency/Frequency (PUF) questionnaires and UPOINT categorization. Patients were stratified to IBS-positive or IBS-negative according to clinical assessment of IBS-like symptoms. The 127 patients (67%) identified with IBS-like symptoms recalled significantly higher BBDQ scores than the 63 patients (33%) who were IBS-negative (2.8 vs. 2.3; p=0.05). The IBS-positive patients also reported a higher number of UPOINT domains than their non-IBS counterparts (3.8 vs. 2.9; p=0.0001), while their PUF total scores were significantly higher (13.6 vs. 12.3; p=0.04). IBS-positive patients more often recalled that in childhood they did not have a daily bowel movement (BM) (p=0.04) and had "to push for a BM" (p=0.009). In childhood, they "urinated only once or twice per day" (p=0.03) and recalled "painful urination" more than those without IBS (p=0.03). There were no significant differences between the groups in answers to the other five questions of the BBDQ. Our symptom recollection survey was able to predict the IBS phenotype of IC/BPS based on a childhood BBDQ. Further prospective studies are needed to further evaluate these novel findings.

  10. Cancer surveillance in inflammatory bowel disease.

    Science.gov (United States)

    Bernstein, C N

    1999-12-01

    This article reviews the rationale and approach to dysplasia surveillance colonoscopy in inflammatory bowel disease. Recent developments in the field are also highlighted, including approaches to polyps that arise in patients with colitis and new diagnostic markers that may complement morphologic assessment for dysplasia.

  11. Targeted therapies for diarrhea-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Olden KW

    2012-05-01

    Full Text Available Kevin W OldenDepartment of Medicine, St Joseph's Hospital and Medical Center, Phoenix, AZ, USAAbstract: Irritable bowel syndrome (IBS causes gastrointestinal symptoms such as abdominal pain, bloating, and bowel pattern abnormalities, which compromise patients' daily functioning. Common therapies address one or two IBS symptoms, while others offer wider symptom control, presumably by targeting pathophysiologic mechanisms of IBS. The aim of this targeted literature review was to capture clinical trial reports of agents receiving the highest recommendation (Grade 1 for treatment of IBS from the 2009 American College of Gastroenterology IBS Task Force, with an emphasis on diarrhea-predominant IBS. Literature searches in PubMed captured articles detailing randomized placebo-controlled trials in IBS/diarrhea-predominant IBS for agents receiving Grade I (strong 2009 American College of Gastroenterology IBS Task Force recommendations: tricyclic antidepressants, nonabsorbable antibiotics, and the 5-HT3 receptor antagonist alosetron. Studies specific for constipation-predominant IBS were excluded. Tricyclic antidepressants appear to improve global IBS symptoms but have variable effects on abdominal pain and uncertain tolerability; effects on stool consistency, frequency, and urgency were not adequately assessed. Nonabsorbable antibiotics show positive effects on global symptoms, abdominal pain, bloating, and stool consistency but may be most efficacious in patients with altered intestinal microbiota. Alosetron improves global symptoms and abdominal pain and normalizes bowel irregularities, including stool frequency, consistency, and fecal urgency. Both the nonabsorbable antibiotic rifaximin and the 5-HT3 receptor antagonist alosetron improve quality of life. Targeted therapies provide more complete relief of IBS symptoms than conventional agents. Familiarization with the quantity and quality of evidence of effectiveness can facilitate more individualized

  12. Targeted therapies for diarrhea-predominant irritable bowel syndrome

    Science.gov (United States)

    Olden, Kevin W

    2012-01-01

    Irritable bowel syndrome (IBS) causes gastrointestinal symptoms such as abdominal pain, bloating, and bowel pattern abnormalities, which compromise patients’ daily functioning. Common therapies address one or two IBS symptoms, while others offer wider symptom control, presumably by targeting pathophysiologic mechanisms of IBS. The aim of this targeted literature review was to capture clinical trial reports of agents receiving the highest recommendation (Grade 1) for treatment of IBS from the 2009 American College of Gastroenterology IBS Task Force, with an emphasis on diarrhea-predominant IBS. Literature searches in PubMed captured articles detailing randomized placebo-controlled trials in IBS/diarrhea-predominant IBS for agents receiving Grade I (strong) 2009 American College of Gastroenterology IBS Task Force recommendations: tricyclic antidepressants, nonabsorbable antibiotics, and the 5-HT3 receptor antagonist alosetron. Studies specific for constipation-predominant IBS were excluded. Tricyclic antidepressants appear to improve global IBS symptoms but have variable effects on abdominal pain and uncertain tolerability; effects on stool consistency, frequency, and urgency were not adequately assessed. Nonabsorbable antibiotics show positive effects on global symptoms, abdominal pain, bloating, and stool consistency but may be most efficacious in patients with altered intestinal microbiota. Alosetron improves global symptoms and abdominal pain and normalizes bowel irregularities, including stool frequency, consistency, and fecal urgency. Both the nonabsorbable antibiotic rifaximin and the 5-HT3 receptor antagonist alosetron improve quality of life. Targeted therapies provide more complete relief of IBS symptoms than conventional agents. Familiarization with the quantity and quality of evidence of effectiveness can facilitate more individualized treatment plans for patients with this heterogeneous disorder. PMID:22754282

  13. Rationale for using serotonergic agents to treat irritable bowel syndrome.

    Science.gov (United States)

    Baker, Danial E

    2005-04-01

    The role of serotonin in gastrointestinal (GI)-tract functioning, the pharmacologic rationale for using serotonergic agents in the treatment of irritable bowel syndrome (IBS), and clinical experience with novel serotonergic agents are described. IBS is a common multisymptom disorder that is associated with a high socioeconomic burden. The goal of treatment is to provide rapid and sustained global relief of the multiple symptoms of IBS with a single, effective, well-tolerated agent. Traditional treatment options target single symptoms, and many patients are dissatisfied with the level of relief achieved and adverse effects. Research has revealed that serotonin is involved in three major actions in the gut: (1) mediating intestinal motility, (2) mediating intestinal secretion in the GI tract, and (3) modulating perception in the bowels. Serotonin is also a vital link in the brain-gut axis. Alterations in key elements of serotonin signaling have been demonstrated in patients with IBS. Tegaserod, a selective serotonin type 4 (5-HT(4))-receptor partial agonist, is indicated for use in women with IBS whose primary bowel symptom is constipation. Alosetron, a 5-HT(3)-receptor antagonist, is indicated for use in women with severe diarrhea-predominant IBS in whom traditional therapies have failed. The clinical usefulness of several other serotonergic agents for IBS is being investigated. The use of serotonergic agents in patients with IBS is based on the critical role that serotonin plays in the maintenance of normal gut function and brain-gut communication. Pharmacologic therapies targeting specific serotonin receptors represent an important step in the management of IBS.

  14. Interstitial Cystitis/Painful Bladder Syndrome and Associated Medical Conditions With an Emphasis on Irritable Bowel Syndrome, Fibromyalgia and Chronic Fatigue Syndrome

    DEFF Research Database (Denmark)

    Nickel, J.C.; Tripp, D.A.; Pontari, M.

    2010-01-01

    Purpose: We characterized and compared the impact of clinical phenotypic associations between interstitial cystitis/painful bladder syndrome and controls in relation to potentially related conditions, particularly irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. Materials...... cystitis/painful bladder syndrome vs controls was irritable bowel syndrome 38.6% vs 5.2%, fibromyalgia 17.7% vs 2.6% and chronic fatigue syndrome 9.5% vs 1.7% (all p painful bladder syndrome cohort 50.3% reported no other associated condition, 24.4% had interstitial...... cystitis/painful bladder syndrome + irritable bowel syndrome only, 2.5% had interstitial cystitis/painful bladder syndrome + fibromyalgia only, 1.5% had interstitial cystitis/painful bladder syndrome + chronic fatigue syndrome only, while 20.2% had multiple associated conditions. As the number...

  15. IRRITABLE BOWEL SYNDROME IN CHILDREN: DIAGNOSTICS AND MODERN APPROACHES TO THERAPY

    Directory of Open Access Journals (Sweden)

    S.Yu. Tereshchenko

    2006-01-01

    Full Text Available In the article modern data on prevalence, diagnostic criteria and approaches to the treatment of irritable bowel in children are presented. The issues of the terminology and classification of recurrent abdominal pains in children are clarified, the basic pathophysiological mechanisms of the disease are indicated. Particular emphasis has been placed on the efficient therapy of the different clinical variants of irritable bowel syndrome. The role of modern spasmolytic drugs in the treatment of abdominal pain syndrome and the rational usage of laxatives in constipation in children is shown.Key words: children, irritable bowel syndrome, diagnostics, treatment.

  16. The role of probiotics in management of irritable bowel syndrome.

    Science.gov (United States)

    Borowiec, Anna M; Fedorak, Richard N

    2007-10-01

    Irritable bowel syndrome (IBS) affects a significant proportion of the North American population; however, the etiology and pathophysiology of this disease remain poorly understood, and treatment is focused on symptom management. Over the years, research has revealed that the bacterial flora in the human gut interact with the bowel in a complex and dynamic relationship and may be responsible for the induction and progression of some of the pathophysiologic aspects of IBS. Probiotics are nonpathogenic bacteria that benefit the host, and the roles they can play in the bacterio-gut relationship provide hope of a safe treatment that would allow for modulation of IBS disease states. Probiotic treatment for IBS has undergone significant exploration, yet the exact therapeutic effects and doses of these beneficial bacteria remain unclear due to the conflicting nature of available evidence. This review discusses the evidence from randomized controlled trials on probiotic treatment of IBS and presents the current understanding of the mechanisms of action of probiotics as they apply to IBS and provides a plausible explanation for the variability in evidence documented by the various trials under review.

  17. Immunomodulation of enteric neural function in irritable bowel syndrome.

    Science.gov (United States)

    O'Malley, Dervla

    2015-06-28

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder which is characterised by symptoms such as bloating, altered bowel habit and visceral pain. It's generally accepted that miscommunication between the brain and gut underlies the changes in motility, absorpto-secretory function and pain sensitivity associated with IBS. However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusive. Anecdotally, IBS patients have noted that periods of stress can result in symptom flares and many patients exhibit co-morbid stress-related mood disorders such as anxiety and depression. However, in addition to psychosocial stressors, infection-related stress has also been linked with the initiation, persistence and severity of symptom flares. Indeed, prior gastrointestinal infection is one of the strongest predictors of developing IBS. Despite a lack of overt morphological inflammation, the importance of immune factors in the pathophysiology of IBS is gaining acceptance. Subtle changes in the numbers of mucosal immune cell infiltrates and elevated levels of circulating pro-inflammatory cytokines have been reproducibly demonstrated in IBS populations. Moreover, these immune mediators directly affect neural signalling. An exciting new area of research is the role of luminal microbiota in the modulation of neuro-immune signalling, resulting in local changes in gastrointestinal function and alterations in central neural functioning. Progress in this area has begun to unravel some of the complexities of neuroimmune and neuroendocrine interactions and how these molecular exchanges contribute to GI dysfunction.

  18. Prevalence of irritable bowel syndrome in obsessive-compulsive disorder.

    Science.gov (United States)

    Masand, Prakash S; Keuthen, Nancy J; Gupta, Sanjay; Virk, Subhdeep; Yu-Siao, Barbara; Kaplan, David

    2006-01-01

    Irritable bowel syndrome (IBS) occurs more frequently in psychiatric patients, especially those with anxiety and mood disorders. We sought to determine the prevalence and phenomenology of IBS in patients diagnosed with obsessive-compulsive disorder (OCD). A semi-structured diagnostic interview was administered to patients seeking treatment for OCD in outpatient settings. Structured questions regarding gastrointestinal functioning and IBS symptoms were administered. IBS was diagnosed by a gastroenterologist using Rome I criteria. Thirty-seven patients (35.1%) with OCD met criteria for IBS. Of these, 53.8% had IBS with both diarrhea and constipation, 30.8% had diarrhea-predominant IBS, and 15.4% had constipation-predominant IBS. The prevalence rate of IBS in an age- and sex-matched control group (n=40) of medical patients in a family practice was 2.5%. IBS prevalence rates were significantly higher for OCD patients than control subjects (P=.0002). IBS and psychiatric illness have high rates of bi-directional comorbidity. This study shows that 35.1% of patients with OCD satisfied criteria for IBS in contrast to 2.5% of the controlled subjects. In most patients the IBS was characterized by both diarrhea and constipation. While taking the initial history clinicians should inquire about bowel symptoms in patients presenting with psychiatric illnesses, including OCD. SSRIs could potentially worsen such symptoms and lead to non-adherence.

  19. Cross-cultural and psychological issues in irritable bowel syndrome.

    Science.gov (United States)

    Sahoo, Swapnajeet; Padhy, Susanta Kumar

    2017-10-01

    Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders encountered by gastroenterologists worldwide. Of all the etiological factors that had been postulated to explain the pathophysiology of IBS, cultural and psychological factors are unique and difficult to understand. Culture plays an important role in coloring the presentation of IBS, and many a times, it has a significant role in several treatment aspects too. Psychological aspects like personality profiles, family relationships, societal myths, and abuse in any form are equally important in the management perspectives of IBS. In this brief review, we had tried to specifically focus on these aspects in IBS and have explained the evidences in favor of these factors. Knowledge about various cross-cultural aspects and psychological factors in patients with IBS is essential for taking an appropriate history and for undertaking a holistic approach for the management of the same. A collaborative team effort by psychiatrists and gastroenterologists could help in reducing the burden of this difficult to treat functional bowel disorder. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  20. Irritable Bowel Syndrome: Clinical Manifestations, Dietary Influences, and Management

    Directory of Open Access Journals (Sweden)

    Ronald Ikechi

    2017-04-01

    Full Text Available Irritable bowel syndrome (IBS is a functional gastrointestinal disorder that is characterized by symptoms of chronic abdominal pain and altered bowel habits in the absence of an overtly identifiable cause. It is the most commonly diagnosed functional gastrointestinal disorder, accounting for about one third of gastroenterology visits. It generally presents as a complex of symptoms, including psychological dysfunction. Hypersensitivity to certain foods, especially foods that contain high amounts of fructose, plays a role in the pathophysiology of IBS. Elevated consumption of high-fructose corn syrup (HFCS has been discussed in this aspect. The treatment options for IBS are challenging and varied. In addition to dietary restrictions for HFCS-induced IBS, such as low-FODMAP (Fermentable Oligosaccharides, Disaccharide, Monosaccharides, and Polyols diets, existing drug therapies are administered based on the predominant symptoms and IBS-subtype. Patients with IBS are likely to suffer from issues, such as anxiety, depression, and post-traumatic-stress disorder. Biopsychosocial factors particularly socioeconomic status, sex, and race should, thus, be considered for diagnostic evaluation of patients with IBS.

  1. Irritable bowel syndrome: A microbiome-gut-brain axis disorder?

    Science.gov (United States)

    Kennedy, Paul J; Cryan, John F; Dinan, Timothy G; Clarke, Gerard

    2014-01-01

    Irritable bowel syndrome (IBS) is an extremely prevalent but poorly understood gastrointestinal disorder. Consequently, there are no clear diagnostic markers to help diagnose the disorder and treatment options are limited to management of the symptoms. The concept of a dysregulated gut-brain axis has been adopted as a suitable model for the disorder. The gut microbiome may play an important role in the onset and exacerbation of symptoms in the disorder and has been extensively studied in this context. Although a causal role cannot yet be inferred from the clinical studies which have attempted to characterise the gut microbiota in IBS, they do confirm alterations in both community stability and diversity. Moreover, it has been reliably demonstrated that manipulation of the microbiota can influence the key symptoms, including abdominal pain and bowel habit, and other prominent features of IBS. A variety of strategies have been taken to study these interactions, including probiotics, antibiotics, faecal transplantations and the use of germ-free animals. There are clear mechanisms through which the microbiota can produce these effects, both humoral and neural. Taken together, these findings firmly establish the microbiota as a critical node in the gut-brain axis and one which is amenable to therapeutic interventions. PMID:25339800

  2. Cognitive change in patients undergoing hypnotherapy for irritable bowel syndrome.

    Science.gov (United States)

    Gonsalkorale, Wendy M; Toner, Brenda B; Whorwell, Peter J

    2004-03-01

    Impaired quality of life and psychological distress are common in irritable bowel syndrome (IBS) and may be associated with unhelpful cognitions. Hypnotherapy (HT) is effective in improving both symptoms and quality of life in patients with IBS, and this study was designed to determine whether this improvement is reflected in cognitive change using a validated scale recently developed for use in such patients. A total of 78 IBS patients completed a validated symptom-scoring questionnaire, the Hospital Anxiety and Depression (HAD) Scale and the Cognitive Scale for Functional Bowel Disorders (FBDs), before and after 12 sessions of gut-focused HT. HT resulted in improvement of symptoms, quality of life and scores for anxiety and depression (all P'scognitions also improved, with reduction in the total cognitive score (TCS; PCognitions were related to symptom severity because the most abnormal cognitive scores were observed in patients with the highest symptom scores (Pcognitive score (Pcognitive score had independence from the other scores and did not serve solely as a proxy for symptom improvement. This study shows that symptom improvement in IBS with HT is associated with cognitive change. It also represents an initial step in unravelling the many possible mechanisms by which treatments such as HT might bring about improvement.

  3. Melatonin for the treatment of irritable bowel syndrome.

    Science.gov (United States)

    Siah, Kewin Tien Ho; Wong, Reuben Kong Min; Ho, Khek Yu

    2014-03-14

    Irritable bowel syndrome (IBS) is a common disorder characterized by recurrent abdominal pain or discomfort, in combination with disturbed bowel habits in the absence of identifiable organic cause. Melatonin (N-acetyl-5-methoxytryptamine) is a hormone produced by the pineal gland and also large number by enterochromaffin cells of the digestive mucosa. Melatonin plays an important part in gastrointestinal physiology which includes regulation of gastrointestinal motility, local anti-inflammatory reaction as well as moderation of visceral sensation. Melatonin is commonly given orally. It is categorized by the United States Food and Drug Administration as a dietary supplement. Melatonin treatment has an extremely wide margin of safety though it may cause minor adverse effects, such as headache, rash and nightmares. Melatonin was touted as a potential effective candidate for IBS treatment. Putative role of melatonin in IBS treatment include analgesic effects, regulator of gastrointestinal motility and sensation to sleep promoter. Placebo-controlled studies in melatonin suffered from heterogeneity in methodology. Most studies utilized 3 mg at bedtime as the standard dose of trial. However, all studies had consistently showed improvement in abdominal pain, some showed improvement in quality of life of IBS patients. Melatonin is a relatively safe drug that possesses potential in treating IBS. Future studies should focus on melatonin effect on gut mobility as well as its central nervous system effect to elucidate its role in IBS patients.

  4. Impact of psychological stress on irritable bowel syndrome.

    Science.gov (United States)

    Qin, Hong-Yan; Cheng, Chung-Wah; Tang, Xu-Dong; Bian, Zhao-Xiang

    2014-10-21

    Psychological stress is an important factor for the development of irritable bowel syndrome (IBS). More and more clinical and experimental evidence showed that IBS is a combination of irritable bowel and irritable brain. In the present review we discuss the potential role of psychological stress in the pathogenesis of IBS and provide comprehensive approaches in clinical treatment. Evidence from clinical and experimental studies showed that psychological stresses have marked impact on intestinal sensitivity, motility, secretion and permeability, and the underlying mechanism has a close correlation with mucosal immune activation, alterations in central nervous system, peripheral neurons and gastrointestinal microbiota. Stress-induced alterations in neuro-endocrine-immune pathways acts on the gut-brain axis and microbiota-gut-brain axis, and cause symptom flare-ups or exaggeration in IBS. IBS is a stress-sensitive disorder, therefore, the treatment of IBS should focus on managing stress and stress-induced responses. Now, non-pharmacological approaches and pharmacological strategies that target on stress-related alterations, such as antidepressants, antipsychotics, miscellaneous agents, 5-HT synthesis inhibitors, selective 5-HT reuptake inhibitors, and specific 5-HT receptor antagonists or agonists have shown a critical role in IBS management. A integrative approach for IBS management is a necessary.

  5. Convergence of neuro-endocrine-immune pathways in the pathophysiology of irritable bowel syndrome

    OpenAIRE

    Buckley, Maria M; O’Mahony, Siobhain M; O’Malley, Dervla

    2014-01-01

    Disordered signalling between the brain and the gut are generally accepted to underlie the functional bowel disorder, irritable bowel syndrome (IBS). However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusive. This common gastrointestinal disorder is characterised by alterations in bowel habit such as diarrhoea and/or constipation, bloating and abdominal pain, and symptom exacerbation has been linked w...

  6. High frequency of early colorectal cancer in inflammatory bowel disease

    NARCIS (Netherlands)

    Lutgens, M. W. M. D.; Vleggaar, F. P.; Schipper, M. E. I.; Stokkers, P. C. F.; van der Woude, C. J.; Hommes, D. W.; de Jong, D. J.; Dijkstra, G.; van Bodegraven, A. A.; Oldenburg, B.; Samsom, M.

    Background and aim: To detect precancerous dysplasia or asymptomatic cancer, patients suffering from inflammatory bowel disease often undergo colonoscopic surveillance based on American or British guidelines. It is recommended that surveillance is initiated after 8-10 years of extensive colitis, or

  7. High frequency of early colorectal cancer in inflammatory bowel disease

    NARCIS (Netherlands)

    Lutgens, M. W. M. D.; Vleggaar, F. P.; Schipper, M. E. I.; Stokkers, P. C. F.; van der Woude, C. J.; Hommes, D. W.; de Jong, D. J.; Dijkstra, G.; van Bodegraven, A. A.; Oldenburg, B.; Samsom, M.

    2008-01-01

    To detect precancerous dysplasia or asymptomatic cancer, patients suffering from inflammatory bowel disease often undergo colonoscopic surveillance based on American or British guidelines. It is recommended that surveillance is initiated after 8-10 years of extensive colitis, or after 15-20 years

  8. Is fructose malabsorption a cause of irritable bowel syndrome?

    Science.gov (United States)

    DiNicolantonio, James J; Lucan, Sean C

    2015-09-01

    Irritable Bowel Syndrome (IBS) is a condition that may be marked by abdominal pain, bloating, fullness, indigestion, belching, constipation and/or diarrhea. IBS symptoms can result from malabsorption of fructose. Fructose is a monosaccharide found naturally in small quantities in fruits and some vegetables, and in much larger quantities in industrially manufactured sweets with added sugars (e.g. sucrose and high fructose corn syrup). Fructose malabsorption leads to osmotic diarrhea as well as gas and bloating due to fermentation in the colon. A low-fructose diet has been found to improve IBS symptoms in some patients. This paper discusses the prevalence of fructose malabsorption and considers fructose ingestion as a possible cause of--and fructose restriction as a possible dietary treatment for--IBS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Wernicke-Korsakoff Syndrome following Small Bowel Obstruction

    Directory of Open Access Journals (Sweden)

    Shoumitro Deb

    2002-01-01

    Full Text Available We report a case of a 64-year-old lady who developed clinical features of Wernicke-Korsakoff syndrome following a laparotomy for small bowel obstruction. Following the operation she developed paralytic ileus and required total parenteral nutrition for one month. A suspected history of average 40 units of weekly alcohol consumption prior to the operation could not be confirmed and the patient did not show any sign of alcohol dependence. Within a few months of treatment with a daily oral dose of thiamine 200 mgs supplemented by multivitamins the patient showed subjective evidence of improvement in confusion, confabulation, and anterograde amnesia, although objective tests showed residual deficits in many areas of cognitive functioning, including immediate and delayed recall of verbal and non-verbal materials, planning and switching of attention.

  10. Mind/Body Psychological Treatments for Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Bruce D. Naliboff

    2008-01-01

    Full Text Available 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 proven efficacious in clinical trials. We propose that incorporating the constructs of mindfulness and acceptance into a mind/body psychologic treatment of IBS may be of added benefit due to the focus on changing awareness and acceptance of one's own state which is a strong component of traditional and Eastern healing philosophies.

  11. Hypokalemia causing rhabdomyolysis in a patient with short bowel syndrome.

    Science.gov (United States)

    Balhara, Kamna S; Highet, Bridget; Omron, Rodney

    2015-04-01

    Rhabdomyolysis, usually in the setting of trauma or drug use, is frequently seen in the emergency setting, and often leads to hyperkalemia at presentation. Hypokalemia, however, is a potentially underrecognized cause of rhabdomyolysis. We present a case of rhabdomyolysis likely due to hypokalemia in the setting of short bowel syndrome. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although less common, hypokalemia can be a significant cause of rhabdomyolysis via its effects on muscle. This scenario should be considered in the differential diagnosis of patients at risk for hypokalemia who present with weakness. Rapid recognition of this relationship and rapid correction of hypokalemia may prove very important in preventing the deleterious effects of rhabdomyolysis. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Breast cancer predisposition syndromes.

    Science.gov (United States)

    Hemel, Deborah; Domchek, Susan M

    2010-10-01

    A small, but important, percentage of breast cancer cases is caused by the inheritance of a single copy of a mutated gene. BRCA1 and BRCA2 are the genes most commonly associated with inherited breast cancer; however, mutations in TP53 and PTEN cause Li-Fraumeni syndrome and Cowden syndrome, respectively, both of which are associated with high lifetime risks of breast cancer. Advances in the field of breast cancer genetics have led to an improved understanding of detection and prevention strategies. More recently, strategies to target the underlying genetic defects in BRCA1- and BRCA2-associated breast and ovarian cancers are emerging and may have implications for certain types of sporadic breast cancer. Copyright 2010 Elsevier Inc. All rights reserved.

  13. The risk of extra-colonic, extra-endometrial cancer in the Lynch syndrome

    DEFF Research Database (Denmark)

    Watson, Patrice; Vasen, Hans F A; Mecklin, Jukka-Pekka

    2008-01-01

    Persons with the Lynch syndrome (LS) are at high risk for cancer, including cancers of the small bowel, stomach, upper urologic tract (renal pelvis and ureter), ovary, biliary tract and brain tumors, in addition to the more commonly observed colorectal and endometrial cancers. Cancer prevention...... after the median year of birth (p cancers of the small bowel, stomach, breast and biliary tract were less common. Urologic tract cancer and ovarian cancer occur frequently enough in some LS subgroups to justify trials to evaluate...... promising prevention interventions. Other cancer types studied occur too infrequently to justify strenuous cancer control interventions....

  14. Psychological adjustment and autonomic disturbances in inflammatory bowel diseases and irritable bowel syndrome.

    Science.gov (United States)

    Pellissier, Sonia; Dantzer, Cécile; Canini, Fréderic; Mathieu, Nicolas; Bonaz, Bruno

    2010-06-01

    Psychological factors and the autonomic nervous system (ANS) are implicated in the pathogenesis of inflammatory bowel diseases (IBD) and irritable bowel syndrome (IBS). This study aimed to assess, firstly the way IBS and IBD patients cope with their pathology according to their affective adjustment and secondly the possible links between these affective adjustments and ANS reactivity. Patients with Crohn's disease (CD; n=26), ulcerative colitis (UC; n=22), or IBS (n=27) were recruited and compared to 21 healthy subjects based on psychological variables (trait- and state anxiety, depressive symptomatology, negative mood, perceived stress, coping, health locus of control) and sympatho-vagal balance through heart-rate variability monitored at rest. A principal component analysis, performed on all affective variables, isolated a leading factor labelled as "affective adjustment". In each disease, patients were distributed into positive and negative affective adjustment. In all the diseases, a positive affect was associated with problem-focused coping, and a negative affect with emotion-focused coping and external health locus of control. Results show that the sympatho-vagal balance varied according to the disease. In CD presenting positive affectivity, an adapted high sympathetic activity was observed. In UC, a parasympathetic blunt was observed in the presence of negative affectivity and an equilibrated sympatho-vagal balance in the presence of positive affectivity. In contrast, in IBS, an important dysautonomia (with high sympathetic and low parasympathetic tone) was constantly observed whatever the affective adjustment. In conclusion, this study suggests that the equilibrium of the ANS is differentially adapted according to the disease. This equilibrium is conjugated with positive affective and cognitive adjustment in IBD (CD and UC) but not in IBS. Copyright 2009 Elsevier Ltd. All rights reserved.

  15. Are Probiotics or Prebiotics useful in pediatric irritable bowel syndrome or inflammatory bowel disease?

    Directory of Open Access Journals (Sweden)

    Stefano eGuandalini

    2014-08-01

    Full Text Available Treatment options for irritable bowel syndrome (IBS and inflammatory bowel disease (IBD are notoriously either inadequate (IBS or loaded with potentially serious side effects and risks (IBD. In recent years a growing interest for effective and safer alternatives has focused on the potential role of probiotics and their metabolic substrates, prebiotics. It is in fact conceivable that the microbiome might be targeted by providing the metabolic fuel needed for the growth and expansion of beneficial microorganisms (prebiotics or by administering to the host such microorganisms (probiotics. This review presents a concise update on currently available data, with a special emphasis on children.Data for prebiotics in IBS are scarce. Low doses have shown a beneficial effect, while high doses are counterproductive. On the contrary, several controlled trials of probiotics have yielded encouraging results. A meta-analysis including 9 randomized clinical trials in children showed an improvement in abdominal pain for Lactobacillus GG, Lactobacillus reuteri DSM 17938 and the probiotic mixture VSL#3. The patients most benefitting from probiotics were those with predominant diarrhea or with a post-infectious IBS. In IBD, the use of prebiotics has been tested only rarely and in small scale clinical trials, with mixed results. As for probiotics, data in humans from about 3 dozens clinical trials offer mixed outcomes. So far none of the tested probiotics has proven successful in Crohn’s disease, while in ulcerative colitis a recent meta-analysis on 12 clinical trials (1 of them in children showed efficacy for the probiotic mixture VSL#3 in contributing to induce and to maintain remission. It is evident that this is a rapidly evolving and promising field; more data are very likely to yield a better understanding on what strains and in what doses should be used in different specific clinical settings.

  16. Prebiotics and probiotics in irritable bowel syndrome and inflammatory bowel disease in children.

    Science.gov (United States)

    Guandalini, S; Cernat, E; Moscoso, D

    2015-01-01

    Underlying pathophysiological mechanisms of irritable bowel syndrome (IBS), a common disorder characterized by abdominal pain associated to a change in stool consistency or frequency, include low-grade inflammation and intestinal microbiota changes. Few and disappointing data are available for prebiotics. A few controlled trials (RCTs) of probiotics are instead available with favourable effects, although most are limited by suboptimal design and small sample size. A recent report from the Rome foundation group included 32 RCTs of probiotics, most of which showed an overall modest improvement in symptoms, with the patients most benefitting from probiotics being those with predominant diarrhoea and those having a post-infectious IBS. A review focusing only on children with functional gastrointestinal disorders concluded that probiotics are more effective than placebo in the treatment of patients with abdominal pain-related functional gastrointestinal disorders, although no effect on constipation was evident. The role for probiotics in inflammatory bowel disease (IBD) appears logical: the endogenous intestinal microbiota plays a central role in their development, and various probiotics have been found effective in animal models of IBD. However, research in humans has been overall quite limited, and it would seem that after a phase of intense research in the first decade of this century, the pace has slowed down, with fewer clinical trials been published in the past 2-3 years. To summarize current evidence: no probiotic has proven successful in Crohn's disease. In ulcerative colitis, on the other hand, data are more promising, and a very recent meta-analysis, that included 23 randomized controlled trials, concluded that there is evidence of efficacy for the probiotic mixture VSL#3 in helping inducing and maintaining remission, as well as in maintaining remission in patients with pouchitis. It is fair to state that for both IBD and IBS, more well-designed, rigorous

  17. The role of abuse in the development of irritable bowel syndrome: a ...

    African Journals Online (AJOL)

    The role of abuse in the development of irritable bowel syndrome: a comparative study: research. ... disorder of unknown causes which is characterised by attacks of abdominal pain and change of bowel habit resulting in diarrhoea or constipation or both. ... No such studies have however been conducted in South Africa.

  18. Prevalence of irritable bowel syndrome, influence of lifestyle factors and bowel habits in Korean college students.

    Science.gov (United States)

    Kim, You Joung; Ban, D J

    2005-03-01

    Irritable bowel syndrome (IBS) is considered to be prevalent in the general population, but there are little data on bowel habits and IBS in Korea. Because nurses are frequently called on to help this patient population with IBS and help manage their symptoms, it is very necessary to get some practical information about patients' experiences and to outline a multifaceted approach to the practical management of patient with IBS. So this study aims to describe the bowel habits and the prevalence of IBS in young university students in Korea and to investigate the influence of lifestyle factors, including dietary habits, on IBS prevalence. Finally, we discuss the nursing needs for an holistic approach. A cross-sectional study, using the self-reported questionnaire based on previous studies done abroad and the Rome alpha criteria was applied with 1717 young university students. The answers of 747 men and 970 women were included in the study. The prevalence of IBS, as defined by the Rome alpha criteria, was 5.7% of the subjects. The proportion of women (70.7%) was significantly higher than the proportion of men in the IBS group as compared to that in the non-IBS group (odds ratio 2.07, 95% CI 1.2-3.7). Residential type (odds ratio 1.27, 95% 1.06-1.5) and frequency of meals (odds ratio 1.69, 95% CI 1.2-2.5) significantly differed between the IBS group and non-IBS group. There was a trend towards the higher prevalence of IBS with fewer hours of exercise (odds ratio 0.99, 95% CI 0.95-1.04). 90.6% of respondents reported stool frequencies between three times per day and three times per week. Characteristics of defecation differed significantly between men and women (pstudy shows that proportionately more women suffered from IBS than men and dietary factors and lifestyle were significantly related to IBS. From our study results, we found that there are multifaceted nursing aspects required to reduce symptoms, such as dietary education and encouragement to change lifestyle

  19. Irritable bowel syndrome: A disease still searching for pathogenesis, diagnosis and therapy

    Science.gov (United States)

    Bellini, Massimo; Gambaccini, Dario; Stasi, Cristina; Urbano, Maria Teresa; Marchi, Santino; Usai-Satta, Paolo

    2014-01-01

    Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that can have a serious impact on the patient’s quality of life. The pathophysiology of IBS is not yet completely clear. Genetic, immune, environmental, inflammatory, neurological and psychological factors, in addition to visceral hypersensitivity, can all play an important role, one that most likely involves the complex interactions between the gut and the brain (gut-brain axis). The diagnosis of IBS can only be made on the basis of the symptoms of the Rome III criteria. Because the probability of organic disease in patients fulfilling the IBS criteria is very low, a careful medical history is critical and should pay particular attention to the possible comorbidities. Nevertheless, the severity of the patient’s symptoms or concerns sometimes compels the physician to perform useless and/or expensive diagnostic tests, transforming IBS into a diagnosis of exclusion. The presence of alarming symptoms (fever, weight loss, rectal bleeding, significant changes in blood chemistry), the presence of palpable abdominal masses, any recent onset of symptoms in patient aged over 50 years, the presence of symptoms at night, and a familial history of celiac disease, colorectal cancer and/or inflammatory bowel diseases all warrant investigation. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. This review examines and discusses the pathophysiological aspects and the diagnostic and therapeutic approaches available for patients with symptoms possibly related to IBS, pointing out controversial issues and the strengths and weaknesses of the current knowledge. PMID:25083055

  20. Laparoscopic Management of a Small Bowel Recurrence of Endometrial Cancer.

    Science.gov (United States)

    Gallotta, Valerio; Nero, Camilla; Callari, Cosimo; Lodoli, Claudio; Fanfani, Francesco; Fagotti, Anna; Scambia, Giovanni

    2016-02-01

    We present a very rare case of focal metastasis of endometrial cancer to the small bowel entirely managed laparoscopically. Case report (Canadian Task Force Classification Study design III). Tertiary referral centre in Rome, Italy. A 58 year-old patient with a FIGO Stage IB G2 N0 endometrial cancer was found to have a vaginal cuff recurrence and an isolated distant metastasis to the small bowel 13 months after primary treatment. In this video we show a fully laparoscopic management mainly focusing on small bowel resection with intracorporeal anastomosis. A laparoscopic partial colpectomy was also performed. Our institutional review board approved this study. Operative time was 180 minutes. Intraoperative blood loss was less than 100 mL. The operation was performed successfully with no intraoperative complications. Pathologic findings showed recurrent disease in the vaginal cuff and in the resected small bowel segment with free resection margins in both specimens and 3 mesenteric local nodes negative for metastasis. The patient was discharged on day 3 and 26 days later started adjuvant chemotherapy. After a 16-month follow-up period, the patient is still disease free and in good general conditions. This case shows a successful laparoscopic management of recurrent endometrial cancer equiring complex surgical procedures. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  1. Irritable Bowel Syndrome and Complementary Health Practices: What the Science Says

    Science.gov (United States)

    ... Talley NJ, Spiegel BM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis . BMJ . 2008;337:a2313. Ford AC, Quigley EM, ...

  2. Pediatric irritable bowel syndrome patient and parental characteristics differ by care management type

    Science.gov (United States)

    This study evaluates whether certain patient or parental characteristics are associated with gastroenterology (GI) referral versus primary pediatrics care for pediatric irritable bowel syndrome (IBS). A retrospective clinical trial sample of patients meeting pediatric Rome III IBS criteria was assem...

  3. Systematic review: The placebo effect of psychological interventions in the treatment of irritable bowel syndrome

    NARCIS (Netherlands)

    Flik, Carla E.; Bakker, Laura; Laan, Wijnand; van Rood, Yanda R.; Smout, André J. P. M.; de Wit, Niek J.

    2017-01-01

    To determine the placebo response rate associated with different types of placebo interventions used in psychological intervention studies for irritable bowel syndrome. Randomized controlled trials comparing psychological interventions (stress management/relaxation therapy (cognitive) behavioral

  4. Efficacy and Safety of Antidepressants for the Treatment of Irritable Bowel Syndrome: A Meta-Analysis

    OpenAIRE

    Xie, Chen; Tang, Yurong; Wang, Yunfeng; Yu, Ting; Wang, Yun; Jiang, Liuqin; Lin, Lin

    2015-01-01

    Aim The aim of this meta-analysis was to analyze the efficacy and safety of antidepressants for the treatment of irritable bowel syndrome. Methods We searched MEDLINE, EMBASE, Scopus and The Cochrane Library for randomized controlled trials investigating the efficacy and safety of antidepressants in the treatment of irritable bowel syndrome. Article quality was evaluated by Jadad score. RevMan 5.0 and Stata 12.0 were used for the meta-analysis. Results Twelve randomized controlled trials were...

  5. Irritable bowel syndrome and other gastrointestinal disorders: evaluating self-medication in an Asian community setting.

    Science.gov (United States)

    Kua, Chong-Han; Ng, Siow-Tian; Lhode, Reshma; Kowalski, Stefan; Gwee, Kok-Ann

    2012-08-01

    Gastrointestinal disorders frequently present symptoms which are often self-treated. To record demographic profile of patients visiting community pharmacies for self-treatment with medications for gastrointestinal disorders, the number of these patients who fulfilled irritable bowel syndrome diagnostic criteria, and to judge the appropriateness of their treatment requests. Singapore community pharmacies. The multicentre study was conducted using ROME III adapted criteria on adults above 18 years who have self-selected medicinal products for treatment of irritable bowel syndrome or gastrointestinal symptoms in the community pharmacy. Among those seeking self-medication, 36.8 % fulfilled criteria for irritable bowel syndrome, with irritable bowel syndrome-mixed (16.3 %) being the most prevalent subtype. For patients not fulfilling criteria for irritable bowel syndrome diagnosis, rates for other functional gastrointestinal disorders were constipation (20.5 %), dyspepsia (16.3 %), gastroesophageal reflux disease (12.1 %), diarrhoea (8.9 %), bloating (4.2 %), and heartburn (3.2 %). There were more females with gastrointestinal complaints. Overall, 21.6 % of the total participants had recently sought medical attention for their gastrointestinal complaint. 20 % of patients selected inappropriate medication for their gastrointestinal complaints, and the antacids class had the highest incidence of inappropriate medication use. Possible co-existing relationships were seen between gastroesophageal reflux disease with dyspepsia, irritable bowel syndrome with gastroesophageal reflux disease, irritable bowel syndrome with dyspepsia, and diarrhoea with constipation. Patients who fulfilled criteria for irritable bowel syndrome had a high tendency to self-treat their gastrointestinal symptoms. Constipation complaints were also common. Around one in five patients self-medicated gastrointestinal symptoms inappropriately, with antacids being the most common.

  6. Randomised controlled trial of colostrum to improve intestinal function in patients with short bowel syndrome

    DEFF Research Database (Denmark)

    Lund, Pernille; Sangild, Per Torp; Aunsholt, L.

    2012-01-01

    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.......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....

  7. Systematic review: Complementary and alternative medicine in the irritable bowel syndrome.

    LENUS (Irish Health Repository)

    Hussain, Z

    2012-02-03

    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.

  8. The serotonin connection in ingestive disorders in women with and without irritable bowel syndrome (IBS)

    OpenAIRE

    Debbie Bloch; Anita D Stuart; H Gertie Pretorius,

    1999-01-01

    This study compared women with lrritable Bowel Syndrome (IBS) and women without IBS, with regards to characteristics of indigestion disturbances, as measured by the Eating Disorder Inventory-2. A comparison between the two groups was also made of their blood-serotonin leveb. A sample group (N = 30) of women that suffer from IBSand~ac ontrol group (N = 28) completed the "lrritable bowel syndrome Client Questionnaire" and the "Eating Disorder Inventory-2". A part of the study attempted to deter...

  9. Sex hormones in the modulation of irritable bowel syndrome.

    Science.gov (United States)

    Mulak, Agata; Taché, Yvette; Larauche, Muriel

    2014-03-14

    Compelling evidence indicates sex and gender differences in epidemiology, symptomatology, pathophysiology, and treatment outcome in irritable bowel syndrome (IBS). Based on the female predominance as well as the correlation between IBS symptoms and hormonal status, several models have been proposed to examine the role of sex hormones in gastrointestinal (GI) function including differences in GI symptoms expression in distinct phases of the menstrual cycle, in pre- and post-menopausal women, during pregnancy, hormonal treatment or after oophorectomy. Sex hormones may influence peripheral and central regulatory mechanisms of the brain-gut axis involved in the pathophysiology of IBS contributing to the alterations in visceral sensitivity, motility, intestinal barrier function, and immune activation of intestinal mucosa. Sex differences in stress response of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, neuroimmune interactions triggered by stress, as well as estrogen interactions with serotonin and corticotropin-releasing factor signaling systems are being increasingly recognized. A concept of "microgenderome" related to the potential role of sex hormone modulation of the gut microbiota is also emerging. Significant differences between IBS female and male patients regarding symptomatology and comorbidity with other chronic pain syndromes and psychiatric disorders, together with differences in efficacy of serotonergic medications in IBS patients confirm the necessity for more sex-tailored therapeutic approach in this disorder.

  10. Inflammatory Bowel Disease and Small Bowel Cancer Risk, Clinical Characteristics, and Histopathology

    DEFF Research Database (Denmark)

    Bojesen, Rasmus Dahlin; Riis, Lene Buhl; Høgdall, Estrid

    2017-01-01

    BACKGROUND & AIMS: Inflammatory bowel disease (IBD) may increase risk of small bowel cancer (SBC). However, little is known of the characteristics and features of IBD-SBC, due to a low number of cases worldwide. We performed a population-based study of IBD and SBC to calculate risk and increase our...... understanding of clinical characteristics and histopathological and molecular features. METHODS: The study population consisted of all individuals aged 16 years or older living in Denmark during 1978-2010. Through linkage between national registers and subsequent scrutiny of medical records and pathology...... descriptions, we identified 40 cases of IBD-SBC. Risk was calculated by standardized incidence ratio (SIR) (observed/expected); patient characteristics were derived from medical files, and surgery specimens were obtained from hospitals nationwide for histopathological and molecular analyses. RESULTS: During...

  11. Intraluminal exfoliated cancer cells and effectiveness of bowel ligatures during sigmoidectomy for sigmoid colon cancer.

    Science.gov (United States)

    Maeda, Kotaro; Hanai, Tsunekazu; Sato, Harunobu; Masumori, Koji; Koide, Yoshikazu; Matsuoka, Hiroshi; Katsuno, Hidetoshi; Kuroda, Makoto

    2014-02-01

    To establish the efficiency of bowel ligatures in colon cancer surgery, focusing on the extent to which exfoliated cancer cells are shed in the colonic lumen during sigmoidectomy. Twenty consecutive patients who underwent sigmoidectomy for sigmoid colon cancer were prospectively randomized into two groups: the "ligatures group", in which bowel ligatures were placed, 3, 5, 10 cm from the tumor proximally and distally before dissection; and the "no ligatures group", in which the corresponding sites were ligated only immediately before taking the specimen out. Each colonic segment ligated was irrigated with saline and samples were sent for blind cytological examination. Cancer cells were found in the colonic segment where the tumor was located, in 18 of 20 samples. The frequency of free cancer cells decreased from 50 to 0 % (p bowel ligatures. Free cancer cells were confirmed in 1 of 10 samples at both colonic segments 5-10 cm from the tumor, even after bowel ligatures. Intraluminal exfoliated cancer cells could be eliminated by placing bowel ligatures during sigmoidectomy. Measures should be considered to eliminate exfoliated cancer cells during colectomy, even after placing bowel ligatures.

  12. Impact of restless legs syndrome in patients with inflammatory bowel disease on sleep, fatigue, and quality of life.

    Science.gov (United States)

    Schindlbeck, Katharina A; Becker, Janek; Berger, Felix; Mehl, Arne; Rewitzer, Charlotte; Geffe, Sarah; Koch, Peter M; Preiß, Jan C; Siegmund, Britta; Maul, Jochen; Marzinzik, Frank

    2017-01-01

    Inflammatory bowel disease has been associated with neurological symptoms including restless legs syndrome. Here, we investigated the impact of restless legs syndrome in patients with inflammatory bowel disease on sleep, fatigue, mood, cognition, and quality of life. Two groups of inflammatory bowel disease patients, with and without restless legs syndrome, were prospectively evaluated for sleep disorders, fatigue, daytime sleepiness, depression, anxiety, and health-related quality of life. Furthermore, global cognitive function, executive function, attention, and concentration were assessed in both groups. Disease activity and duration of inflammatory bowel disease as well as current medication were assessed by interview. Inflammatory bowel disease patients with and without restless legs syndrome were matched for age, education, severity, and duration of their inflammatory bowel disease. Patients with inflammatory bowel disease and clinically relevant restless leg syndrome suffered significantly more frequent from sleep disturbances including sleep latency and duration, more fatigue, and worse health-related quality of life as compared to inflammatory bowel disease patients without restless legs syndrome. Affect and cognitive function including cognitive flexibility, attention, and concentration showed no significant differences among groups, indicating to be not related to restless legs syndrome. Sleep disorders including longer sleep latency, shorter sleep duration, and fatigue are characteristic symptoms of restless legs syndrome in inflammatory bowel disease patients, resulting in worse health-related quality of life. Therefore, clinicians treating patients with inflammatory bowel disease should be alert for restless legs syndrome.

  13. Sex, gender, and irritable bowel syndrome: making the connections.

    Science.gov (United States)

    Payne, Sarah

    2004-08-01

    Irritable bowel syndrome (IBS) is a widespread chronic health condition experienced more often by women than by men. The extent to which women outnumber men varies, however, with a narrower sex ratio found in population surveys and the widest in gastroenterology clinics. This suggests that explanations of women's excess risk of this condition likely involve both sex, or biological, differences between men and women as well as gender, or social, differences. This article reviews research on sex and gender factors in IBS and, in particular, the ways in which these factors affect the risk of IBS, either independently or in synergy. A multidisciplinary literature review of English-language IBS research published between 1966 and 2002 was conducted using a number of electronic databases (ASSIA, MEDLINE, PsycLIT, and SSCI/Web of Knowledge), augmented by manual search of issues not yet entered onto the databases. The key terms sex, gender, women, men, and irritable bowel disease were used to identify articles with potential relevance; titles and abstracts were reviewed and downloaded to a bibliographic referencing system. This approach yielded approximately 450 articles of interest in the subject area. The literature review highlighted a range of sex- and gender-linked factors in IBS, including hormonal factors, genetic differences, psychosocial factors related to stress, mental well-being, gender roles, and the experience of sexual abuse. In addition, the literature suggests that gender-related factors overlap each other in explanations of IBS among women, and the interactions between these factors and sex-linked biology are not yet fully understood. A complex model is needed-reflecting sex- and gender-linked factors and their interactions-to fully understand how these factors affect variations in risk and outcome between men and women with IBS.

  14. Whole-bowel transit in patients with the irritable bowel syndrome

    International Nuclear Information System (INIS)

    Hardy, J.G.; Clark, A.G.; Wood, E.; Reynolds, J.R.

    1986-01-01

    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.)

  15. Whole-bowel transit in patients with the irritable bowel syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, J.G.; Clark, A.G.; Wood, E.; Reynolds, J.R.

    1986-02-01

    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.).

  16. Irritable Bowel Syndrome and Migraine: Bystanders or Partners?

    Science.gov (United States)

    Lu, Ching-Liang

    2013-01-01

    Irritable bowel syndrome (IBS) and migraine are distinct clinical disorders. Apart from the characteristics of chronic and recurrent pain in nature, these pain-related disorders apparently share many similarities. For example, IBS is female predominant with community prevalence about 5-10%, whereas that of migraine is 1-3% also showing female predominance. They are often associated with many somatic and psychiatric comorbidities in terms of fibromyaglia, chronic fatigue syndrome, interstitial cystitis, insomnia and depression etc., even the IBS subjects may have coexisted migraine with an estimated odds ratio of 2.66. They similarly reduce the quality of life of victims leading to the social, medical and economic burdens. Their pathogeneses have been somewhat addressed in relation to biopsychosocial dysfunction, heredity, genetic polymorphism, central/visceral hypersensitivity, somatic/cutaneous allodynia, neurolimbic pain network, gonadal hormones and abuses etc. Both disorders are diagnosed according to the symptomatically based criteria. Multidisciplinary managements such as receptor target new drugs, melantonin, antispasmodics, and psychological drugs and measures, complementary and alternatives etc. are recommended to treat them although the used agents may not be necessarily the same. Finally, the prognosis of IBS is pretty good, whereas that of migraine is less fair since suicide attempt and stroke are at risk. In conclusion, both distinct chronic pain disorders to share many similarities among various aspects probably suggest that they may locate within the same spectrum of a pain-centered disorder such as central sensitization syndromes. The true pathogenesis to involve these disorders remains to be clarified in the future. PMID:23875096

  17. Carbohydrate malabsorption and the effect of dietary restriction on symptoms of irritable bowel syndrome and functional bowel complaints.

    Science.gov (United States)

    Goldstein, R; Braverman, D; Stankiewicz, H

    2000-08-01

    Carbohydrate malabsorption of lactose, fructose and sorbitol has already been described in normal volunteers and in patients with functional bowel complaints including irritable bowel syndrome. Elimination of the offending sugar(s) should result in clinical improvement. To examine the importance of carbohydrate malabsorption in outpatients previously diagnosed as having functional bowel disorders, and to estimate the degree of clinical improvement following dietary restriction of the malabsorbed sugar(s). A cohort of 239 patients defined as functional bowel complaints was divided into a group of 94 patients who met the Rome criteria for irritable bowel syndrome and a second group of 145 patients who did not fulfill these criteria and were defined as functional complaints. Lactose (18 g), fructose (25 g) and a mixture of fructose (25 g) plus sorbitol (5 g) solutions were administered at weekly intervals. End-expiratory hydrogen and methane breath samples were collected at 30 minute intervals for 4 hours. Incomplete absorption was defined as an increment in breath hydrogen of at least 20 ppm, or its equivalent in methane of at least 5 ppm. All patients received a diet without the offending sugar(s) for one month. Only 7% of patients with IBS and 8% of patients with FC absorbed all three sugars normally. The frequency of isolated lactose malabsorption was 16% and 12% respectively. The association of lactose and fructose-sorbitol malabsorption occurred in 61% of both patient groups. The frequency of sugar malabsorption among patients in both groups was 78% for lactose malabsorption (IBS 82%, FC 75%), 44% for fructose malabsorption and 73% for fructose-sorbitol malabsorption (IBS 70%, FC 75%). A marked improvement occurred in 56% of IBS and 60% of FC patients following dietary restriction. The number of symptoms decreased significantly in both groups (P malabsorption patterns are common in functional bowel disorders and may contribute to symptomatology in most patients

  18. Irritable bowel syndrome: diagnostic approaches in clinical practice

    Directory of Open Access Journals (Sweden)

    Eugene J Burbige

    2010-09-01

    Full Text Available Eugene J BurbigeDivision of Gastroenterology, Gastrointestinal and Liver Research, John Muir Medical Center, Concord, CA, USABackground: Irritable bowel syndrome (IBS, a functional gastrointestinal disorder long considered a diagnosis of exclusion, has chronic symptoms that vary over time and overlap with those of non-IBS disorders. Traditional symptom-based criteria effectively identify IBS patients but are not easily applied in clinical practice, leaving >40% of patients to experience symptoms up to 5 years before diagnosis.Objective: To review the diagnostic evaluation of patients with suspected IBS, strengths and weaknesses of current methodologies, and newer diagnostic tools that can augment current symptom-based criteria.Methods: The peer-reviewed literature (PubMed was searched for primary reports and reviews using the limiters of date (1999–2009 and English language and the search terms irritable bowel syndrome, diagnosis, gastrointestinal disease, symptom-based criteria, outcome, serology, and fecal markers. Abstracts from Digestive Disease Week 2008–2009 and reference lists of identified articles were reviewed.Results: A disconnect is apparent between practice guidelines and clinical practice. The American Gastroenterological Association and American College of Gastroenterology recommend diagnosing IBS in patients without alarm features of organic disease using symptom-based criteria (eg, Rome. However, physicians report confidence in a symptom-based diagnosis without further testing only up to 42% of the time; many order laboratory tests and perform sigmoidoscopies or colonoscopies despite good evidence showing no utility for this work-up in uncomplicated cases. In the absence of diagnostic criteria easily usable in a busy practice, newer diagnostic methods, such as stool-form examination, fecal inflammatory markers, and serum biomarkers, have been proposed as adjunctive tools to aid in an IBS diagnosis by increasing physicians

  19. Irritable bowel syndrome and endometriosis: New insights for old diseases.

    Science.gov (United States)

    Viganò, Davide; Zara, Federica; Usai, Paolo

    2018-03-01

    Irritable bowel syndrome and endometriosis are two diseases affecting a significant part of the female population, either together or individually, with remarkable consequences in the quality of life. Several studies suggest an epidemiological association between them. Their association may not be just an epidemiological phenomenon, but the manifestation of a pathophysiological correlation, which probably generates a mutual promotion phenomenon. In particular, both clinical entities share the presence of a chronic low-grade inflammatory state at the basis of the disease persistence. Recognizing this association is highly significant due to their prevalence and the common clinical manifestation occurring with a chronic abdominal pain. A further multi disciplinary approach is suggested in these patients' management in order to achieve an adequate diagnostic work up and a targeted therapy. This paper analyses some common pathophysiological mechanisms, such as activation of mast cell line, neuronal inflammation, dysbiosis and impaired intestinal permeability. The aim was to investigate their presence in both IBS and endometriosis, and to show the complexity of their relationship in the generation and maintenance of chronic inflammation. Copyright © 2017. Published by Elsevier Ltd.

  20. Gut microbiota role in irritable bowel syndrome: New therapeutic strategies

    Science.gov (United States)

    Distrutti, Eleonora; Monaldi, Lorenzo; Ricci, Patrizia; Fiorucci, Stefano

    2016-01-01

    In the last decade the impressive expansion of our knowledge of the vast microbial community that resides in the human intestine, the gut microbiota, has provided support to the concept that a disturbed intestinal ecology might promote development and maintenance of symptoms in irritable bowel syndrome (IBS). As a correlate, manipulation of gut microbiota represents a new strategy for the treatment of this multifactorial disease. A number of attempts have been made to modulate the gut bacterial composition, following the idea that expansion of bacterial species considered as beneficial (Lactobacilli and Bifidobacteria) associated with the reduction of those considered harmful (Clostridium, Escherichia coli, Salmonella, Shigella and Pseudomonas) should attenuate IBS symptoms. In this conceptual framework, probiotics appear an attractive option in terms of both efficacy and safety, while prebiotics, synbiotics and antibiotics still need confirmation. Fecal transplant is an old treatment translated from the cure of intestinal infective pathologies that has recently gained a new life as therapeutic option for those patients with a disturbed gut ecosystem, but data on IBS are scanty and randomized, placebo-controlled studies are required. PMID:26900286

  1. Self-schema in irritable bowel syndrome and depression.

    Science.gov (United States)

    Toner, B B; Garfinkel, P E; Jeejeebhoy, K N; Scher, H; Shulhan, D; Di Gasbarro, I

    1990-01-01

    Some investigators have suggested that irritable bowel syndrome (IBS) represents a physiologic expression of an affective disorder. This study investigated whether IBS patients differed in their self-schema from depressed patients. Self-schema refers to a cognitive framework of the individual's beliefs, attitudes, and self-perceptions which is stored in memory and which influences incoming information. The sample consisted of 21 IBS patients, 21 psychiatric outpatients with major depression (MD), and 19 normal controls. All groups were age matched. Subjects completed a structured psychiatric interview (Diagnostic Interview Schedule (DIS) and a Beck Depression Inventory (BDI), in addition to a test of self-schema, which involved rating and recall of a variety of "depressed" and "nondepressed" content adjectives. Consistent with previous work on self-schema, the MD group recalled significantly more depressed adjectives rated under the self-referent task than the Control group (p less than 0.05) and, also, the IBS group (p less than 0.05). Most striking was the finding that a subgroup of IBS patients who met criteria for MD (43% of the sample) recalled significantly more self-referent nondepressed words (and less self-referent depressed words) than the MD group (p less than 0.05). In other words, IBS patients with MD do not view themselves as depressed. These findings suggest that while some IBS and depressed psychiatric outpatients may share depressive symptoms, these groups can be differentiated by their self-schema.

  2. Serotonergic agents and the irritable bowel syndrome: what goes wrong?

    Science.gov (United States)

    Spiller, Robin

    2008-12-01

    It is now nine years since the first large randomised controlled trials showed the benefit of a 5HT(3) antagonist in irritable bowel syndrome (IBS) with diarrhoea (IBS-D) and a 5HT(4) partial agonist in IBS with constipation (IBS-C). Although both of these drugs have now been withdrawn because of rare complications (ischaemic colitis and thrombotic episodes respectively), their clinical effectiveness has stimulated substantial advances in our understanding of the physiological role of serotonin and its disturbance in IBS. 5HT-containing enteroendocrine cells are most numerous in the duodenum and colon and are responsive to a range of stimuli including tastants, mechanic force and short chain fatty acids. Several studies have described an excess of 5HT in IBS-D and abnormally low 5HT availability in IBS-C. Serotonin transporter (SERT) is only weakly expressed in the colon and whether this is further reduced in IBS is unclear with conflicting reports. SERT promoter polymorphisms are inconsistently related to IBS subtypes but appear to partly predict response to both 5HT(3) antagonists and 5HT(4) agonists. Stressors release serotonin and 5HT(3) antagonists have been shown to inhibit the associated acceleration of colonic transit. Newer 5HT(3) antagonists and 5HT(4) agonists are under development. Their undoubted effectiveness in subgroups of IBS should stimulate further work to define biomarkers of both responsiveness and of risk of developing adverse events to improve the risk benefit balance for these potentially useful therapies.

  3. Personality traits and emotional patterns in irritable bowel syndrome.

    Science.gov (United States)

    Muscatello, Maria Rosaria A; Bruno, Antonio; Mento, Carmela; Pandolfo, Gianluca; Zoccali, Rocco A

    2016-07-28

    The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.

  4. Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment.

    Science.gov (United States)

    Mahvi-Shirazi, Majid; Fathi-Ashtiani, Ali; Rasoolzade-Tabatabaei, Sayed-Kazem; Amini, Mohsen

    2012-02-29

    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. Applying general sampling, 50 IBS patients were selected from among those who used to refer to a Gastroenterology Clinic. After physical and mental evaluations based on ROME-II scale and SCL-90-R questionnaires, the subjects were randomly superseded into: the control group with medical treatment and, the case group with a combination of medical and psychological treatments. The acquired data were then analyzed through t-test and Mann-Whitney U-test. The findings show that the mental health of patients receiving cognitive behavioral therapy along with the medical treatment was higher than those of the control group at post-test level. It was observed that the therapy reduces the disability caused by IBS. Comparatively, while the cognitive therapy and medical treatments cured 80% of the patients, those receiving cognitive therapy alone showed an extensive reduction of symptoms. Considering the role of cognitive behavioral therapy, it is therefore recommend that such patients be managed by a combined team of gastroenterologists and psychologists.

  5. Symptomatic fructose malabsorption in irritable bowel syndrome: A prospective study.

    Science.gov (United States)

    Melchior, Chloé; Gourcerol, Guillaume; Déchelotte, Pierre; Leroi, Anne-Marie; Ducrotté, Philippe

    2014-04-01

    Fructose can trigger or worsen symptoms in irritable bowel syndrome (IBS) patients. The aim of this study was to determine the prevalence of symptomatic fructose malabsorption in IBS patients and to test whether the patient's characteristics can help to detect a fructose malabsorption. Ninety Rome III IBS patients (predominant diarrhoea (IBS-D): 31%, predominant constipation (IBS-C): 18%, mixed type (IBS-M): 51%) were included prospectively. After exclusion of a small intestinal bacterial overgrowth by a glucose breath test, fructose malabsorption was assessed by a five-hour breath test, with symptom monitoring, after a 25 g load of fructose. An increase of more than 20 ppm of hydrogen (H2) or methane (CH4) levels in the exhaled air led to the diagnosis of malabsorption. Fructose test was abnormal in 20/90 patients among whom only 35% were intolerant, with a simultaneous rise of H2/CH4 levels and the onset of abdominal discomfort or diarrhoea. IBS characteristics were not predictive even if young (p = 0.031) and male IBS patients (p = 0.029) were at higher risk of malabsorption. At variance, 18 additional patients experienced intestinal symptoms during the test despite normal fructose absorption. After a 25 g fructose load, symptomatic fructose malabsorption and intolerance without malabsorption were detected in 22% and 28% of IBS patients respectively.

  6. Irritable bowel syndrome: role of food in pathogenesis and management.

    LENUS (Irish Health Repository)

    Morcos, Ashraf

    2009-11-01

    Patients with the irritable bowel syndrome (IBS) commonly report the precipitation of symptoms on food ingestion. Though the role of dietary constituents in IBS has not been extensively studied, food could contribute to symptom onset or even the causation of IBS through a number of mechanisms. First, the physiological response of the intestine to food ingestion could precipitate symptoms in predisposed individuals; second, there is some evidence that allergy or intolerance to a particular food can produce IBS-like symptoms, third, certain foods may alter the composition of the luminal milieu, either directly or indirectly through effects on bacterial metabolism, and thus induce symptoms and, finally, IBS may develop following exposure to food-borne pathogens. Anticipatory, psychological factors generated by previous negative experiences with food ingestion or other factors may also contribute though their contribution has been scarcely quantified. Not surprisingly, there is considerable interest in the potential roles of diet and food supplements in the therapy of IBS; for the most part, the evidence base for such recommendations remains slim though certain probiotics show considerable promise.

  7. Total parenteral nutrition in patients with short bowel syndrome.

    Science.gov (United States)

    Ekema, G; Milianti, S; Boroni, G

    2009-06-01

    Nowadays short bowel syndrome (SBS) is quite frequent, because of more aggressive surgical and medical approaches to the management of neonatal intra-addominal catastrophes. Intestinal rehabilitation can be reached in case of SBS with a strategy that merges nutritional, pharmacologic and surgical approaches to achieve the ultimate goal of enteral nutrition. Long-term clinical nutrition which combines total parenteral nutrition (TPN) and enteral nutrition is required for the adaptation process. Long-term TPN can, however, be associated with mechanical, septic and metabolic complications, most of which have been consistently reduced by a better understanding of the prerequisites for its application and by improvements in parenteral solutions. Parenteral nutrition associated cholestasis (PNAC) and liver disease (PNALD) remain indeed the most worrisome complications and bear with them a high mortality rate. Their prevention will further improve the role of TPN in patients with SBS. The etiology of PNAC and PNALD, although elusive, is thought to be multifactorial and proposed theories also include problems arising from lipid emulsions. Parenteral nutrition, that includes n-3 fatty acids, appear to diminish the extent of the inflammatory response thought to be responsible for PNAC and PNALD. This article will attempt to review the role of TPN in the rehabilitation process and discuss energy and macronutrients requirements.

  8. Role of gut pathogens in development of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Madhusudan Grover

    2014-01-01

    Full Text Available Acute infectious gastroenteritis is one of the most commonly identifiable risk factors for the development of irritable bowel syndrome (IBS. A number of bacterial, viral and parasitic pathogens have been found to be associated with the development of IBS and other functional gastrointestinal (GI disorders. Epidemiological studies have identified demographic and acute enteritis-related risk factors for the development of post-infectious-IBS (PI-IBS. Immune dysregulation, alterations in barrier function, serotonergic and mast cell activation have been identified as potential pathophysiological mechanisms. Additionally, variations in host genes involved in barrier function, antigen presentation and cytokine response have been associated with PI-IBS development. However, it is unknown whether specific pathogens have unique effects on long-term alterations in gut physiology or different pathogens converge to cause common alterations resulting in similar phenotype. The role of microbial virulence and pathogenicity factors in development of PI-IBS is also largely unknown. Additionally, alterations in host gut sensation, motility, secretion, and barrier function in PI-IBS need to be elucidated. Finally, both GI infections and antibiotics used to treat these infections can cause long-term alterations in host commensal microbiota. It is plausible that alteration in the commensal microbiome persists in a subset of patients predisposing them to develop PI-IBS.

  9. [Irritable bowel syndrome: New pathophysiological hypotheses and practical issues].

    Science.gov (United States)

    Duboc, H; Dior, M; Coffin, B

    2016-08-01

    In 2015, besides the fact that it still fills the gastroenterologists' offices and impairs patient's quality of life, the irritable bowel syndrome has considerably evolved on several points. The pathophysiology is now organized around a consensual hypothesis called the "brain-gut axis", which gather all the influences of peripheral factors as gut microbiota or local serotonin secretion, on the central pain perception, contributing to visceral hypersensitivity and transit modifications. About the diagnosis, the key message is "avoid over-prescription" of additional tests, and reminds that a positive clinical diagnosis based on Rome III criteria is possible after the elimination of simple clinical warning signs. Finally, the food component, a neglected and historical claim of patients, finally finds a strong scientific rational, with a diet low in fermentable sugar and polyols, that gives positive and reproducible results. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  10. Benefits from Long-Term Treatment in Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Stefano Evangelista

    2012-01-01

    Full Text Available 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 that is often time-dependent but with high relapse rates (around 40%–50% when stopping treatment. Relapse is not always immediate after stopping treatment and the recent data from OBIS trial with otilonium bromide or with psychotherapy, showed that due to different chemico-physical characteristics of the drugs or the psychosomatic impact to the disease not all treatment gave the same relapsing rate if compared to placebo. Results of IBS clinical trials with different therapies tailored to the patient needs indicate that a cyclic treatment therapy is advisable to counteract the nature of the disease.

  11. Moving beyond perceptions: internalized stigma in the irritable bowel syndrome.

    Science.gov (United States)

    Taft, T H; Riehl, M E; Dowjotas, K L; Keefer, L

    2014-07-01

    Internalized stigma (IS) is an important construct in the chronic illness literature with implications for several patient reported outcomes. To date, no study exists evaluating IS in patients with the irritable bowel syndrome (IBS). Two hundred and forty three online and clinical participants completed the following questionnaires: the IS scale for mental illness (ISMI; modified for IBS), perceived stigma scale for IBS, NIH-PROMIS Anxiety and Depression Scales, IBS quality of life scale, and the Perceived Health Competence Scale. Demographical and clinical data were also collected. The modified ISMI was reliable and valid in this population. Participants reported both perceived and IS. Alienation was most reported, followed by social withdrawal and discrimination experiences. IS predicted 25-40% of the variance in psychological functioning, quality of life, healthcare utilization, and health competence when controlling for stigma perception and disease variables. IBS patients perceived more stigma from personal relations than healthcare providers. Hispanic participants reported more perceived stigma, indicating there may be cultural differences in IBS-related stigma experience. Symptom severity, disruptiveness, and treatment choices are also implicated in stigma perception and internalization. Patients with IBS report both perceived and IS with alienation most reported. However, IS significantly predicts several patient outcomes when controlling for PS. Cultural and illness traits may influence how stigma is perceived and internalized. Future research is warranted. © 2014 John Wiley & Sons Ltd.

  12. The Role of Mast Cells in Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Kang Nyeong Lee

    2016-01-01

    Full Text Available Irritable bowel syndrome (IBS is one of the most common functional gastrointestinal disorders, but its treatment is unsatisfactory as its pathophysiology is multifactorial. The putative factors of IBS pathophysiology are visceral hypersensitivity and intestinal dysmotility, also including psychological factors, dysregulated gut-brain axis, intestinal microbiota alterations, impaired intestinal permeability, and mucosal immune alterations. Recently, mucosal immune alterations have received much attention with the role of mast cells in IBS. Mast cells are abundant in the intestines and function as intestinal gatekeepers at the interface between the luminal environment in the intestine and the internal milieu under the intestinal epithelium. As a gatekeeper at the interface, mast cells communicate with the adjacent cells such as epithelial, neuronal, and other immune cells throughout the mediators released when they themselves are activated. Many studies have suggested that mast cells play a role in the pathophysiology of IBS. This review will focus on studies of the role of mast cell in IBS and the limitations of studies and will also consider future directions.

  13. PREVALENCE OF SMALL INTESTINAL BACTERIAL OVERGROWTH IN IRRITABLE BOWEL SYNDROME

    Directory of Open Access Journals (Sweden)

    Premaletha Narayanan

    2017-12-01

    Full Text Available BACKGROUND Irritable Bowel Syndrome (IBS is a common functional disorder and the pathophysiology of IBS is poorly understood. The aim of the study is to assess the prevalence of SIBO in patients with IBS using Lactulose Hydrogen Breath Test (LHBT. Diagnosis of IBS was made according to the Rome III Criteria and Lactulose Hydrogen Breath Test (LHBT was done. MATERIALS AND METHODS The current hypothesis suggests that altered gastrointestinal motility, disturbance of visceral hypersensitivity and infection may contribute to the symptoms. Gut microbiota and intestinal pathogens are likely to influence the pathogenesis of IBS. Small Intestinal Bacterial Overgrowth (SIBO is defined as an abnormally high bacterial count (≥105 colony-forming units/mL in the proximal small intestine. RESULTS Out of the 120 patients, 9 were LHBT positive (7.5% compared to none in controls (p <0.01. IBS patients with LHBT positivity was correlated well with the increased frequency of stools. There was no correlation noted with LHBT positivity and abdominal pain or flatulence or bloating compared to IBS patients who were LHBT negative. CONCLUSION These findings may suggest that patients with chronic diarrhoea including IBS should be tested for SIBO. Our study also showed that LHBT positivity is associated with increased frequency of stools and diarrhoea. If SIBO is found in patients with chronic diarrhoea, specific treatment with antibiotics may benefit them.

  14. Gut microbiota role in irritable bowel syndrome: New therapeutic strategies.

    Science.gov (United States)

    Distrutti, Eleonora; Monaldi, Lorenzo; Ricci, Patrizia; Fiorucci, Stefano

    2016-02-21

    In the last decade the impressive expansion of our knowledge of the vast microbial community that resides in the human intestine, the gut microbiota, has provided support to the concept that a disturbed intestinal ecology might promote development and maintenance of symptoms in irritable bowel syndrome (IBS). As a correlate, manipulation of gut microbiota represents a new strategy for the treatment of this multifactorial disease. A number of attempts have been made to modulate the gut bacterial composition, following the idea that expansion of bacterial species considered as beneficial (Lactobacilli and Bifidobacteria) associated with the reduction of those considered harmful (Clostridium, Escherichia coli, Salmonella, Shigella and Pseudomonas) should attenuate IBS symptoms. In this conceptual framework, probiotics appear an attractive option in terms of both efficacy and safety, while prebiotics, synbiotics and antibiotics still need confirmation. Fecal transplant is an old treatment translated from the cure of intestinal infective pathologies that has recently gained a new life as therapeutic option for those patients with a disturbed gut ecosystem, but data on IBS are scanty and randomized, placebo-controlled studies are required.

  15. Unraveling the ties between irritable bowel syndrome and intestinal microbiota.

    Science.gov (United States)

    Hong, Sung Noh; Rhee, Poong-Lyul

    2014-03-14

    Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder. It is a multifactorial disorder. Intestinal microbiota may cause the pathogenesis of IBS by contributing to abnormal gastrointestinal motility, low-grade inflammation, visceral hypersensitivity, communication in the gut-brain axis, and so on. Previous attempts to identify the intestinal microbiota composition in IBS patients have yielded inconsistent and occasionally contradictory results. This inconsistency may be due to the differences in the molecular techniques employed, the sample collection and handling methods, use of single samples that are not linked to fluctuating symptoms, or other factors such as patients' diets and phenotypic characterizations. Despite these difficulties, previous studies found that the intestinal microbiota in some IBS patients was completely different from that in healthy controls, and there does appear to be a consistent theme of Firmicutes enrichment and reduced abundance of Bacteroides. Based on the differences in intestinal microbiota composition, many studies have addressed the roles of microbiota-targeted treatments, such as antibiotics and probiotics, in alleviating certain symptoms of IBS. This review summarizes the current knowledge of the associations between intestinal microbiota and IBS as well as the possible modes of action of intestinal microbiota in the pathogenesis of IBS. Improving the current level of understanding of host-microbiota interactions in IBS is important not only for determining the role of intestinal microbiota in IBS pathogenesis but also for therapeutic modulation of the microbiota.

  16. Recent developments in the pathophysiology of irritable bowel syndrome.

    Science.gov (United States)

    El-Salhy, Magdy

    2015-07-07

    Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, the pathophysiology of which is not completely known, although it has been shown that genetic/social learning factors, diet, intestinal microbiota, intestinal low-grade inflammation, and abnormal gastrointestinal endocrine cells play a major role. Studies of familial aggregation and on twins have confirmed the heritability of IBS. However, the proposed IBS risk genes are thus far nonvalidated hits rather than true predisposing factors. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, with the effect exerted by diet seemingly caused by intake of poorly absorbed carbohydrates and fiber. Obesity is a possible comorbidity of IBS. Differences in the microbiota between IBS patients and healthy controls have been reported, but the association between IBS symptoms and specific bacterial species is uncertain. Low-grade inflammation appears to play a role in the pathophysiology of a major subset of IBS, namely postinfectious IBS. The density of intestinal endocrine cells is reduced in patients with IBS, possibly as a result of genetic factors, diet, intestinal microbiota, and low-grade inflammation interfering with the regulatory signals controlling the intestinal stem-cell clonogenic and differentiation activities. Furthermore, there is speculation that this decreased number of endocrine cells is responsible for the visceral hypersensitivity, disturbed gastrointestinal motility, and abnormal gut secretion seen in IBS patients.

  17. Irritable bowel syndrome and chronic constipation: Fact and fiction.

    Science.gov (United States)

    Bellini, Massimo; Gambaccini, Dario; Usai-Satta, Paolo; De Bortoli, Nicola; Bertani, Lorenzo; Marchi, Santino; Stasi, Cristina

    2015-10-28

    Irritable bowel syndrome (IBS) and functional constipation (FC) are the most common functional gastrointestinal disorders. According to the Rome III Criteria these two disorders should be theoretically separated mainly by the presence of abdominal pain or discomfort relieved by defecation (typical of IBS) and they should be mutually exclusive. However, many gastroenterologists have serious doubts as regards a clear separation. Both IBS-C and FC, often associated with many other functional digestive and non digestive disorders, are responsible for a low quality of life. The impact of the media on patients' perception of these topics is sometimes disruptive, often suggesting a distorted view of pathophysiology, diagnosis and therapy. These messages frequently overlap with previous subjective opinions and are further processed on the basis of the different culture and the previous experience of the constipated patients, often producing odd, useless or even dangerous behaviors. The aim of this review was to analyze the most common patients' beliefs about IBS-C and CC, helping physicians to understand where they should focus their attention when communicating with patients, detecting false opinions and misconceptions and correcting them on the basis of scientific evidence.

  18. Annual Costs of Care for Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, and Functional Abdominal Pain Syndrome

    NARCIS (Netherlands)

    Hoekman, Daniël R.; Rutten, Juliette M. T. M.; Vlieger, Arine M.; Benninga, Marc A.; Dijkgraaf, Marcel G. W.

    2015-01-01

    To estimate annual medical and nonmedical costs of care for children diagnosed with irritable bowel syndrome (IBS) or functional abdominal pain (syndrome; FAP/FAPS). Baseline data from children with IBS or FAP/FAPS who were included in a multicenter trial (NTR2725) in The Netherlands were analyzed.

  19. Microbiota regulation of inflammatory bowel disease and colorectal cancer.

    Science.gov (United States)

    Liu, Zhanju; Cao, Anthony T; Cong, Yingzi

    2013-12-01

    The host and microbiota have evolved mechanisms for coexistence over millions of years. Accumulating evidence indicates that a dynamic mutualism between the host and the commensal microbiota has important implications for health, and microbial colonization contributes to the maintenance of intestinal immune homeostasis. However, alterations in communication between the mucosal immune system and gut microbial communities have been implicated as the core defect that leads to chronic intestinal inflammation and cancer development. We will discuss the recent progress on how gut microbiota regulates intestinal homeostasis and the pathogenesis of inflammatory bowel disease and colorectal cancer. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Lower Gastrointestinal Microbiota in Health and Irritable Bowel Syndrome : Characterisation and Effect of Probiotic Intervention

    OpenAIRE

    Krogius-Kurikka, Lotta

    2011-01-01

    The human gastrointestinal (GI) microbiota is a complex ecosystem that lives in symbiosis with its host. The growing awareness of the importance of the microbiota to the host as well as the development of culture-free laboratory techniques and computational methods has enormously expanded our knowledge of this microbial community. Irritable bowel syndrome (IBS) is a common functional bowel disorder affecting up to a fifth of the Western population. To date, IBS diagnosis has been based on GI ...

  1. Intensive Nutrition Management in a Patient with Short Bowel Syndrome Who Underwent Bariatric Surgery

    OpenAIRE

    Kweon, MeeRa; Ju, Dal Lae; Park, Misun; Choe, JiHyeong; Suh, Yun-Suhk; Seol, Eun-Mi; Lee, Hyuk-Joon

    2017-01-01

    Many individuals with short bowel syndrome (SBS) require long-term parenteral nutrition (PN) to maintain adequate nutritional status. Herein, we report a successful intestinal adaptation of a patient with SBS through 13 times intensive nutritional support team (NST) managements. A thirty-five-year-old woman who could not eat due to intestinal discontinuity visited Seoul National University Hospital for reconstruction of the bowel. She received laparoscopic Roux-en-Y gastric bypass (RYGB) due ...

  2. ASSESSING THE SLEEP QUALITY AND DEPRESSION-ANXIETY-STRESS IN IRRITABLE BOWEL SYNDROME PATIENTS

    OpenAIRE

    Nadieh BANIASADI; Mohammad Moein DEHESH; Elham MOHEBBI; Mahdy HAYATBAKHSH ABBASI; Zohreh OGHABIAN

    2017-01-01

    ABSTRACT BACKGROUND Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders with chronic abdominal pain and altered bowel habit without any organic reason. Sleep disorders may be associated to IBS. OBJECTIVE We aimed to assess sleep disturbances and depression-anxiety-stress in IBS patients. METHODS In this analytical cross sectional study from November 2013 to May 2014, A total of 123 IBS patients were recruited by simple random sampling. IBS was dia...

  3. Role of anxiety in the pathophysiology of irritable bowel syndrome: importance of the amygdala

    OpenAIRE

    Brent Myers; Brent Myers; Beverley Greenwood-VanMeerveld; Beverley Greenwood-VanMeerveld; Beverley Greenwood-VanMeerveld

    2009-01-01

    A common characteristic of irritable bowel syndrome (IBS) is that symptoms, including abdominal pain and abnormal bowel habits, are often triggered or exacerbated during periods of stress and anxiety. However, the impact of anxiety and affective disorders on the gastrointestinal (GI) tract is poorly understood and may in part explain the lack of effective therapeutic approaches to treat IBS. The amygdala is an important structure for regulating anxiety with the central nucleus of the amygdala...

  4. Role of Anxiety in the Pathophysiology of Irritable Bowel Syndrome: Importance of the Amygdala

    OpenAIRE

    Myers, Brent; Greenwood-Van Meerveld, Beverley

    2009-01-01

    A common characteristic of irritable bowel syndrome (IBS) is that symptoms, including abdominal pain and abnormal bowel habits, are often triggered or exacerbated during periods of stress and anxiety. However, the impact of anxiety and affective disorders on the gastrointestinal (GI) tract is poorly understood and may in part explain the lack of effective therapeutic approaches to treat IBS. The amygdala is an important structure for regulating anxiety with the central nucleus of the amygdala...

  5. Severe ischemic bowel necrosis caused by terlipressin during treatment of hepatorenal syndrome

    Directory of Open Access Journals (Sweden)

    Hae Rim Kim

    2013-12-01

    Full Text Available Terlipressin is a vasopressin analogue that is widely used in the treatment of hepatorenal syndrome or variceal bleeding. Because it acts mainly on splanchnic vessels, terlipressin has a lower incidence of severe ischemic complications than does vasopressin. However, it can still lead to serious complications such as myocardial infarction, skin necrosis, or bowel ischemia. Herein we report a case of severe ischemic bowel necrosis in a 46-year-old cirrhotic patient treated with terlipressin. Although the patient received bowel resection, death occurred due to ongoing hypotension and metabolic acidosis. Attention should be paid to patients complaining of abdominal pain during treatment with terlipressin.

  6. The role of abuse in the development of irritable bowel syndrome: a comparative study

    Directory of Open Access Journals (Sweden)

    G Eileen Rossouw

    2003-11-01

    Full Text Available Irritable Bowel Syndrome (IBS is defined as a chronic relapsing functional bowel disorder of unknown causes which is characterised by attacks of abdominal pain and change of bowel habit resulting in diarrhoea or constipation or both. Opsomming Prikkelbare Dermsindroom (PDS word gedefinieer as ’n chroniese, herhalende, funksionele ingewandsversteuring wat gekenmerk word deur aanvalle van buikpyn en ‘n verandering in ingewandsgewoontes, wat diarree of hardlywigheid, of beide, tot gevolg het. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  7. Evaluation of drug treatment in irritable bowel syndrome

    Science.gov (United States)

    Talley, Nicholas J

    2003-01-01

    The irritable bowel syndrome (IBS) remains a therapeutic challenge in part because of the limited understanding of the pathophysiology. The placebo response rate varies in randomized controlled trials from 20 to 70%, and can persist for up to at least 1 year. It is contentious whether dietary fibre and bulking agents relieve the symptoms of IBS; constipation probably improves. Anticholinergic and antispasmodic agents are of questionable benefit in IBS despite positive meta-analyses of poor quality trials. A meta-analysis concluded that the tricyclic antidepressants were superior to placebo in IBS, although the individual trial results were variable. Selective serotonin reuptake inhibitors are of uncertain benefit. Laxatives are used for constipation but probably poorly control the IBS symptom complex. Loperamide is superior to placebo in improvement of diarrhoea but not abdominal pain in IBS. Tegaserod is a well- tolerated aminoguanidine indole derivative of serotonin that is a partial 5HT4–receptor agonist with prokinetic properties; a therapeutic gain over placebo of 5% to 15% has been observed in constipation-predominant IBS in females. Alosetron is a 5HT3-receptor antagonist that is efficacious in females with diarrhoea-predominant IBS, with a 12% to 17% therapeutic gain; the risk of ischaemic colitis is 1 in 350, with very severe constipation occurring in about 1 in 1000. Optimizing study design remains a challenge in IBS. New visceral analgesic and motility modifying agents, as well as anti-inflammatory agents are in trials, and hopefully additional efficacious therapeutic options for patients with IBS will soon emerge. PMID:12968980

  8. Treatments for irritable bowel syndrome: patients' attitudes and acceptability

    Directory of Open Access Journals (Sweden)

    Roberts Lesley

    2008-12-01

    Full Text Available Abstract Background Irritable Bowel Syndrome, a highly prevalent chronic disorder, places significant burden on the health service and the individual. Symptomatic distress and reduced quality of life are compounded by few efficacious treatments available. As researchers continue to demonstrate the clinical efficacy of alternative therapies, it would be useful to gain a patient-perspective of treatment acceptability and identify patient's attitudes towards those modalities considered not acceptable. Methods Six hundred and forty-five participants identified from an earlier IBS-prevalence study received a postal questionnaire to evaluate preferences and acceptability of nine forms of treatment. Proportions accepting each form of treatment were calculated and thematic analysis of qualitative data undertaken. Results A total of 256 (39.7% of 645 potential respondents completed the questionnaire (mean age 55.9 years, 73% female. Tablets were most acceptable (84%, followed by lifestyle changes (diet (82%, yoga (77%. Acupuncture (59% and suppositories (57% were less acceptable. When explaining lack of acceptability, patient views fell into four broad categories: dislike treatment modality, do not perceive benefit, general barriers and insufficient knowledge. Scepticism, lack of scientific rationale and fear of CAM were mentioned, although others expressed a dislike of conventional medical treatments. Past experiences, age and health concerns, and need for proof of efficacy were reported. Conclusion Most patients were willing to accept various forms of treatment. However, the reservations expressed by this patient-population must be recognised with particular focus directed towards allaying fears and misconceptions, seeking further evidence base for certain therapies and incorporating physician support and advice.

  9. Empirically derived dietary habits are associated with irritable bowel syndrome.

    Science.gov (United States)

    Zaribaf, Fatemeh; Keshteli, Ammar Hassanzadeh; Esmaillzadeh, Ahmad; Saneei, Parvane; Feizi, Awat; Daghaghzadeh, Hamed; Feinle-Bisset, Christine; Adibi, Peyman

    2018-03-13

    The associations between empirically derived dietary habits and irritable bowel syndrome (IBS) have not been investigated. This study aimed to assess the relationship between empirically derived dietary habits and IBS in a large population of Iranian adults. In a cross-sectional study, dietary habits of 4763 adults were assessed in three domains, "meal pattern", "eating rate" and "intra-meal fluid intake". We used latent class analysis to identify classes of dietary habits. IBS was defined based on ROME III criteria. IBS was prevalent in 20.3% (n = 966) of the study population. Two distinct classes of meal patterns: "regular" and "irregular", three classes of eating rates: "moderate", "moderate-to-slow" and "moderate-to-fast" and two classes of fluid ingestion with meals: "moderate" and "heavy intra-meal drinking" were identified. After adjustment for confounders, "heavy intra-meal fluid intake" was protectively associated with IBS (OR = 0.79; 95% CI:0.64-0.96). When potential confounders were considered, "meal pattern" and "eating rate" were not significantly associated with IBS in the whole population. After adjustment for confounders, women with "irregular meal pattern" had a 30% greater risk of having IBS, compared with those with "regular meal pattern" (OR = 1.30; 95% CI:1.02-1.67). Overweight participants with "fast eating rate" were 70% more likely to have IBS, compared to those with "moderate eating rate" (OR = 1.70; 95% CI:1.13-2.55). "Irregular meal pattern" was related to frequency and severity of abdominal pain. We found a significant association between heavy intra-meal fluid intake" and IBS. More large-scale prospective studies are needed to affirm this association.

  10. Economic burden of irritable bowel syndrome in China.

    Science.gov (United States)

    Zhang, Fang; Xiang, Wei; Li, Chun-Yan; Li, Shu-Chuen

    2016-12-21

    To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome (IBS) and subtypes. Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct (including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t -tests were performed to determine differences between groups after controlling for IBS subtypes. A total of 105 IBS patients (64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNY18262.84 (USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similar to published studies in other countries. Nationally, the total costs of managing IBS would amount to CNY123.83 billion (USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNY18891.18 (USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes ( P = 0.031). IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.

  11. 75 FR 13765 - Draft Guidance for Industry on Irritable Bowel Syndrome-Clinical Evaluation of Products for...

    Science.gov (United States)

    2010-03-23

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Irritable Bowel Syndrome... and symptom assessment for IBS with diarrhea (IBS-D) and IBS with constipation (IBS-C): The evolution... irritable bowel syndrome. It does not create or confer any rights for or on any person and does not operate...

  12. Challenges and outcome of surgery for bowel obstruction in women with gynaecologic cancer.

    Science.gov (United States)

    Furnes, Bjorg; Svensen, Rune; Helland, Harald; Ovrebo, Kjell

    2016-03-01

    Bowel obstruction is associated with a reduction in quality of life and survival among cancer patients, and the entity is traditionally treated by general surgeons without dedication to the different malignancies that cause bowel obstruction or to palliation. This study aims to identify and improve outcome of bowel obstruction in women with a history of a gynaecologic cancer. Women operated for bowel obstruction were screened for a history of gynaecologic cancer and their records were reviewed. Bowel obstruction followed cancer treatment by a median of 18.4 months (range 2.3-277) in 59 women. A malignant cause was identified in 53% and recurrence of cancer in 61%. The cause of malignant bowel obstruction was peritoneal carcinomatosis (19%), obstructing tumour and carcinomatosis (31%) and solitary tumour (3%). Ovarian cancer (OR: 6.29, 95% CI 1.95-20.21), residual tumour during initial surgery (R2-stage) (OR: 18.7, 96% CI: 4.35-80.46) and chemotherapy (OR: 7.19, 95% CI: 2.28-22.67) were all associated with malignant bowel obstruction. Surgery solved 84% of malignant bowel obstructions, but median survival was brief (2.5 months, 95% CI: 1.4-3.6) when compared to benign bowel obstruction (95.3 months, 64.7-125.9) (p bowel obstruction occurred after a median of 4.3 months (95% CI: 3.1-5.5) in surviving patients with malignant bowel obstruction and after a median of 84.5 months (95% CI: 73.6-95.3) with adhesive obstruction (p bowel obstruction may improve treatment strategy in these women. Women with malignant bowel obstruction should be carefully identified and differentiated in order to improve quality of life rather than pursuing emergency surgical procedures. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  13. Impact of bowel dysfunction on quality of life after sphincter-preserving resection for rectal cancer

    DEFF Research Database (Denmark)

    Emmertsen, Katrine; Laurberg, Solveig; Jess, Per

    2013-01-01

    Bowel dysfunction after sphincter-preserving surgery for rectal cancer is a common complication, with the potential to affect quality of life (QoL) strongly. The aim of this study was to examine the extent of bowel dysfunction and impact on health-related QoL after curative sphincter......-preserving resection for rectal cancer....

  14. Description of age, sex and site distribution of large bowel cancer in ...

    African Journals Online (AJOL)

    Aims/Objective: To determine the distribution of bowel cancer with special emphasis on age, sex and site. Methods: One hundred and sixty cases of histologically confirmed large bowel cancers at Jos University Teaching Hospital between January 1991 – December 2000 were reviewed. The records were collected from the ...

  15. Stagnant loop syndrome resulting from small-bowel irradiation injury and intestinal by-pass

    International Nuclear Information System (INIS)

    Swan, R.W.

    1974-01-01

    Stagnant or blind-loop syndrome includes vitamin B12 malabsorption, steatorrhea, and bacterial overgrowth of the small intestine. A case is presented to demonstrate this syndrome occurring after small-bowel irradiation injury with exaggeration postenterocolic by-pass. Alteration of normal small-bowel flora is basic to development of the stagnant-loop syndrome. Certain strains of bacteria as Bacteriodes and E. coli are capable of producing a malabsorption state. Definitive therapy for this syndrome developing after severe irradiation injury and intestinal by-pass includes antibiotics. Rapid symptomatic relief from diarrhea and improved malabsorption studies usually follow appropriate antibiotic therapy. Recolonization of the loop(s) with the offending bacterial species may produce exacerbation of symptoms. Since antibiotics are effective, recognition of this syndrome is important. Foul diarrheal stools should not be considered a necessary consequence of irradiation injury and intestinal by-pass

  16. [Study on treatment of irritable bowel syndrome: based on relationship between heart and intestines].

    Science.gov (United States)

    Wang, Su-Na; Wang, Zu-Hong; Xie, Su-Juan; Han, Li-Bing; Yi, Rong

    2010-11-01

    The article puts forward the treatment of irritable bowel syndrome through regulating heart vitality since it is held that the pathological factors of the disease lay in dysfunction of heart and intestines as well as disorder of qi circulation. At the same time, the internal-external relationship between the heart the small intestine is discussed from the theory of Brain-gut Axis in modern medicine, which provides theoretical base of modern medicine for the treatment of irritable bowel syndrome through regulation of the heart functions.

  17. When Good Evidence Is Not Enough: The Role of Context in Bowel Cancer Screening Policy in New Zealand

    Science.gov (United States)

    Flitcroft, Kathy L.; Gillespie, James A.; Carter, Stacy M.; Trevena, Lyndal J.; Salkeld, Glenn P.

    2011-01-01

    Bowel cancer is a serious health problem in developed countries. Australia, the United Kingdom (UK) and New Zealand (NZ) reviewed the same randomised controlled trial evidence on the benefits and harms of population-based bowel cancer screening. Yet only NZ, with the highest age standardised rate of bowel cancer mortality, decided against…

  18. Quality indicators for screening colonoscopies and colonoscopist performance and the subsequent risk of interval bowel cancer

    DEFF Research Database (Denmark)

    Lund, Martin; Trads, Mette; Erichsen, Rune

    2017-01-01

    REVIEW QUESTION/OBJECTIVE:: The objective of this systematic review is to assess the association between quality indicators related to the individual colonoscopist's performance and subsequent interval cancers in patients participating in bowel cancer screening programs, following the JBI approach...

  19. Methodological issues in the study of intestinal microbiota in irritable bowel syndrome.

    Science.gov (United States)

    Taverniti, Valentina; Guglielmetti, Simone

    2014-07-21

    Irritable bowel syndrome (IBS) is an intestinal functional disorder with the highest prevalence in the industrialized world. The intestinal microbiota (IM) plays a role in the pathogenesis of IBS and is not merely a consequence of this disorder. Previous research efforts have not revealed unequivocal microbiological signatures of IBS, and the experimental results are contradictory. The experimental methodologies adopted to investigate the complex intestinal ecosystem drastically impact the quality and significance of the results. Therefore, to consider the methodological aspects of the research on IM in IBS, we reviewed 29 relevant original research articles identified through a PubMed search using three combinations of keywords: "irritable bowel syndrome + microflora", "irritable bowel syndrome + microbiota" and "irritable bowel syndrome + microbiome". For each study, we reviewed the quality and significance of the scientific evidence obtained with respect to the experimental method adopted. The data obtained from each study were compared with all considered publications to identify potential inconsistencies and explain contradictory results. The analytical revision of the studies referenced in the present review has contributed to the identification of microbial groups whose relative abundance significantly alters IBS, suggesting that these microbial groups could be IM signatures for this syndrome. The identification of microbial biomarkers in the IM can be advantageous for the development of new diagnostic tools and novel therapeutic strategies for the treatment of different subtypes of IBS.

  20. Reproductive history and risk of small bowel cancer by histologic type: a population-based study.

    Science.gov (United States)

    Lu, Yunxia; Lambe, Mats; Martling, Anna; Lagergren, Jesper

    2012-12-01

    The male predominance of the two main histologic malignancies of the small bowel cancer may reflect a role of sex hormones which will be examined in this study. This was a nationwide population-based nested case-control study, based on a cohort of subjects born between 1932 and 2008, as identified in the Swedish Multi-Generation Register. For each case of small bowel cancer, 10 age- and sex-matched controls were randomly selected. Number of children and age at having the first child were analyzed in relation to the risk of small bowel cancer using conditional logistic regression, providing odds ratios (ORs) and 95 % confidence intervals (CIs). A total of 632 female cases and 894 male cases of small bowel cancer were included. No overall increased risk of small bowel cancer was found in parous compared to non-parous women (OR = 1.02, 95 % CI 0.67-1.54). There was no association between age at first birth and small bowel cancer (>30 years of age vs bowel. No distinct risk patterns were discerned in men compared to women. Reproductive history does not seem to be associated with the risk of small bowel cancer, independent of histologic type.

  1. Comparison of three strategies to delineate the bowel for whole pelvis IMRT of prostate cancer.

    Science.gov (United States)

    Sanguineti, Giuseppe; Little, Michael; Endres, Eugene J; Sormani, Maria Pia; Parker, Brent C

    2008-07-01

    To compare three different contouring approaches of the bowel before and during whole pelvis IMRT of localized prostate cancer. Nine patients were randomly selected among those treated for localized prostate cancer at UTMB from March 2004 to August 2006. On the planning CT, besides the usual organs at risk (OAR), for each patient we contoured the bowel according to three different definitions: each bowel segment ('BS'); 'BS+1', BS uniformly expanded by 1cm; intestinal cavity ('IC') or the 'container' of the bowel loops up to the pelvic/abdominal walls. For each patient we generated three rival plans each considering a different bowel definition, otherwise identical. Provided that the same target coverage and other OAR spare had been achieved, plans were compared for their ability to minimize bowel dose at planning. Furthermore, after co-registering 6 weekly CT to the initial planning CT for each patient, we investigated which of the three definitions would allow the best bowel protection also during treatment. All definitions provided a very similar average bowel DVH at planning. During treatment BS allowed an average approximately 20 cc more of bowel to receive at least 45 Gy over BS+1 and IC (p=0.008 and 0.029, respectively); on the contrary bowel V45 between IC and BS+1 were not significantly different (p=0.65). A definition that takes into account internal organ motion is warranted to maximize bowel protection during treatment.

  2. Prevalence, comorbidity and impact of irritable bowel syndrome in Norway.

    Science.gov (United States)

    Vandvik, Per Olav; Lydersen, Stian; Farup, Per G

    2006-06-01

    To study the prevalence of irritable bowel syndrome (IBS) and its comorbidity in a Norwegian adult population. In 2001, 11,078 inhabitants (aged 30-75 years) in Oppland County were invited to take part in a public health survey. A total of 4622 subjects (42%) completed the questionnaires on symptoms of IBS (Rome II criteria), comorbidity, health-care visits and medications. The impact of comorbidity on global health, working disability and use of health-care resources in subjects with IBS was explored by stepwise logistic regression. The population prevalence of IBS was 388/4622 (8.4% (95% CI: 7.6-9.4%)) with a female predominance and an age-dependent decrease. The proportion who had consulted for IBS ranged from 51% among 30-year-olds to 79% in 75-year-olds (p=0.05). IBS was associated with musculoskeletal complaints (OR = 2.4-3.4 for six different items), fibromyalgia (OR = 3.6 [2.7-4.8]), mood disorder (OR = 3.3 (2.6-4.3)), reduced global health (OR = 2.6 (2.1-3.2)), working disability (OR = 1.6 (1.2-2.1)), more frequent health-care visits and use of medications (OR 1.7-2.3). When controlling for comorbidity, reduced global health (OR = 1.5 (1.1-2.0)) and use of alternative health care (OR = 1.7 (1.3-2.4)) remained associated with IBS. Severity of abdominal pain/discomfort was a predictor of having to seek a physician for IBS (OR = 1.3 (1.2-1.5)). Symptoms of IBS were reported by 8% of Norwegian adults and had resulted in consultations with physicians for the majority in the long run. Subjects with IBS in the community were characterized by frequent somatic and psychiatric comorbidity. Their observed reduced health, working disability and increased use of health resources were largely explained by comorbid symptoms and disorders.

  3. [Psychiatric comorbidities in patients referred for irritable bowel syndrome].

    Science.gov (United States)

    Hao, Jing-xin; Han, Mai; Duan, Li-ping; Ge, Ying; Huang, Yue-qin

    2011-07-19

    To assess the prevalence of psychiatric comorbidities in patients referred for irritable bowel syndrome (IBS) with questionnaires for mental disorders. A total of 83 IBS patients at our hospital were enrolled and assessed with the Personality Diagnostic Questionnaire for DSM-IV, version 4 (PDQ-4) and Composite International Diagnostic Interview, version 3.0 and 2.1 (CIDI-3.0 & CIDI-2.1) by trained interviewers. Such items as personality dysfunction, mental disorder and somatization disorder were examined. The male-female ratio was 1.08/1. Their mean age was (38 ± 14) years old. Among them, 20 patients (24.1%) were constipation-predominant, 31 (37.3%) diarrhea-predominant, 15 (18.1%) mixed and 17 (20.5%) unclassified type. (1) Sixty-two (74.7%) patients scored positive for any personality dysfunction. There was no significant gender difference. The cluster C (anxious-fearful) personality disorder was most commonly found in IBS patients (n = 58, 69.9%). The prevalence of somatoform disorders plus personality dysfunction was 46.8% (29/62). It was significantly higher than those without personality dysfunction [19.0% (4/21), P = 0.025]. (2) Thirty-seven patients (44.6%) had a lifetime CIDI-3.0 diagnosis. It was significantly higher than that in the general population. There was no gender difference. Anxiety and mood disorders were the most common types of psychiatric comorbidities [n = 21 (25.3%) and n = 19 (22.9%) respectively]. The lifetime prevalence of alcohol or nicotine abuse and(or) dependence and intermittent explosive disorder were 10.8% (n = 9) and 8.4% (n = 7). Psychiatric comorbidities were most commonly found in diarrhea-predominant patients (58.1%). But there was no significant difference among the subgroups. (3) Thirty-three patients (39.8%) had somatoform disorders. Neither gender nor subgroup difference was observed. The IBS patients with anxiety disorders presented significantly more somatoform disorders than the remainders [61.9% (13/21) vs 32

  4. Perception of lactose intolerance in irritable bowel syndrome patients.

    Science.gov (United States)

    Dainese, Raffaella; Casellas, Francesc; Mariné-Barjoan, Eugènia; Vivinus-Nébot, Mylène; Schneider, Stéphane M; Hébuterne, Xavier; Piche, Thierry

    2014-10-01

    The importance of lactose malabsorption in irritable bowel syndrome (IBS) is not well defined and these patients often complain of lactose intolerance. To objectively measure lactose malabsorption, a hydrogen breath test (HBT) can be performed, but a discrepancy emerges between the results of the HBT and the symptomatic response during the HBT. To determine in a group of IBS patients whether self-perceived lactose intolerance and the symptomatic response to lactose HBT were conditioned by other factors besides the presence of lactose malabsorption. Oral challenge to lactose (50 g) was tested in 51 IBS patients to assess HBT malabsorption and the symptomatic response to lactose intolerance was scored on a validated questionnaire. Allergological screening for common inhalants and food allergens (including cow's milk) was performed. The presence of psychological factors (e.g. anxiety, depression, fatigue) was evaluated using validated questionnaires. A total of 21 out of 51 patients (41.1%) were self-perceived to be lactose intolerant, 24/51 (47%) had a positive HBT, and 14/51 (27.4%) presented with symptoms of lactose intolerance during HBT. The serological screening for inhalant and food allergens was positive in 6/21 (28.6%) and 4/21 (19%) of patients who self-perceived lactose intolerance and in 5/14 (37.5%) and 3/14 (21.4%) in intolerant patients symptomatic during HBT. Only 1/51 (1.9%) presented evidence of IgE-mediated hypersensitivity to cow's milk. Patients who experienced symptoms of lactose intolerance during HBT presented more severe IBS symptoms [326 (296-398) vs. 215 (126-295) P=0.05] and a higher score of anxiety, depression, and fatigue. Factors influencing the symptoms of lactose intolerance during HBT resulted in an increase in hydrogen produced and in the severity of IBS. In a cohort of 51 IBS patients, the symptoms of lactose intolerance during HBT were influenced by the capacity to absorb lactose and the severity of IBS. Other factors, such as

  5. Neuroendocrine Dysregulation in Irritable Bowel Syndrome Patients: A Pilot Study.

    Science.gov (United States)

    Stasi, Cristina; Bellini, Massimo; Gambaccini, Dario; Duranti, Emiliano; de Bortoli, Nicola; Fani, Bernardo; Albano, Eleonora; Russo, Salvatore; Sudano, Isabella; Laffi, Giacomo; Taddei, Stefano; Marchi, Santino; Bruno, Rosa Maria

    2017-07-30

    Irritable bowel syndrome (IBS) is a multifactorial disorder, involving dysregulation of brain-gut axis. Our aim was to evaluate the neuroendocrine activity in IBS. Thirty IBS and 30 healthy volunteers were enrolled. Psychological symptoms were evaluated by questionnaires. Urinary 5-hydroxyindoleacetic acid, plasma serotonin (5-hydroxytryptamine, 5-HT), endothelin, and neuropeptide Y (NPY), and plasma and urinary cortisol levels were evaluated. Fourteen IBS subjects underwent microneurography to obtain multiunit recordings of efferent postganglionic muscle sympathetic nerve activity (MSNA). Prevalent psychological symptoms in IBS were maladjustment (60%), trait (40%) and state (17%) anxiety, obsessive compulsive-disorders (23%), and depressive symptoms (23%). IBS showed increased NPY (31.9 [43.7] vs 14.8 [18.1] pmol/L, P = 0.006), 5-HT (214.9 [182.6] vs 141.0 [45.5] pg/mL, P = 0.010), and endothelin [1.1 [1.4] vs 2.1 [8.1] pg/mL, P = 0.054], compared to healthy volunteers. Moreover, plasma NPY, endothelin, cortisol and 5-HT, and urinary 5-hydroxyindoleacetic acid were associated with some psychological disorders ( P ≤ 0.05). Despite a similar resting MSNA, after cold pressor test, IBS showed a blunted increase in MSNA burst frequency (+4.1 vs +7.8 bursts/min, P = 0.048; +30.1% vs +78.1%, P = 0.023). Baseline MSNA tended to be associated with urinary cortisol ( ρ = 0.557, P = 0.059). Moreover, changes in heart rate after mental stress were associated with urinary cortisol ( ρ = 0.682, P = 0.021) and changes in MSNA after mental stress were associated with plasma cortisol ( ρ = 0.671, P = 0.024)." Higher concentrations of endothelin, NPY, and 5-HT were found to be associated with some psychological disorders in IBS patients together with an altered cardiovascular autonomic reactivity to acute stressors compared to healthy volunteers.

  6. Limitations of the bowel bag contouring technique in the definitive treatment of cervical cancer.

    Science.gov (United States)

    Dominello, Michael M; Nalichowski, Adrian; Paximadis, Peter; Kaufman, Isaac; McSpadden, Erin; Joiner, Michael; Miller, Steven; Konski, Andre

    2014-01-01

    Incidence of acute grade 3 and 4 small bowel toxicity in the definitive treatment of cervical cancer is approximately 15%. Given uncertainties in position of the bowel at time of treatment, techniques including the contouring of a bowel bag have been suggested. The purpose of this study is to describe interfraction variability in bowel location for the female pelvis with intact reproductive organs and to characterize the ability of the bowel bag technique, as described in the Radiation Therapy Oncology Group pelvic normal tissue contouring guidelines, to account for organ motion in this specific clinical setting. Bowel position was assessed for 45 computed tomographic scans used in treatment planning for 9 consecutive cervical cancer patients. After a single operator contoured bowel loops, most superior, anterior, posterior, and inferior positions of bowel were recorded. Mixed effects models were used to assess significance of interfraction variability. Frequency of bowel loop migration outside of the bowel bag was then considered for each patient given all potential bowel bag volumes. Standardized scoring was used to determine additional margins that would be required to account for 95%, 90%, and 85% of significant bowel motion. Interfraction variability in the inferior-most bowel position was significant (P = .002). Median maximum variation in the inferior bowel position was 2.1 cm (range, 0.9 cm-4.8 cm). When applying the bowel bag technique, 100% of bowel motion was accounted for as the bowel translated laterally, anteriorly, posteriorly, and superiorly, though accounted for just 70.3% of motion in the inferior direction. A 4-cm inferior margin was required to account for 90% of motion in the inferior direction. In the intact female pelvis, the bowel bag technique is successful in accounting for most interfraction variability in bowel position but underestimates inferior motion. Until an improved approach to predicting small bowel motion can be routinely

  7. Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study.

    Science.gov (United States)

    Giorda, Giorgio; Gadducci, Angiolo; Lucia, Emilio; Sorio, Roberto; Bounous, Valentina E; Sopracordevole, Francesco; Tinelli, Andrea; Baldassarre, Gustavo; Campagnutta, Elio

    2014-07-09

    Optimal debulking surgery is postulated to be useful in survival of ovarian cancer patients. Some studies highlighted the possible role of bowel surgery in this topic. We wanted to evaluate the role of bowel involvement in patients with advanced epithelial ovarian cancer who underwent optimal cytoreduction. Between 1997 and 2004, 301 patients with advanced epithelial cancer underwent surgery at Department of Gynecological Oncology of Centro di Riferimento Oncologico (CRO) National Cancer Institute Aviano (PN) Italy. All underwent maximal surgical effort, including bowel and upper abdominal procedure, in order to achieve optimal debulking (R Bowel resection was performed in 116 patients (38.5%): recto-sigmoidectomy alone (69.8%), upper bowel resection only (14.7%) and both recto-sigmoidectomy and other bowel resection (15.5%). Pelvic peritonectomy and upper abdomen procedures were carried out in 202 (67.1%) and 82 (27.2%) patients respectively. Among the 284 patients available for follow-up, PFS and OS were significantly better in patients with R bowel involvement was associated with decreased PFS and OS in G1-2 patients whereas in G3 patients OS, but not PFS, was adversely affected. In the 199 patients with R0, PFS and OS were significantly better (p bowel involvement whereas only significant OS (p bowel involvement versus G3 patients with bowel involvement. Optimal cytoreduction (R cancer. In the optimally cytoreduced (R bowel involvement is associated with dismal prognosis for OS both in patients with G1-2 grading and in patients with G3 grading. Bowel involvement in G3 patients, carries instead the same risk of recurrence for PFS.

  8. Effects of two natural medicine formulations on irritable bowel syndrome symptoms: a pilot study.

    Science.gov (United States)

    Hawrelak, Jason A; Myers, Stephen P

    2010-10-01

    The study objective was to assess the effects and tolerability of two novel natural medicine formulations in improving bowel habit and abdominal symptoms in patients with irritable bowel syndrome (IBS). The DA-IBS formula was designed to treat diarrhea-predominant and alternating bowel habit IBS, and the C-IBS formula was designed to treat constipation-predominant IBS. This was a two arm, open-label, uncontrolled pilot study. Subjects were recruited from the greater Lismore area (NSW, Australia) in 2001. The study included 31 patients who fulfilled the Rome II criteria for IBS. Twenty-one (21) patients were classified as suffering from diarrhea-predominant or alternating bowel habit IBS and 10 patients were classified with constipation-predominant IBS. The DA-IBS formula consisted of a mixture of dried, powdered bilberry fruit, slippery elm bark, agrimony aerial parts, and cinnamon quills. The C-IBS formula consisted of a mixture of dried powdered slippery elm bark, lactulose, oat bran, and licorice root. The aim of each formula was to normalize stool frequency and stool consistency. Ingestion of the DA-IBS formula was associated with a small, but significant increase in bowel movement frequency (p = 0.027). Subjects in the DA-IBS group also experienced reductions in straining (p = 0.004), abdominal pain (p = 0.006), bloating (p treatment phase of the trial. Subjects in the C-IBS group experienced a 20% increase in bowel movement frequency (p = 0.016) and significant reductions in straining (p bowel habit in individuals with diarrhea-predominant or alternating bowel habit IBS, although it did significantly improve a number of IBS symptoms. The C-IBS formula significantly improved both bowel habit and IBS symptoms in patients with constipation-predominant IBS. Further research is warranted on C-IBS, as a potentially useful therapeutic formula.

  9. The frequency of microscopic and focal active colitis in patients with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Akyuz Umit

    2011-08-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS is a chronic functional bowel disorder. The frequency of microscopic colitis and focal active colitis in the colonic mucosa has been investigated in IBS patients. Methods Between June 2007 and September 2010, 378 patients (between 16 and 84 years were recruited prospectively. Of these 378 patients, 226 patients were diagnosed with IBS using the Rome III criteria. 152 control patients were also enrolled who were undergoing colonoscopy for colorectal cancer screening or investigation of anemia. Histopathological abnormalities identified during colonoscopy were compared between the IBS and control groups. Results The average age of the IBS group was 46.13 ± 14.16 years and and the average age of the control group was 57.01 ± 13.07 years. The prevalence of microscopic colitis (MC in the diarrhea predominant and the mixed subgroup of IBS patients was 4.32% (7/162 whereas in all IBS patients, the prevalence was 3.09% (7/226. MC was not found in the 152 control cases, (p = 0.045. Lymphocytic colitis was seen in 7 IBS patients, with 1 case in the mixed group and 6 cases in the diarrhea group and there was a significant difference in the frequency of lymphocytic colitis between the IBS subgroups (p Conclusion Microscopic colitis was more often found in the diarrhea predominant/mixed subgroups of IBS patients and in patients who were older women. In patients who are older woman with non-constipated IBS, it may be reasonable to perform a biopsy to screen for microscopic colitis. Focal active colitis was significantly increased in patients with IBS compared to controls.

  10. Effect of colesevelam on faecal bile acids and bowel functions in diarrhoea-predominant irritable bowel syndrome.

    Science.gov (United States)

    Camilleri, M; Acosta, A; Busciglio, I; Boldingh, A; Dyer, R B; Zinsmeister, A R; Lueke, A; Gray, A; Donato, L J

    2015-03-01

    About one-third of patients with IBS-diarrhoea (irritable bowel syndrome-D) have evidence of increased bile acid synthesis or excretion. To assess effects of the bile acid sequestrant, colesevelam, on faecal excretion of BAs, hepatic BA synthesis and diarrhoea in IBS-D; to appraise whether individual or random stool samples accurately reflect 48-h total faecal bile acid excretion and proportions of the main bile acids excreted and to study the faecal fat excretion in response to colesevelam. A single-centre, unblinded, single-dose trial of effects of colesevelam, 1875 mg [3 tablets (625 mg tablets)] orally, twice daily, for 10 days on total 48-h faecal bile acid excretion and fasting serum C4 (7α-hydroxy-4-cholesten-3-one; surrogate of hepatic bile acid synthesis). Stool diaries documented bowel functions for 8 days prior and 8 days during colesevelam treatment. Stool 48-h samples and fasting serum were collected for faecal fat, faecal bile acid and serum C4. Colesevelam was associated with significantly increased faecal total bile acid excretion and deoxycholic acid excretion, increased serum C4 and more solid stool consistency. There was a significant inverse correlation between number of bowel movements per week and the total bile acid sequestered into stool during the last 48 h of treatment. Random stool samples did not accurately reflect 48-h total or individual faecal bile acid excretion. Sequestration of bile acids by colesevelam did not increase faecal fat. Colesevelam increases delivery of bile acids to stool while improving stool consistency, and increases hepatic bile acid synthesis, avoiding steatorrhoea in patients with IBS-D. Overall effects are consistent with luminal bile acid sequestration by colesevelam. © 2015 John Wiley & Sons Ltd.

  11. Irritable Bowel Syndrome: Prevalence and Dietary Factors in the Sylhet District of Bangladesh.

    Science.gov (United States)

    Saha, M; Parveen, I; Uddoula, M S; Alam, M J; Afsar, N S; Debnath, B C; Ali, S E

    2018-01-01

    Irritable bowel syndrome (IBS) is a common functional bowel disorder. Along with other factors diet plays an important role in the causation of IBS. This population-based study was done to find out the prevalence of IBS and to find out the dietary factors associated with IBS from August 2011 to December 2011 in Sylhet district of Bangladesh. Nineteen hundred apparently healthy subjects selected by cluster sampling methods were interviewed by a validated bowel disease questionnaire. Dietary history of the subjects was also taken. Irritable bowel syndrome was diagnosed according to Rome III criteria. The prevalence of IBS was found 14.2% (n=269, M=15%, F=13.4%, p=0.365). Mean age of the IBS patients were higher than the study population (41.35 years vs. 34.74 years, p=0.000). Irritable bowel syndrome was found more in low education group (16.3%) with lower socioeconomic status (16.5%) and in single person (16.7%). IBSD was the most prevalent subtype (48.7%), IBSM was the next common subtype. Abdominal pain relieved by defecation (81%) and abdominal pain associated with loose stools (81%) were the two commonest symptoms. Age (OR 1.023, p=0.000), less intake of meat (OR 2.281, p=0.000) and pulses (OR 1.648, p=0.001) and more intake of tea (OR 1.524, p=0.009) and spices (OR 0.452, p=0.000) were found as independent predictor of IBS. Irritable bowel syndrome is a common disorder in our community. IBSD is the most prevalent subtype. Less intake of meat, pulses and more intakes of tea and spices are important associated factors for IBS.

  12. Assessment of Consensus-Based Pharmacological Therapies in Irritable Bowel Syndrome

    OpenAIRE

    Abtahi; Zareian

    2015-01-01

    Context The irritable bowel syndrome (IBS) is a symptom-based gastrointestinal (GI) disease with the presence of symptoms such as abdominal pain and abnormal intestinal activities. It is a frequent GI problem encountered by physicians. The purpose of this paper was to review and assess some of the current and emerging pharmacological therapies for this syndrome. Evidence Acquisition In the present study, data on the IBS were princ...

  13. Cogan's Syndrome in Patients With Inflammatory Bowel Disease--A Case Series

    DEFF Research Database (Denmark)

    Vavricka, Stephan R; Greuter, Thomas; Scharl, Michael

    2015-01-01

    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 ...

  14. Painful irritable bowel syndrome and diverticulosis. One hypermotile state? Correlation of pain and hypermotility.

    NARCIS (Netherlands)

    Ritsema, Gerrit Homme

    1987-01-01

    Radiological and motility studies of the sigmoid are described in three common conditions: painful irritable bowel syndrome (IBS), diverticulosis without and diverticulosis with IBS-like pain. The phenomenon, especially studies in these patients and compared with a control group, was their left

  15. Autonomic nervous system function in young children with functional abdominal pain or irritable bowel syndrome

    Science.gov (United States)

    Adults with irritable bowel syndrome (IBS) have been reported to have alterations in autonomic nervous system function as measured by vagal activity via heart rate variability. Whether the same is true for children is unknown. We compared young children 7 to 10 years of age with functional abdominal...

  16. Serotonergic reinforcement of intestinal barrier function is impaired in irritable bowel syndrome

    NARCIS (Netherlands)

    Keszthelyi, D.; Troost, F.J.; Jonkers, D.M.; Eijk, van H.M.; Lindsey, P.J.; Dekker, J.; Buurman, W.A.; Masclee, A.A.M.

    2014-01-01

    Background Alterations in serotonergic (5-HT) metabolism and/or intestinal integrity have been associated with irritable bowel syndrome (IBS). Aims To assess the effects of the precursor of 5-HT, 5-hydroxytryptophan (5-HTP), on mucosal 5-HT availability and intestinal integrity, and to assess

  17. Nutritional effects of the serial transverse enteroplasty procedure in experimental short bowel syndrome

    DEFF Research Database (Denmark)

    Kaji, Tatsuru; Tanaka, Hiroaki; Wallace, Laurie E

    2009-01-01

    The serial transverse enteroplasty (STEP) procedure appears beneficial clinically, but the mechanism(s) underlying these effects remains unclear. The present study evaluated the nutritional, hormonal, and morphologic effects of the STEP procedure in a rodent model of short bowel syndrome....

  18. Progress with treating the microbial dysbiosis associated with irritable bowel syndrome.

    Science.gov (United States)

    Pearson, James S; Whorwell, Peter J

    2017-01-01

    Microbial dysbiosis is receiving increasing attention as possibly being important in the pathophysiology of irritable bowel syndrome. This review will summarize the most recent literature addressing attempts to explore and target the microbiome in patients with irritable bowel syndrome. Manipulation of the intestinal microbiota in irritable bowel syndrome is receiving increasing attention. Traditionally, dietary manipulation has been utilized. There is now evidence that a low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet has not only been able to improve symptoms, but may have an effect on the gut microbiota. Probiotics are a safe and attractive option for the manipulation of the microbiota. There have been a number of well-designed trials examining the efficacy of certain strains of bacteria, and even yeasts are receiving attention. The role of antibiotics remains controversial and it seems likely that their use should currently be limited to those individuals with small intestinal bacterial overgrowth. Interest in the role of faecal microbiota transplantation for the treatment of a number of gastrointestinal conditions has intensified and irritable bowel syndrome is no exception. The manipulation of the microbial dysbiosis is gaining momentum. Further research, however, is required in order to identify the most appropriate treatment option for each individual patient.

  19. Habitual diet and diet quality in Irritable Bowel Syndrome : A case-control study

    NARCIS (Netherlands)

    Tigchelaar, E. F.; Mujagic, Z.; Zhernakova, A.; Hesselink, M. A. M.; Meijboom, S.; Perenboom, C. W. M.; Masclee, A. A. M.; Wijmenga, C.; Feskens, E. J. M.; Jonkers, D. M. A. E.

    2017-01-01

    Background: Diet is considered to be a key factor in symptom generation in Irritable Bowel Syndrome (IBS) and patients tend to exclude food products from their diet in pursue of symptom relief, which may impair diet quality. Methods: We evaluated habitual dietary intake in IBS patients with regard

  20. Systematic review : knowledge and educational needs of patients with irritable bowel syndrome

    NARCIS (Netherlands)

    Flik, Carla E.; van Rood, Yanda R.; de Wit, NJ

    Educational programs have been used as a control condition in trials on psychological therapies for irritable bowel syndrome (IBS). An optimal control condition should have all logistic features of the experimental intervention, except the active component, but also have basic therapeutic benefit

  1. Serological screening for celiac disease in adult Chinese patients with diarrhea predominant irritable bowel syndrome

    NARCIS (Netherlands)

    H. Wang (Hongling); G. Zhou (Guoying); L. Luo (Linjie); J.B.A. Crusius; A. Yuan (Anlong); J. Kou (Jiguang); G. Yang (Guifang); M. Wang (Min); J. Wu (Jing); B.M.E. von Blomberg (Mary); S.A. Morré (Servaas); A. Salvador Pena; B. Xia (Bing)

    2015-01-01

    textabstractCeliac 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

  2. Childhood irritable bowel syndrome characteristics are related to both sex and pubertal development

    Science.gov (United States)

    To determine the relationship of both pubertal development and sex to childhood irritable bowel syndrome (IBS) clinical characteristics including gastrointestinal symptoms (eg, abdominal pain) and psychological factors. Cross-sectional study with children ages 7-17 years (n'='143) with a pediatric R...

  3. A molecular analysis of fecal and mucosal bacterial communities in irritable bowel syndrome.

    LENUS (Irish Health Repository)

    Codling, Caroline

    2010-02-01

    The objectives of this study were, firstly, to determine the diversity of the host\\'s gut microbiota in irritable bowel syndrome (IBS) using a culture-independent method (DGGE of the 16S rRNA gene) and, secondly, to examine mucosal biopsies of IBS patients and compare them to their own fecal microbiota.

  4. Brown-bowel syndrome. Review of the literature and presentation of cases

    DEFF Research Database (Denmark)

    Horn, T; Svendsen, L B; Nielsen, R

    1990-01-01

    Four cases of brown-bowel syndrome (BBS) are presented. BBS is found in malabsorptive conditions secondary to diseases involving the liver, pancreas, and gastrointestinal tract. Morphologically, BBS is characterized by deposition of lipofuscin in the tunica muscularis, and electron microscopy shows...

  5. Pattern of irritable bowel syndrome and its impact on quality of life in ...

    African Journals Online (AJOL)

    Introduction: Irritable bowel syndrome (IBS) is one of the most common disorders diagnosed by gastroenterologists and a common cause of general practice visits. Although this disease is not life threatening, patients with IBS seem to be seriously affected in their everyday life. The study was designed to explore the pattern ...

  6. Hypnotherapy for children with functional abdominal pain or irritable bowel syndrome: a randomized controlled trial

    NARCIS (Netherlands)

    Vlieger, Arine M.; Menko-Frankenhuis, Carla; Wolfkamp, Simone C. S.; Tromp, Ellen; Benninga, Marc A.

    2007-01-01

    BACKGROUND & AIMS: Functional abdominal pain (FAP) and irritable bowel syndrome (IBS) are highly prevalent in childhood. A substantial proportion of patients continues to experience long-lasting symptoms. Gut-directed hypnotherapy (HT) has been shown to be highly effective in the treatment of adult

  7. Interdisciplinary management of infantile short bowel syndrome: resource consumption, growth, and nutrition

    NARCIS (Netherlands)

    Olieman, Joanne F.; Poley, Marten J.; Gischler, Saskia J.; Penning, Corine; Escher, Johanna C.; van den Hoonaard, Thelma L.; van Goudoever, Johannes B.; Bax, Nikolaas M. A.; Tibboel, Dick; Ijsselstijn, Hanneke

    2010-01-01

    To date, there are hardly any data on the treatment costs of infantile short bowel syndrome (SBS), despite growing interest in evidence-based and cost-effective medicine. Therefore, the aim of the study was to evaluate resource consumption and costs, next to studying nutritional and growth outcomes,

  8. Frequency of irritable bowel syndrome, entrance examination-related stress, mental health, and quality of life in high school students.

    Science.gov (United States)

    Park, Hyojung; Lim, Sunyoung

    2011-01-01

    The purpose of this study was to examine entrance examination-related stress, mental health, and the quality of life of high school students with and without irritable bowel syndrome. We administered a descriptive survey by collecting data from 1,877 students from eight schools in Gyeonggi province, Korea. This study employed the Rome III criteria for the assessment of irritable bowel syndrome, an entrance examination stress scale for measuring entrance examination-related stress, the revised Symptom Checklist-90-Revised for measuring mental health, and the World Health Organization Quality of Life Scale Abbreviated Version for measuring the quality of life. The frequency of irritable bowel syndrome in students was 19.0%. A majority had a mixed constipation and diarrhea subtype of irritable bowel syndrome. Compared with the high school students without irritable bowel syndrome, those with irritable bowel syndrome reported a significantly higher score on the entrance examination stress scale, Symptom Checklist-90-Revised, and World Health Organization Quality of Life Scale Abbreviated Version. Results suggest support for creating a high school education program that provides knowledge and information about irritable bowel syndrome to students. Furthermore, it is important to explore suitable therapeutic approaches and nursing interventions for this population.

  9. The incidence and risk of early postoperative small bowel obstruction after laparoscopic resection for colorectal cancer.

    Science.gov (United States)

    Kim, Chang Hyun; Joo, Jae Kyun; Kim, Hyeong Rok; Kim, Young Jin

    2014-08-01

    Early postoperative small bowel obstruction is associated with considerable morbidity and mortality but has not been well documented in the era of laparoscopic surgery for colorectal cancer. Consecutive patients who had undergone laparoscopic resection for colorectal cancer were studied. In total, 1787 patients (105 with and 1682 without early postoperative small bowel obstruction) with colorectal cancer requiring laparoscopic colorectal surgery were evaluated in this study. Ten patients (0.56% among the total patient population, 9.5% among patients who experienced early postoperative small bowel obstruction) who did not respond to conservative treatment for more than 14 days required surgical intervention. Multivariate analysis showed that male sex (adjusted odds ratio [AOR]=2.27), combined operation (AOR=2.23), and diverting stoma (AOR=4.79) were associated with a higher early postoperative small bowel obstruction rate. For factors related to surgical difficulty, open conversion (AOR=2.85), blood transfusion (AOR=3.51), and an operation time longer than 180 minutes (AOR=1.91) were independent factors associated with an increased early postoperative small bowel obstruction rate. Early postoperative small bowel obstruction following laparoscopic resection for colorectal cancer occurred in 5.9% of patients. Factors for predicting the development of early postoperative small bowel obstruction in patients with colorectal cancer are variables reflective of a more difficult surgery, rather than pathologic disease severity or anatomical location. In addition, most patients with early postoperative small bowel obstruction improved with conservative treatment, and surgical treatment was rarely needed.

  10. Young people's beliefs about the risk of bowel cancer and its link with physical activity.

    Science.gov (United States)

    Newby, Katie V; Cook, Chloe; Meisel, Susanne F; Webb, Thomas L; Fisher, Bernadette; Fisher, Abi

    2017-09-01

    The primary objective was to explore young people's risk appraisals of bowel cancer, including whether they had a coherent understanding of the protective effects of physical activity (PA). A secondary objective was to examine whether the illness risk representations (IRRs) framework could be used to understand beliefs underlying bowel cancer risk appraisals. Qualitative. Framework analysis of semi-structured interviews with 19 people aged 14-17 years. Participants judged their risk of getting bowel cancer as low. This was based on a lack of family history of cancer and their current lifestyle behaviours, which were viewed as having a protective effect, or because they planned on making change to their lifestyle in the future when disease risk became more relevant. Participants were not aware of, and struggled to understand, the link between PA and bowel cancer. They also lacked knowledge of the effects of, or treatments for, bowel cancer. Beliefs underlying judgements about the risk of bowel cancer fitted the IRR framework reasonably well. The present research suggests that interventions designed to increase PA with a view to reducing the risk of bowel cancer should aim to make the future risk of bowel cancer feel more tangible, help young people to understand the full range of consequences, explain how and why preventative behaviours such as PA are effective in reducing risk, and emphasize that the typical late presentation of symptoms, and therefore investigation by health care services, reduces treatability. Statement of contribution What is already known on this subject? Physical activity (PA) performed throughout the lifespan can have a protective effect on bowel cancer, but levels of PA are low among young people. Changing beliefs about the risk of getting bowel cancer may be a useful strategy in motivating PA. What does this study add? Increased understanding of how young people think about bowel cancer and the relationship between PA and cancer

  11. Are cardiac syndrome X, irritable bowel syndrome and reflex sympathetic dystrophy examples of lateral medullary ischaemic syndromes?

    Science.gov (United States)

    Syme, Paul

    2005-01-01

    Altered pain appreciation and autonomic function are hallmarks of Cardiac syndrome X, Irritable bowel syndrome and Reflex sympathetic dystrophy. Both pain appreciation and autonomic function are controlled by the lateral medulla. This hypothesis proposes that lateral medullary ischaemia at a microvascular level is responsible for these syndromes and could also be linked to other conditions where autonomic dysfunction is a major feature such as late-onset asthma, type 2 diabetes and essential hypertension. Autonomic function is controlled by the nucleus tractus solitarius, which acts as the main viscero-afferent nucleus in the brain stem regulating vagal tone. It is particularly susceptible to ischaemia since it is highly metabolically active and lies in a medullary arterial watershed zone. The anatomical route of the vertebral artery through cervical vertebra makes it vulnerable to injury from whiplash with or without any genetic predisposition to atheroma formation. This could make microvascular occlusion commonplace and a plausible explanation for the above syndromes. Ischaemia rather than infarction occurs because of the excellent collateral blood supply in the brainstem. In support of this hypothesis, a new Transcranial doppler ultrasonography arterial signal has been described called small vessel knock, the ultrasound signal of small vessel occlusion. Recent evidence has shown that ultrasound targeting of this signal in the vertebral artery improves clinical symptoms in these syndromes which supports this hypothesis. Two such cases are discussed.

  12. Clinical Practice Guideline: irritable bowel syndrome with constipation and functional constipation in the adult

    Directory of Open Access Journals (Sweden)

    Fermín Mearin

    Full Text Available In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants. Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone

  13. Towards an Irritable Bowel Syndrome Control System Based on Artificial Neural Networks

    Science.gov (United States)

    Podolski, Ina; Rettberg, Achim

    To solve health problems with medical applications that use complex algorithms is a trend nowadays. It could also be a chance to help patients with critical problems caused from nerve irritations to overcome them and provide a better living situation. In this paper a system for monitoring and controlling the nerves from the intestine is described on a theoretical basis. The presented system could be applied to the irritable bowel syndrome. For control a neural network is used. The advantages for using a neural network for the control of irritable bowel syndrome are the adaptation and learning. These two aspects are important because the syndrome behavior varies from patient to patient and have also concerning the time a lot of variations with respect to each patient. The developed neural network is implemented and can be simulated. Therefore, it can be shown how the network monitor and control the nerves for individual input parameters.

  14. THE INTESTINAL MICROBIOTA AND THE ROLE OF PROBIOTICS IN IRRITABLE BOWEL SYNDROME: a review

    Directory of Open Access Journals (Sweden)

    Joaquim Prado MORAES-FILHO

    2015-12-01

    Full Text Available Irritable bowel syndrome is a common, chronic relapsing gastrointestinal disorder that affects 7%-22% of the population worldwide. According to Rome III Criteria, the disorder is defined by the coexistence of abdominal discomfort or pain associated with an alteration in bowel habits. Its pathophysiology is not completely understood but, in addition to some important abnormalities, the disturbed intestinal microbiota has also been described supported by several strands of evidence. The treatment of irritable bowel syndrome is based upon several therapeutic approaches but few have been successful or without adverse events and more recently the gut microbiota and the use of probiotics have emerged as a factor to be considered. Probiotics are live micro-organisms which when consumed in adequate amounts confer a health benefit to the host, such as Lactic bacteria among others. An important scientific rationale has emerged for the use of probiotics in irritable bowel syndrome, although the data regarding different species are still limited. Not all probiotics are beneficial: it is important to select the specific strain which should be supported by good evidence base. The mechanisms of action of probiotics are described and the main strains are quoted.

  15. Bacterial metabolic 'toxins': a new mechanism for lactose and food intolerance, and irritable bowel syndrome.

    Science.gov (United States)

    Campbell, A K; Matthews, S B; Vassel, N; Cox, C D; Naseem, R; Chaichi, J; Holland, I B; Green, J; Wann, K T

    2010-12-30

    Lactose and food intolerance cause a wide range of gut and systemic symptoms, including gas, gut pain, diarrhoea or constipation, severe headaches, severe fatigue, loss of cognitive functions such as concentration, memory and reasoning, muscle and joint pain, heart palpitations, and a variety of allergies (Matthews and Campbell, 2000; Matthews et al., 2005; Waud et al., 2008). These can be explained by the production of toxic metabolites from gut bacteria, as a result of anaerobic digestion of carbohydrates and other foods, not absorbed in the small intestine. These metabolites include alcohols, diols such as butan 2,3 diol, ketones, acids, and aldehydes such as methylglyoxal (Campbell et al., 2005, 2009). These 'toxins' induce calcium signals in bacteria and affect their growth, thereby acting to modify the balance of microflora in the gut (Campbell et al., 2004, 2007a,b). These bacterial 'toxins' also affect signalling mechanisms in cells around the body, thereby explaining the wide range of symptoms in people with food intolerance. This new mechanism also explains the most common referral to gastroenterologists, irritable bowel syndrome (IBS), and the illness that afflicted Charles Darwin for 50 years (Campbell and Matthews, 2005a,b). We propose it will lead to a new understanding of the molecular mechanism of type 2 diabetes and some cancers. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. A Randomised Controlled Trial on hypnotherapy for Irritable Bowel Syndrome: design and methodological challenges (the IMAGINE study)

    NARCIS (Netherlands)

    Flik, Carla E.; van Rood, Yanda R.; Laan, Wijnand; Smout, André J. P. M.; Weusten, Bas L. A. M.; Whorwell, Peter J.; de Wit, Niek J.

    2012-01-01

    Background: Irritable Bowel Syndrome (IBS) is a common gastro-intestinal disorder in primary and secondary care, characterised by abdominal pain, discomfort, altered bowel habits and/or symptoms of bloating and distension. In general the efficacy of drug therapies is poor. Hypnotherapy as well as

  17. Review article: gut-directed hypnotherapy in the management of irritable bowel syndrome and inflammatory bowel disease.

    Science.gov (United States)

    Peters, S L; Muir, J G; Gibson, P R

    2015-06-01

    Gut-directed hypnotherapy is being increasingly applied to patients with irritable bowel syndrome (IBS) and to a lesser extent, inflammatory bowel disease (IBD). To review the technique, mechanisms of action and evidence for efficacy, and to identify gaps in the understanding of gut-directed hypnotherapy as a treatment for IBS and IBD. A review of published literature and a systematic review of clinical trials in its application to patients with IBS and IBD were performed. Gut-directed hypnotherapy is a clearly described technique. Its potential mechanisms of action on the brain-gut axis are multiple with evidence spanning psychological effects through to physiological gastrointestinal modifications. Six of seven randomised IBS studies reported a significant reduction (all P hypnotherapy ranged between 24% and 73%. Efficacy was maintained long-term in four of five studies. A therapeutic effect was also observed in the maintenance of clinical remission in patients with ulcerative colitis. Uncontrolled trials supported the efficacy and durability of gut-directed hypnotherapy in IBS. Gaps in understanding included to whom and when it should be applied, the paucity of adequately trained hypnotherapists, and the difficulties in designing well controlled-trials. Gut-directed hypnotherapy has durable efficacy in patients with IBS and possibly ulcerative colitis. Whether it sits in the therapeutic arsenal as a primary and/or adjunctive therapy cannot be ascertained on the current evidence base. Further research into efficacy, mechanisms of action and predictors of response is required. © 2015 John Wiley & Sons Ltd.

  18. The prevalence of overgrowth by aerobic bacteria in the small intestine by small bowel culture: relationship with irritable bowel syndrome.

    Science.gov (United States)

    Pyleris, Emmannouil; Giamarellos-Bourboulis, Evangelos J; Tzivras, Dimitrios; Koussoulas, Vassilios; Barbatzas, Charalambos; Pimentel, Mark

    2012-05-01

    Many studies have linked irritable bowel syndrome (IBS) with small intestinal bacterial overgrowth (SIBO), although they have done so on a qualitative basis using breath tests even though quantitative cultures are the hallmark of diagnosis. The purpose of this study was to underscore the frequency of SIBO in a large number of Greeks necessitating upper gastrointestinal (GI) tract endoscopy by using quantitative microbiological assessment of the duodenal aspirate. Consecutive subjects presenting for upper GI endoscopy were eligible to participate. Quantitative culture of aspirates sampled from the third part of the duodenum during upper GI tract endoscopy was conducted under aerobic conditions. IBS was defined by Rome II criteria. Among 320 subjects enrolled, SIBO was diagnosed in 62 (19.4%); 42 of 62 had IBS (67.7%). SIBO was found in 37.5% of IBS sufferers. SIBO was found in 60% of IBS patients with predominant diarrhea compared with 27.3% without diarrhea (P = 0.004). Escherichia coli, Enterococcus spp and Klebsiella pneumoniae were the most common isolates within patients with SIBO. A step-wise logistic regression analysis revealed that IBS, history of type 2 diabetes mellitus and intake of proton pump inhibitors were independently and positively linked with SIBO; gastritis was protective against SIBO. Using culture of the small bowel, SIBO by aerobe bacteria is independently linked with IBS. These results reinforce results of clinical trials evidencing a therapeutic role of non-absorbable antibiotics for the management of IBS symptoms.

  19. Gut Microbiota in Health, Diverticular Disease, Irritable Bowel Syndrome, and Inflammatory Bowel Diseases: Time for Microbial Marker of Gastrointestinal Disorders.

    Science.gov (United States)

    Lopetuso, Loris Riccardo; Petito, Valentina; Graziani, Cristina; Schiavoni, Elisa; Paroni Sterbini, Francesco; Poscia, Andrea; Gaetani, Eleonora; Franceschi, Francesco; Cammarota, Giovanni; Sanguinetti, Maurizio; Masucci, Luca; Scaldaferri, Franco; Gasbarrini, Antonio

    2018-01-01

    Few data exist on differences in gut microbiota composition among principal gastrointestinal (GI) diseases. We evaluated the differences in gut microbiota composition among uncomplicated diverticular disease (DD), irritable bowel syndrome (IBS) and inflammatory bowel diseases (IBD) patients. DD, IBS, and IBD patients along with healthy controls (CT) were enrolled in our Italian GI outpatient clinic. Stool samples were collected. Microbiota composition was evaluated through a metagenomic gene-targeted approach. GI pathology represented a continuous spectrum of diseases where IBD displayed one extreme, while CT displayed the other. Among Phyla, Biplot PC2/PC3 and dendogram plot showed major differences in samples from IBS and IBD. DD resembled species CT composition, but not for Bacteroides fragilis. In IBS, Dialister spp. and then Faecalibacterium prausnitzii were the most representative species. Ulcerative colitis showed a reduced concentration of Clostridium difficile and an increase of Bacteroides fragilis. In Crohn's disease, Parabacteroides distasonis was the most represented, while Faecalibacterium prausnitzii and Bacteroides fragilis were significantly reduced. Each disorder has its definite overall microbial signature, which produces a clear differentiation from the others. On the other hand, shared alterations constitute the "core dysbiosis" of GI diseases. The assessment of these microbial markers represents a parameter that may complete the diagnostic assessment. © 2017 S. Karger AG, Basel.

  20. From Inflammation to Cancer in Inflammatory Bowel Disease: Molecular Perspectives.

    Science.gov (United States)

    Romano, Maurizio; DE Francesco, Francesco; Zarantonello, Laura; Ruffolo, Cesare; Ferraro, Giuseppe A; Zanus, Giacomo; Giordano, Antonio; Bassi, Nicolò; Cillo, Umberto

    2016-04-01

    Inflammatory bowel diseases (IBD) are associated with an increased risk of colitis-associated colorectal carcinoma (CAC). CAC is one of the most important causes of morbidity and mortality in patients with Crohn's disease and ulcerative colitis. The aim of the present review was to discuss the most important signaling pathways and genetic alterations involved in carcinogenesis related to IBD, focusing on the molecular aspects of cancer stem cell physiology and the impact of the inflammatory microenvironment. Molecular mechanisms involved in CAC development differ from those in sporadic colorectal cancer, reflecting the prominent role of inflammation-induced carcinogenesis in the development of CAC. The alteration of the physiological microenvironment is thought to be responsible for the initiation of carcinogenesis in IBD. Furthermore, cancer stem cells seem to have a fundamental role in the generation and growth of CAC. We also address prevention and treatment modalities of CAC and its involvement in IBD. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  1. Congenital Short Bowel Syndrome: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Mohammed Hasosah

    2008-01-01

    Full Text Available Congenital short bowel syndrome (SBS is a rare condition of the newborn, with several reports demonstrating high mortality. A six-week-old boy presented with chronic diarrhea and failure to thrive. An upper gastrointestinal endoscopy showed a straight duodenum, and multiple small bowel biopsies were histologically normal. An upper gastrointestinal series showed malrotation. At laparotomy, the small bowel was 50 cm in length, confirming the diagnosis of congenital SBS. Parenteral nutrition was initiated and enteral feeding with an amino acid-based formula containing long-chain fatty acids was introduced early and gradually advanced. At the last follow-up examination at 24 months, he was thriving on a regular diet, with normal growth and development. Long-term survival of children with congenital SBS is now possible if enteral feeds are introduced early to promote intestinal adaptation, with subsequent weaning off parenteral nutrition.

  2. Mucosal Immune Cell Numbers and Visceral Sensitivity in Patients With Irritable Bowel Syndrome: Is There Any Relationship

    NARCIS (Netherlands)

    Braak, Breg; Klooker, Tamira K.; Wouters, Mira M.; Welting, Olaf; van der Loos, Chris M.; Stanisor, Oana I.; van Diest, Sophie; van den Wijngaard, Rene M.; Boeckxstaens, Guy E.

    2012-01-01

    OBJECTIVES: Repeated exposure to stress leads to mast cell degranulation, microscopic inflammation, and subsequent visceral hypersensitivity in animal models. To what extent this pathophysiological pathway has a role in patients with the irritable bowel syndrome (IBS) has not been properly

  3. Histamine, mast cells, and the enteric nervous system in the irritable bowel syndrome, enteritis, and food allergies

    OpenAIRE

    Wood, J D

    2006-01-01

    There is altered expression of histamine H1 and H2 receptor subtypes in mucosal biopsies from the terminal ileum and large intestine of patients with symptoms of food allergy and/or irritable bowel syndrome

  4. Protocol for a randomized controlled study of Iyengar yoga for youth with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Sternlieb Beth

    2011-01-01

    Full Text Available Abstract Introduction Irritable bowel syndrome affects as many as 14% of high school-aged students. Symptoms include discomfort in the abdomen, along with diarrhea and/or constipation and other gastroenterological symptoms that can significantly impact quality of life and daily functioning. Emotional stress appears to exacerbate irritable bowel syndrome symptoms suggesting that mind-body interventions reducing arousal may prove beneficial. For many sufferers, symptoms can be traced to childhood and adolescence, making the early manifestation of irritable bowel syndrome important to understand. The current study will focus on young people aged 14-26 years with irritable bowel syndrome. The study will test the potential benefits of Iyengar yoga on clinical symptoms, psychospiritual functioning and visceral sensitivity. Yoga is thought to bring physical, psychological and spiritual benefits to practitioners and has been associated with reduced stress and pain. Through its focus on restoration and use of props, Iyengar yoga is especially designed to decrease arousal and promote psychospiritual resources in physically compromised individuals. An extensive and standardized teacher-training program support Iyengar yoga's reliability and safety. It is hypothesized that yoga will be feasible with less than 20% attrition; and the yoga group will demonstrate significantly improved outcomes compared to controls, with physiological and psychospiritual mechanisms contributing to improvements. Methods/Design Sixty irritable bowel syndrome patients aged 14-26 will be randomly assigned to a standardized 6-week twice weekly Iyengar yoga group-based program or a wait-list usual care control group. The groups will be compared on the primary clinical outcomes of irritable bowel syndrome symptoms, quality of life and global improvement at post-treatment and 2-month follow-up. Secondary outcomes will include visceral pain sensitivity assessed with a standardized

  5. New psychological therapies for irritable bowel syndrome: mindfulness, acceptance and commitment therapy (ACT

    Directory of Open Access Journals (Sweden)

    Beatriz Sebastián Sánchez

    Full Text Available The current goal of treatment in irritable bowel syndrome (IBS focuses primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life. According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome. Cognitive behavioral therapy (CBT is the best studied treatment and seems to be the most promising therapeutic approach. However, some studies have challenged the effectiveness of this therapy for irritable bowel syndrome. One study concluded that cognitive behavioral therapy is no more effective than attention placebo control condition and another study showed that the beneficial effects wane after six months of follow-up. A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches. In this article we review these new psychological treatment approaches in an attempt to raise awareness of alternative treatments to gastroenterologists that treat this clinical syndrome.

  6. Gastric emptying rate and small bowel transit time in patients with irritable bowel syndrome determined with 99mTc-labeled pellets and scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, O.H.; Gjorup, T.; Christensen, F.N.

    1986-12-01

    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.

  7. Gastric emptying rate and small bowel transit time in patients with irritable bowel syndrome determined with 99mTc-labeled pellets and scintigraphy

    International Nuclear Information System (INIS)

    Nielsen, O.H.; Gjorup, T.; Christensen, F.N.

    1986-01-01

    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

  8. Administration of a dipeptidyl peptidase IV inhibitor enhances the intestinal adaptation in a mouse model of short bowel syndrome

    DEFF Research Database (Denmark)

    Okawada, Manabu; Holst, Jens Juul; Teitelbaum, Daniel H

    2011-01-01

    Glucagon-like peptide-2 induces small intestine mucosal epithelial cell proliferation and may have benefit for patients who suffer from short bowel syndrome. However, glucagon-like peptide-2 is inactivated rapidly in vivo by dipeptidyl peptidase IV. Therefore, we hypothesized that selectively...... inhibiting dipeptidyl peptidase IV would prolong the circulating life of glucagon-like peptide-2 and lead to increased intestinal adaptation after development of short bowel syndrome....

  9. Radiation-induced bowel injury: the impact of radiotherapy on survivorship after treatment for gynaecological cancers.

    Science.gov (United States)

    Kuku, S; Fragkos, C; McCormack, M; Forbes, A

    2013-09-17

    The number of women surviving cancer who live with symptoms of bowel toxicity affecting their quality of life continues to rise. In this retrospective study, we sought to describe and analyse the presenting clinical features in our cohort, and evaluate possible predictors of severity and chronicity in women with radiation-induced bowel injury after treatment for cervical and endometrial cancers. Review of records of 541 women treated within the North London Gynaecological Cancer Network between 2003 and 2010 with radiotherapy with or without chemotherapy for cervical and endometrial cancer identified 152 women who reported significant new bowel symptoms after pelvic radiation. Factor analysis showed that the 14 most common and important presenting symptoms could be 'clustered' into 3 groups with predictive significance for chronicity and severity of disease. Median follow-up for all patients was 60 months. Univariate analysis showed increasing age, smoking, extended field radiation, cervical cancer treatment and the need for surgical intervention to be significant predictors for severity of ongoing disease at last follow-up. On multivariate analysis, only age, cancer type (cervix) and symptom combinations/'cluster' of (bloating, flatulence, urgency, rectal bleeding and per-rectal mucus) were found to be significant predictors of disease severity. Fifteen (19%) women in the cervical cancer group had radiation-induced bowel injury requiring surgical intervention compared with five (6.7%) in the endometrial cancer group. Women with cervical cancer are younger and appear to suffer more severe symptoms of late bowel toxicity, whereas women treated for endometrial cancer suffer milder more chronic disease. The impact of radiation-induced bowel injury and the effect on cancer survivorship warrants further research into investigation of predictors of severe late toxicity. There is a need for prospective trials to aid early diagnosis, while identifying the underlying patho

  10. Bowel Dysfunction After Low Anterior Resection With Neoadjuvant Chemoradiotherapy or Chemotherapy Alone for Rectal Cancer: A Cross-Sectional Study from China.

    Science.gov (United States)

    Qin, Qiyuan; Huang, Binjie; Cao, Wuteng; Zhou, Jie; Ma, Tenghui; Zhou, Zhiyang; Wang, Jianping; Wang, Lei

    2017-07-01

    Neoadjuvant therapy plays a vital role in the treatment of locally advanced rectal cancer but impairs bowel function after restorative surgery. Optimal decision making requires adequate information of functional outcomes. This study aimed to assess postoperative bowel function and to identify predictors for severe dysfunction. The study included a cross-sectional cohort and retrospective assessments of pelvic anatomic features. The study was conducted at a tertiary GI hospital in China. Included patients underwent neoadjuvant chemoradiotherapy or chemotherapy without radiation and curative low anterior resection for rectal cancer between 2012 and 2014. Bowel function was assessed using the validated low anterior resection syndrome score. The thicknesses of the rectal wall, obturator internus, and levator ani were measured by preoperative MRI. A total of 151 eligible patients were identified, and 142 patients (94.0%) participated after a median of 19 months from surgery. Bowel dysfunction was observed in 71.1% (101/142) of patients, with 44.4% (63/142) reporting severe dysfunction. Symptoms of urgency and clustering were found to be major disturbances. Regression analysis identified preoperative long-course radiotherapy (p bowel dysfunction. Irradiated patients with a lower-third tumor (OR = 14.06; p Bowel function deteriorates frequently after low anterior resection for rectal cancer. Severe bowel dysfunction is significantly associated with preoperative long-course radiotherapy and a lower-third tumor, and the thickening of rectal wall after radiation is a strong predictor. Treatment decisions and patient consent should be implemented with raising awareness of bowel symptom burdens. See Video Abstract at http://links.lww.com/DCR/A317.

  11. Bowel Dysfunction

    Science.gov (United States)

    ... to PCF? Featured Fundraise for PCF: Many vs Cancer Contact Us Bowel Dysfunction The broad term of bowel dysfunction includes ... immodium) can be used to help with loose bowel movements. Increasing fiber intake through whole grains, ... mission 82% Join the fight against prostate ...

  12. Pyometra presenting in conjunction with bowel cancer in a post-menopausal women: a case report.

    Science.gov (United States)

    Soleymani Majd, Hooman; Watermeyer, Sean; Ismail, Lamiese

    2008-07-08

    This case describes a 71 year old, post-menopausal woman who developed vaginal discharge. This complaint ultimately led to the discovery of bowel cancer in conjunction with a large sterile pyometra.The pyometra was not due to genital malignancy. The most likely conclusion is that the pyometra may have arisen as an inflammatory response to the adjacent bowel pathology. This case report highlights the need for clinicians to consider non-gynaecological cancer as a possible cause for otherwise unexplained pyometra.

  13. Pyometra presenting in conjunction with bowel cancer in a post-menopausal women: a case report

    OpenAIRE

    Soleymani majd, Hooman; Watermeyer, Sean; Ismail, Lamiese

    2008-01-01

    This case describes a 71 year old, post-menopausal woman who developed vaginal discharge. This complaint ultimately led to the discovery of bowel cancer in conjunction with a large sterile pyometra. The pyometra was not due to genital malignancy. The most likely conclusion is that the pyometra may have arisen as an inflammatory response to the adjacent bowel pathology. This case report highlights the need for clinicians to consider non-gynaecological cancer as a possible cause for otherwise u...

  14. Systematic review: serotonergic modulators in the treatment of irritable bowel syndrome--influence on psychiatric and gastrointestinal symptoms.

    Science.gov (United States)

    Kilkens, T O C; Honig, A; Rozendaal, N; Van Nieuwenhoven, M A; Brummer, R-J M

    2003-01-01

    Both central and peripheral serotonergic modulators are used in the treatment of irritable bowel syndrome. The majority of patients with irritable bowel syndrome presenting to a gastroenterologist demonstrate affective dysregulation. Serotonin may play a regulatory role in both gastrointestinal motility and sensitivity, as well as in affective dysregulation, in irritable bowel syndrome. To analyse, systematically, randomized controlled trials studying the influence of serotonergic modulators on both gastrointestinal and psychiatric symptoms in irritable bowel syndrome, in order to elucidate baseline irritable bowel syndrome symptomatology and possible differential effects of serotonergic modulation on this symptomatology. A standardized qualitative analysis was performed of studies investigating the influence of serotonergic modulators on both gastrointestinal and psychiatric symptoms in irritable bowel syndrome using a blind review approach. The studies were ranked according to their total quality score (maximum 100 points). Eleven studies fulfilled the entry criteria, six of which scored above 55 points. An association between gastroenterological and psychiatric changes was present in five of the six studies. The results strengthen the serotonergic association between gastroenterological and psychiatric symptoms. Adjusted guidelines for combined gastrointestinal and psychiatric assessments are recommended in order to further elucidate the serotonergic interaction between gastrointestinal and psychiatric symptoms.

  15. The risk of extra-colonic, extra-endometrial cancer in the Lynch syndrome

    DEFF Research Database (Denmark)

    Watson, Patrice; Vasen, Hans F A; Mecklin, Jukka-Pekka

    2008-01-01

    Persons with the Lynch syndrome (LS) are at high risk for cancer, including cancers of the small bowel, stomach, upper urologic tract (renal pelvis and ureter), ovary, biliary tract and brain tumors, in addition to the more commonly observed colorectal and endometrial cancers. Cancer prevention...... after the median year of birth (p cancers of the small bowel, stomach, breast and biliary tract were less common. Urologic tract cancer and ovarian cancer occur frequently enough in some LS subgroups to justify trials to evaluate...... strategies for these less common cancers require accurate, age-specific risk estimation. We pooled data from 4 LS research centers in a retrospective cohort study, to produce absolute incidence estimates for these cancer types, and to evaluate several potential risk modifiers. After elimination of 135...

  16. The relationship of food intolerance and irritable bowel syndrome in adults.

    Science.gov (United States)

    Zigich, Sara; Heuberger, Roschelle

    2013-01-01

    The purpose of this literature review is to develop a thorough understanding of the research on food intolerance and its relationship to irritable bowel syndrome. Knowledge of the connection between the two conditions will assist allied healthcare professionals in working with patients to better manage their symptoms. Reduced healthcare costs may also result if patients are able to identify problematic foods and experience symptom improvement with diet changes. The review consists of an overview of food intolerance including prevalence, specific foods implicated including an in-depth review of research on bulk sweeteners, as well as methods of diagnosis. In addition, prevalence, specific foods associated with food intolerance in irritable bowel syndrome patients such as carbohydrates and lipids, nutritional consequences of food intolerance, and possible food-related methods of treatment including increased fiber intake are discussed. Finally, suggestions for future research and possible directions allied healthcare professionals can start with in assisting patients are provided.

  17. D-lactic acidosis in short-bowel syndrome managed with antibiotics and probiotics.

    Science.gov (United States)

    Uchida, Hiroo; Yamamoto, Hideki; Kisaki, Yoshiyuki; Fujino, Junko; Ishimaru, Yuki; Ikeda, Hitoshi

    2004-04-01

    D-lactic acidosis sometimes occurs in malabsorbed patients with short-bowel syndrome and is characterized by recurrent episodes of encephalopathy and metabolic acidosis. The characteristic neurologic abnormalities and the presence of metabolic acidosis raises a diagnostic suspicion, and the diagnosis is made when the serum level of D-lactic acid is greater than 3 mmol/L. Standard treatment consists of restricting oral carbohydrates or fasting, correction of metabolic acidosis, and a long-term suppression of pathogenic floras with antibiotics. The authors present a case of D-lactic acidosis in a 22-year-old patient with short-bowel syndrome, to whom intestinal bacterial agents (probiotics) were given in addition to oral kanamycin. Recolonization of the intestine with nonpathogenic floras should be a long-term treatment for D-lactic acidosis.

  18. [Irritable bowel syndrome--a multifactorial disease in children and adults].

    Science.gov (United States)

    Blomhoff, Svein; Diseth, Trond H; Jacobsen, Morten B; Vatn, Morten

    2002-05-10

    Irritable bowel syndrome is the most frequent gastrointestinal disorder in Norway. Though there has been huge research activity in the field, no proven single aetiology or effective treatment has emerged. Consensus-based clinical diagnostic criteria have not yet brought diagnostic clarity. Possibly, there are dysfunctions in the processing of sensory stimuli in the "brain-gut" axis that may cause visceral hypersensitivity and secondary motility changes. In some patients, a multifactorial explanation of the mechanisms is useful, including stressful life events or other psychological factors. Psychiatric co-morbidity is probably the most important maintaining factor. Irritable bowel syndrome may serve as a model for the study of the interaction between biological, psychological and social factors in functional disorders. A good therapeutic relationship between the physician and the patient is an important element in the treatment approach.

  19. Irritable Bowel Syndrome May Be Associated with Elevated Alanine Aminotransferase and Metabolic Syndrome.

    Science.gov (United States)

    Lee, Seung Hwa; Kim, Kyu Nam; Kim, Kwang Min; Joo, Nam Seok

    2016-01-01

    Recent studies have revealed close relationships between hepatic injury, metabolic pathways, and gut microbiota. The microorganisms in the intestine also cause irritable bowel syndrome (IBS). The aim of this study was to examine whether IBS was associated with elevated hepatic enzyme [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)], gamma-glutamyl transferase (γ-GT) levels, and metabolic syndrome (MS). This was a retrospective, cross-sectional, case-control study. The case and control groups comprised subjects who visited our health promotion center for general check-ups from June 2010 to December 2010. Of the 1127 initially screened subjects, 83 had IBS according to the Rome III criteria. The control group consisted of 260 age- and sex-matched subjects without IBS who visited our health promotion center during the same period. Compared to control subjects, patients with IBS showed significantly higher values of anthropometric parameters (body mass index, waist circumference), liver enzymes, γ-GT, and lipid levels. The prevalences of elevated ALT (16.9% vs. 7.7%; p=0.015) and γ-GT (24.1% vs. 11.5%; p=0.037) levels were significantly higher in patients with IBS than in control subjects. A statistically significant difference was observed in the prevalence of MS between controls and IBS patients (12.7% vs. 32.5%; p<0.001). The relationships between elevated ALT levels, MS, and IBS remained statistically significant after controlling for potential confounding factors. On the basis of our study results, IBS may be an important condition in certain patients with elevated ALT levels and MS.

  20. Mood and Anxiety Disorders in Chronic Fatigue Syndrome, Fibromyalgia, and Irritable Bowel Syndrome : Results From the LifeLines Cohort Study

    NARCIS (Netherlands)

    Janssens, Karin A. M.; Zijlema, Wilma L.; Joustra, Monica L.; Rosmalen, Judith G. M.

    Objective: Functional somatic syndromes (FSSs) have often been linked to psychopathology. The aim of the current study was to compare prevalence rates of psychiatric disorders among individuals with chronic fatigue syndrome (CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS). Methods: This

  1. Bowel Dysfunction and Self-management for Bowel Symptoms After Sphincter-Preserving Surgery: A Cross-sectional Survey of Chinese Rectal Cancer Patients.

    Science.gov (United States)

    Hou, Xiao-Ting; Pang, Dong; Lu, Qian; Yang, Ping; Jin, San-Li

    After sphincter-preserving surgery (SPS), patients with rectal cancer present multiple bowel symptoms, which significantly affect their daily lives. However, to date, few studies have been conducted in China to identify bowel symptoms and self-management behaviors and to explore the relationship between these behaviors and bowel symptoms. To describe bowel symptoms among Chinese patients with rectal cancer after SPS, the self-management behaviors used, and the relationship between the symptoms and behaviors. A convenience sample of 175 rectal cancer patients who underwent SPS was recruited from 2 tertiary hospitals in Beijing, China, between July and December 2014. The participants completed a general information structural questionnaire, the Chinese version of the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument, and the Bowel Symptoms Self-Management Behaviors Questionnaire. The frequencies of 18 bowel symptoms ranged between 16.0% and 96.0%. Diet self-management was the most common behavior and therapy self-management was the least frequent behavior. Although therapy self-management had best effects relatively, other effective behaviors included self-management of the perianal skin and self-management of social activities. The frequency of use of self-management behaviors was significantly positively associated with bowel symptoms (r=-0.232 to -0.580, P bowel symptoms after SPS are highly prevalent. Patients with severe bowel symptoms are more likely to use self-management behaviors regularly; however, there is no scientific evidence that these behaviors produce satisfactory results. Healthcare providers should identify bowel symptoms after SPS and develop supportive interventions for the self-management of symptoms.

  2. Analysis of influence factors on the volume of pelvic bowel irradiated for rectal cancer

    International Nuclear Information System (INIS)

    He Yuxiang; Cai Yong; Zhu Xianggao; Han Shukui; Xu Bo

    2007-01-01

    Objective: To evaluate influence of prone/ supine position, gender, operation, bladder distension on bowel irradiated for patients with rectal cancer during pelvic radiotherapy. Methods: 36 patients with rectal cancer were investigated. Treatment plans were created with three dimensional treatment planning system. The dose and volume of bowel irradiated were analyzed according to dose-volume histograms (DVH) for every patient. The prescribed dose was 50 Gy. Results: The extent of bladder distension significantly influenced the mean doses and the V 45 high dose volumes of bowel irradiated. The treatment position and gender significantly influenced the V 15 low dose volume of bowel irradiated, the operation significantly influenced the mean doses of bowel. Either prone and supine position, or preoperative and postoperative, the doses of bowel irradiated for good bladder distension were lower and the volumes were smaller than that for bad bladder distension. The V 45 high dose volume of bowel irradiated for bad and good bladder distension at prone position were 15.3% and 7.4% (P=0.023), respectively, and at postoperative 14.1% and 7.2% (P=0.014), respectively. Conclusions: The doses and volumes of pelvic bowel irradiated were significantly influenced by the extent of bladder distension, and partly influenced by the prone/supine position, gender and operation. (authors)

  3. Pharmacological Approach for Managing Pain in Irritable Bowel Syndrome: A Review Article

    OpenAIRE

    Chen, Longtu; Ilham, Sheikh J.; Feng, Bin

    2017-01-01

    Context Visceral pain is a leading symptom for patients with irritable bowel syndrome (IBS) that affects 10% - 20 % of the world population. Conventional pharmacological treatments to manage IBS-related visceral pain is unsatisfactory. Recently, medications have emerged to treat IBS patients by targeting the gastrointestinal (GI) tract and peripheral nerves to alleviate visceral pain while avoiding adverse effects on the central nervous system (CNS). Several investigational drugs for IBS also...

  4. Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure

    DEFF Research Database (Denmark)

    Jeppesen, Palle B; Pertkiewicz, Marek; Messing, Bernard

    2012-01-01

    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....

  5. Acupuncture for irritable bowel syndrome: primary care based pragmatic randomised controlled trial

    Directory of Open Access Journals (Sweden)

    MacPherson Hugh

    2012-10-01

    Full Text Available Abstract Background Acupuncture is used by patients as a treatment for irritable bowel syndrome (IBS but the evidence on effectiveness is limited. The purpose of the study was to evaluate the effectiveness of acupuncture for irritable bowel syndrome in primary care when provided as an adjunct to usual care. Methods Design: A two-arm pragmatic randomised controlled trial. Setting: Primary care in the United Kingdom. Patients: 233 patients had irritable bowel syndrome with average duration of 13 years and score of at least 100 on the IBS Symptom Severity Score (SSS. Interventions: 116 patients were offered 10 weekly individualised acupuncture sessions plus usual care, 117 patients continued with usual care alone. Measurements: Primary outcome was the IBS SSS at three months, with outcome data collected every three months to 12 months. Results There was a statistically significant difference between groups at three months favouring acupuncture with a reduction in IBS Symptom Severity Score of −27.43 (95% CI: –48.66 to −6.21, p = 0.012. The number needed to treat for successful treatment (≥50 point reduction in the IBS SSS was six (95% CI: 3 to 17, based on 49% success in the acupuncture group vs. 31% in the control group, a difference between groups of 18% (95% CI: 6% to 31%. This benefit largely persisted at 6, 9 and 12 months. Conclusions Acupuncture for irritable bowel syndrome provided an additional benefit over usual care alone. The magnitude of the effect was sustained over the longer term. Acupuncture should be considered as a treatment option to be offered in primary care alongside other evidenced based treatments. Trial Registration Current Controlled Trials ISRCTN08827905

  6. The effect of biofeedback therapy on dyssynergic constipation in patients with or without Irritable Bowel Syndrome

    OpenAIRE

    Tannaz Ahadi; Faezeh Madjlesi; Bahar Mahjoubi; Rezvan Mirzaei; Bijan Forogh; Seyedeh Somayeh Daliri; Seyed Majid Derakhshandeh; Roxana Bazaz Behbahani; G Reza Raissi

    2014-01-01

    Background: The Rome II and III diagnostic criteria for dyssynergic defecation recommended the exclusion of irritable bowel syndrome (IBS). This study determined the effect of biofeedback therapy on dyssynergic constipation in patients with or without IBS. Materials and Methods: This study was a nonrandomized, single blinded, semi experimental study. Dyssynergic defecation patients with and without IBS were asked to undergo biofeedback therapy 8 sessions. The defecation dynamics and balloon e...

  7. Lubiprostone for the Treatment of Adult Women with Irritable Bowel Syndrome with Constipation

    OpenAIRE

    Soubra, Mahmoud; Schey, Ron

    2012-01-01

    Irritable bowel syndrome with constipation (IBS-C) affects approximately 5% of the population in western countries. The majority of those afflicted are women. Symptoms are often detrimental to the individual's quality of life and incur high healthcare costs to society. There is no evidence to support changes in lifestyle, laxatives or over the counter supplements. Tegaserod appeared to have promising results but was promptly removed from the market due to adverse cardiovascular events. In 200...

  8. Irritable bowel syndrome diagnosed in primary care : Occurrence, treatment and impact on everyday life

    OpenAIRE

    Olsen Faresjö, Åshild

    2006-01-01

    Background: IBS is the most common functional gastrointestinal disorders and affects approximately 10-20 % of the general population and is widespread in all societies and socio-economic groups. Although the disorder does not have a life-threatening course, it still seriously affects the patients in their everyday life. Aim: The general aims of this thesis were to estimate the occurrence of irritable bowel syndrome in the general population and to achieve a better understanding of present tre...

  9. [Irritable bowel syndrome: from guideline to made-to-measure care?].

    Science.gov (United States)

    Engels, Leopold G

    2012-01-01

    The new guideline on irritable bowel syndrome (IBS) advocates distinguishing IBS patients who predominantly suffer from constipation from those who mainly suffer from diarrhoea or from alternating bouts of diarrhoea and constipation. In the latter two groups, coeliac disease should be excluded, as should lactose intolerance if at all possible. Since there is no gold standard for the treatment of IBS a thorough explanation of the condition to patients is recommended.

  10. Differential expression of toll-like receptors in patients with irritable bowel syndrome.

    LENUS (Irish Health Repository)

    Brint, Elizabeth K

    2011-02-01

    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.

  11. Prevalence of functional constipation and constipation-predominant irritable bowel syndrome in Indian patients with constipation

    OpenAIRE

    Ramesh Rooprai; Naresh Bhat; Rajesh Sainani; Mayur M. Mayabhate

    2017-01-01

    Background: Evaluate prevalence of functional constipation (FC) and irritable bowel syndrome-constipation (IBS-C) in Indian constipated patients and assess their demographic/socio-economic/clinical characteristics. Methods: Patients (≥18 years) who visited their general physician with symptoms of constipation (Rome III criteria for FC or IBS-C as per physician assessment) and willing to participate were enrolled in this prospective, clinical-epidemiological study. Demographic, socioeconom...

  12. Risk factors for bowel dysfunction after sphincter-preserving rectal cancer surgery: a prospective study using the Memorial Sloan Kettering Cancer Center bowel function instrument.

    Science.gov (United States)

    Ihn, Myong Hoon; Kang, Sung-Bum; Kim, Duck-Woo; Oh, Heung-Kwon; Lee, Soo Young; Hong, Sa Min

    2014-08-01

    Until recently, no studies have prospectively evaluated bowel function after sphincter-preserving surgery for rectal cancer with the use of a validated bowel function scoring system. The aim of this study was to investigate possible risk factors for altered bowel function after sphincter-preserving surgery. This was a prospective study. The study was conducted between January 2006 and May 2012 at the authors' institution. Patients who underwent sphincter-preserving rectal cancer surgery were recruited. Bowel function was assessed 1 day before (baseline) and at 1 year after sphincter-preserving surgery or temporary ileostomy takedown with the use of the Memorial Sloan Kettering Cancer Center questionnaire. Multivariable analysis was performed to identify the factors associated with altered bowel function after surgery. Overall, 266 patients were eligible for the analysis. The tumor was located in the upper, middle, and lower rectum in 68 (25.5%), 113 (42.5%), and 85 (32.0%) patients. Intersphincteric resection and temporary ileostomy were performed in 18 (6.8%) and 129 (48.5%) patients. The mean Memorial Sloan Kettering Cancer Center score was 64.5 ± 7.6 at 1 year after sphincter-preserving surgery or temporary ileostomy takedown. The Memorial Sloan Kettering Cancer Center score decreased in 163/266 patients (61.3%) between baseline and 1 year after surgery. Tumor location (p = 0.01), operative method (p = 0.03), anastomotic type (p = 0.01), and temporary ileostomy (p = 0.01) were associated with altered bowel function after sphincter-preserving surgery in univariate analyses. In multivariable analysis, only tumor location was independently associated with impaired bowel function after sphincter-preserving rectal cancer surgery. This study was limited by its nonrandomized design and the lack of measurement before preoperative chemoradiotherapy. We suggest that preoperative counseling should be implemented to inform patients of the risk of bowel dysfunction

  13. Predicting the Risk of Bowel-Related Quality-of-Life Impairment After Restorative Resection for Rectal Cancer: A Multicenter Cross-Sectional Study.

    Science.gov (United States)

    Battersby, Nick J; Juul, Therese; Christensen, Peter; Janjua, Ahmed Z; Branagan, Graham; Emmertsen, Katrine J; Norton, Christine; Hughes, Robert; Laurberg, Søren; Moran, Brendan J

    2016-04-01

    Restorative anterior resection is considered the optimal procedure for most patients with rectal cancer and is frequently preceded by radiotherapy. Both surgery and preoperative radiotherapy impair bowel function, which adversely affects quality of life. This study aimed to report symptoms associated with and key predictors for bowel-related quality-of-life impairment. The study included a cross-sectional cohort. This was a multicenter study from 12 United Kingdom centers. A total of 578 patients with rectal cancer underwent curative restorative anterior resection between 2001 and 2012 (median, 5.25 years postsurgery). Patients completed outcome measures that assessed bowel dysfunction (low anterior resection syndrome score), incontinence (Wexner score), and quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30), plus an anchor question: "Overall how does bowel function affect your quality of life?" The response rate was 80% (462/578). Overall, 85% (391/462) of patients reported bowel-related quality-of-life impairment, with 40% (187/462) reporting major impairment. A large difference in global quality of life (22 points; p cancer treated with and without preoperative radiotherapy compared with 47% and 33% of middle/upper rectal cancers with and without preoperative radiotherapy. Advances in radiotherapy delivery and improvements in posttreatment symptom control, although currently of limited efficacy, imply that the content of this consent aid should be re-evaluated in 5 to 10 years. Before a restorative anterior resection, patients with rectal cancer should be informed that bowel-related quality-of-life impairment is common. The key risk factors are neoadjuvant therapy and a low tumor height. This study presents quality-of-life and functional outcome data, along with a consent aid, that will enhance this preoperative patient discussion.

  14. Review article: Associations between immune activation, intestinal permeability and the irritable bowel syndrome.

    Science.gov (United States)

    Matricon, J; Meleine, M; Gelot, A; Piche, T; Dapoigny, M; Muller, E; Ardid, D

    2012-12-01

    Irritable bowel syndrome (IBS), one of the most common gastrointestinal disorders, markedly impairing patients' quality of life. Drug development for IBS treatment has been hampered by the lack of understanding of IBS aetiology. In recent years, numerous data have emerged that suggest the involvement of immune activation in IBS, at least in a subset of patients. To determine whether immune activation and intestinal permeabilisation are more frequently observed in IBS patients compared with healthy controls. The scientific bibliography was searched using the following keywords: irritable bowel syndrome, inflammation, immune activation, permeabilisation, intestine, assay, histology and human. The retrieved studies, including blood, faecal and histological studies, were analysed to provide a comprehensive and structured overview of the available data including the type of assay, type of inflammatory marker investigated or intestinal segment studied. Immune activation was more frequently observed in IBS patients than in healthy controls. An increase in the number of mast cells and lymphocytes, an alteration in cytokine levels and intestinal permeabilisation were reported in IBS patients. No consistent changes in the numbers of B cells or enterochromaffin cells or in mucosal serotonin production were demonstrated. The changes observed were modest and often heterogeneous among the studied population. Only appropriate interventions improving irritable bowel syndrome symptoms could highlight and confirm the role of immune activation in this pathophysiology. © 2012 Blackwell Publishing Ltd.

  15. Microscopic colitis and small intestinal bacterial overgrowth--diagnosis behind the irritable bowel syndrome?

    Science.gov (United States)

    Stoicescu, Adriana; Andrei, M; Becheanu, G; Stoicescu, M; Nicolaie, T; Diculescu, M

    2012-01-01

    Some patients previously diagnosed with irritable bowel syndrome (IBS) may develop microscopic colitis or small intestinal bacterial overgrowth (SIBO). To estimate the prevalence of microscopic colitis and SIBO in patients with IBS, to evaluate the symptoms and the efficacy of treatment. We examined patients with IBS admitted in our clinic during a three-year period. We identified patients with microscopic colitis by performing total colonoscopy with multiple biopsies from normal intestinal mucosa and those with SIBO by performing a H2-breath test with glucose. We compared the symptoms and the effectiveness of the treatment. Out of the 132 patients initially diagnosed with IBS 3% (n=4) had microscopic colitis and 43.9% (n=58) had SIBO. Diarrhea was the main symptom in patients with microscopic colitis and SIBO (p=0.041), while abdominal pain, abdominal bloating and flatulence were prominent in IBS patients (p=0.042; p=0.039; p=0.048). Specific treatment with rifaximin in SIBO patients negativated H2-breath test in 70.9% cases. Patients suspected to have irritable bowel syndrome should be evaluated for microscopic colitis and SIBO. The proper diagnosis and the specific treatment may cure some difficult cases of the so called "irritable bowel syndrome".

  16. Palliative care in patients with ovarian cancer and bowel obstruction.

    Science.gov (United States)

    Daniele, Alberto; Ferrero, A; Fuso, L; Mineccia, M; Porcellana, V; Vassallo, D; Biglia, N; Menato, G

    2015-11-01

    Malignant bowel obstruction (MBO) is usually a pre-terminal event in patients with ovarian cancer. However, because of the lack of data in literature, decisions around surgical intervention, non-resectional procedures, or medical treatment of MBO in patients with ovarian cancer cannot be lightly undertaken. We analyzed medical and surgical procedures, performance status, nutritional status, cachexia, and their prognostic value in this group of patients. We retrospectively selected all consecutive patients with recurrent ovarian cancer who received medical or surgical treatment for MBO between October 2008 and January 2014 at the Academic Department of Gynecological Oncology of Mauriziano Hospital of Turin (Italy). We found 40 patients: 18 of them underwent medical treatment and 22 of them were submitted to surgery. In the group of surgery, the hospitalization was shorter (p 0.02), the pain reduction was more effective (p 0.001), the number of chemotherapy lines was higher (p 0.03), and re-obstruction was more rare (p 0.02). Between the two groups, we did not find any differences in post-palliation episodes of vomit (p 0.83), type of diet (p 0.34), ability to return home (p 0.72), and death setting (p 0.28). Median survival after palliation was longer in the group of surgery (p 0.025). Cachexia, low performance status, and poor nutritional status were significant predictors of worse survival after MBO, independently by the treatment. Surgery has to be considered in patients without serious contraindications; otherwise, a medical protocol, including antisecretory drugs, is the standard of care in frail patients.

  17. IMPACT OF FOOD ENRICHED WITH DIETARY FIBER ON PATIENTS WITH CONSTIPATION PREDOMINANT IRRITABLE BOWEL SYNDROME.

    Science.gov (United States)

    Sulaberidze, G; Okujava, M; Liluashvili, K; Tughushi, M; Abramashvili, M

    2017-03-01

    The causes of motility disorder of gastrointestinal tract and in particular Irritable Bowel Syndrome IBS are multifold, leading to complexity of treatment and requirement of more precise investigation of different pharmacological and non-pharmacological approaches. The aim of the study was investigation and comparison of the dietary fiber intake among women with constipation-predominant irritable bowel syndrome (IBS-C) and without, improvement of the dietary fiber intake using interventions with less rough changes of food related behavior and study of its effects on the bowel function, general wellbeing and compliance of patients. In total 100 healthy women, without any clinical signs of gastrointestinal disorders and 98 women who met Rome III criteria of IBS-C were enrolled in the dietary fiber intake assessment survey. The dietary habits of all participants, as well as bowel function, digestive feelings and general wellbeing of patients at baseline, on the 7th and 14th day of dietary intervention was assessed by the means of adopted questionnaires. The dietary supplementation was provided during the breakfast with fiber enriched food - bread and muesli. Research data reviled significantly lower daily intake of dietary fiber among patients with IBS-C compared with healthy group. The main source of dietary fiber in IBS-C group was bread and cereals, therefore introduction of dietary fiber rich bread and muesli in the breakfast didn't affect diet-related habits and determined high compliance of patients. Two week long intervention significantly improved the bowel function and irritation related complains, the feeling of general wellbeing was considerably better on the endpoint as well.

  18. Small Bowel Bleeding

    Science.gov (United States)

    ... Hepatitis C Inflammatory Bowel Disease Irritable Bowel Syndrome Obesity Digestive Health Topics Abdominal Pain Syndrome Belching, Bloating, and Flatulence Common GI Symptoms Gastroparesis See All Topics (A-Z) GI Procedures ...

  19. How Patients View Probiotics: Findings from a Multicenter Study of Patients with Inflammatory Bowel Disease and Irritable Bowel Syndrome

    Science.gov (United States)

    Mercer, MaryBeth; Brinich, Margaret A.; Geller, Gail; Harrison, Krista; Highland, Janelle; James, Katherine; Marshall, Patricia; McCormick, Jennifer B.; Tilburt, Jon; Achkar, Jean-Paul; Farrell, Ruth M.; Sharp, Richard R.

    2011-01-01

    Background Patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) have access to a growing number of probiotic products marketed to improve digestive health. It is unclear how patients make decisions about probiotics and what role they expect their gastroenterologists to play as they consider using probiotics. Understanding patients’ knowledge, attitudes and expectations of probiotics may help gastroenterologists engage patients in collaborative discussions about probiotics. Study Focus groups were conducted with patients with IBD and IBS at the Cleveland Clinic, Mayo Clinic and Johns Hopkins University. Inductive analytic methods were utilized to identify common themes and draw interpretations from focus group narratives. Results One hundred thirty-six patients participated in 22 focus groups between March and August 2009. Patients viewed probiotics as an appealing alternative to pharmaceutical drugs and understood probiotics as a more “natural,” low-risk therapeutic option. Many patients were hesitant to use them without consulting their gastroenterologists. Patients would weigh the risks and benefits of probiotics, their disease severity and satisfaction with current treatments when considering probiotic use. Conclusions Patients are interested in probiotics but have many unanswered questions about their use. Our findings suggest that patients with IBD and IBS will look to gastroenterologists and other clinicians as trustworthy advisors regarding the utility of probiotics as an alternative or supplement to pharmaceutical drugs. Gastroenterologists and other clinicians who care for patients with these diseases should be prepared to discuss the potential benefits and risks of probiotics and assist patients in making informed decisions about their use. PMID:21716123

  20. Apo AIV and Citrulline Plasma Concentrations in Short Bowel Syndrome Patients: The Influence of Short Bowel Anatomy

    Science.gov (United States)

    Targarona, Jordi; Ruiz, Jorge; García, Natalia; Oró, Denise; García-Villoria, Judit; Creus, Gloria; Pita, Ana M.

    2016-01-01

    Introduction Parenteral nutrition (PN) dependence in short bowel syndrome (SBS) patients is linked to the functionality of the remnant small bowel (RSB). Patients may wean off PN following a period of intestinal adaptation that restores this functionality. Currently, plasma citrulline is the standard biomarker for monitoring intestinal functionality and adaptation. However, available studies reveal that the relationship the biomarker with the length and function of the RSB is arguable. Thus, having additional biomarkers would improve pointing out PN weaning. Aim By measuring concomitant changes in citrulline and the novel biomarker apolipoprotein AIV (Apo AIV), as well as taking into account the anatomy of the RSB, this exploratory study aims to a better understanding of the intestinal adaptation process and characterization of the SBS patients under PN. Methods Thirty four adult SBS patients were selected and assigned to adapted (aSBS) and non-adapted (nSBS) groups after reconstructive surgeries. Remaining jejunum and ileum lengths were recorded. The aSBS patients were either on an oral diet (ORAL group), those with intestinal insufficiency, or on oral and home parenteral nutrition (HPN group), those with chronic intestinal failure. Apo AIV and citrulline were analyzed in plasma samples after overnight fasting. An exploratory ROC analysis using citrulline as gold standard was performed. Results Biomarkers, Apo AIV and citrulline showed a significant correlation with RSBL in aSBS patients. In jejuno-ileocolic patients, only Apo AIV correlated with RSBL (rb = 0.54) and with ileum length (rb = 0.84). In patients without ileum neither biomarker showed any correlation with RSBL. ROC analysis indicated the Apo AIV cut-off value to be 4.6 mg /100 mL for differentiating between the aSBS HPN and ORAL groups. Conclusions Therefore, in addition to citrulline, Apo AIV can be set as a biomarker to monitor intestinal adaptation in SBS patients. As short bowel anatomy is shown

  1. Increased incidence of bowel cancer after non-surgical treatment of appendicitis.

    Science.gov (United States)

    Enblad, Malin; Birgisson, Helgi; Ekbom, Anders; Sandin, Fredrik; Graf, Wilhelm

    2017-11-01

    There is an ongoing debate on the use of antibiotics instead of appendectomy for treating appendicitis but diagnostic difficulties and longstanding inflammation might lead to increased incidence of bowel cancer in these patients. The aim of this population-based study was to investigate the incidence of bowel cancer after non-surgical treatment of appendicitis. Patients diagnosed with appendicitis but lacking the surgical procedure code for appendix removal were retrieved from the Swedish National Inpatient Register 1987-2013. The cohort was matched with the Swedish Cancer Registry and the standardised incidence ratios (SIR) with 95% confidence interval (95% CI) for appendiceal, colorectal and small bowel cancers were calculated. Of 13 595 patients with non-surgical treatment of appendicitis, 352 (2.6%) were diagnosed with appendiceal, colorectal or small bowel cancer (SIR 4.1, 95% CI 3.7-4.6). The largest incidence increase was found for appendiceal (SIR 35, 95% CI 26-46) and right-sided colon cancer (SIR 7.5, 95% CI 6.6-8.6). SIR was still elevated when excluding patients with less than 12 months since appendicitis and the incidence of right-sided colon cancer was elevated five years after appendicitis (SIR 3.5, 95% CI 2.1-5.4). An increased incidence of bowel cancer was found after appendicitis with abscess (SIR 4.6, 95% CI 4.0-5.2), and without abscess (SIR 3.5, 95% CI 2.9-4.1). Patients with non-surgical treatment of appendicitis have an increased short and long-term incidence of bowel cancer. This should be considered in the discussion about optimal management of patients with appendicitis. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  2. Treatment Patterns, Outcomes, and Costs for Bowel Obstruction in Ovarian Cancer.

    Science.gov (United States)

    Suidan, Rudy S; He, Weiguo; Sun, Charlotte C; Zhao, Hui; Ramondetta, Lois M; Badgwell, Brian D; Bodurka, Diane C; Lu, Karen H; Giordano, Sharon H; Meyer, Larissa A

    2017-09-01

    The aim of this study was to assess treatment patterns, outcomes, and costs for bowel obstruction in ovarian cancer. All patients with stage II to IV ovarian cancer who were admitted for bowel obstruction greater than or equal to 6 months after cancer diagnosis from 2000 to 2011 were identified from the Surveillance, Epidemiology, and End Results registry-Medicare database. Management strategies and outcomes of bowel obstruction were compared. Among 1397 women with bowel obstruction, 562 (40%) underwent surgery, and 154 (11%) had a gastrostomy or jejunostomy (G/J) tube placed. Thirty-four percent of patients who underwent surgery subsequently received chemotherapy, compared with 8% of those managed with a G/J tube (odds ratio, 4.8; 95% confidence interval [CI], 2.7-8.8). Thirty-day complications were higher for patients in the surgery group compared with those in the tube group (69% vs 46%; odds ratio, 2.5; 95% CI, 1.8-3.7), as were mean adjusted 30-day total costs ($28,872 vs $18,528, P cancer who develop bowel obstruction, surgery may benefit a subset of patients, likely related to the ability to receive subsequent chemotherapy. Efforts to identify those who derive no benefit may reduce unnecessary laparotomy, along with its associated complications and costs. Given this population's limited survival, patient preferences should be evaluated in future studies assessing the management of bowel obstruction.

  3. Efficacy and tolerability of tegaserod in constipation dominant irritable bowel syndrome

    International Nuclear Information System (INIS)

    Shah, S.H.A.; Jafri, S.W.; Gul, M.; Butt, J.A.; Naqvi, A.; Rasheed, I.

    2004-01-01

    Objective: To determine the efficacy and tolerability of tegaserod in the treatment of symptoms of irritable bowel syndrome (IBS) IBS-C patients. Patients and Methods: Tegaserod was administered in a dose of 6 mg (twice-a-day) orally for a period of 6 weeks. Symptoms were assessed before and during treatment using a questionnaire. Results: The mean age of patients was 37.5 years and 81 (69.2%) were males. The study enrolled 117 patients and 101 patients completed the study. Number of bowel movements, symptoms of straining at defecation, stool consistency, bloating, urgency and abdominal pain improved significantly following treatment (p<0.05). Analysis of data in both genders separately showed statistically significant improvement in symptoms of urgency, straining at defecation, abdominal pain and number of bowel movements following treatment. Side effects of diarrhea and vertigo (6 and 1 patients respectively) necessitating discontinuation of treatment were infrequent. Conclusion: Tegaserod given in a dose of 6 mg b.d. is effective and well tolerated in IBS-C patients. It is equally effective in males and females in relieving the symptoms of abdominal pain, bloating, straining at defecation as well as increased in the mean number of bowel movements per week. (author)

  4. Resistant starch: a promising dietary agent for the prevention/treatment of inflammatory bowel disease and bowel cancer.

    Science.gov (United States)

    Higgins, Janine A; Brown, Ian L

    2013-03-01

    Resistant starch represents a diverse range of indigestible starch-based dietary carbohydrates. Resistant starch has been investigated in the past for its effects on bowel health (pH, epithelial thickness, and apoptosis of colorectal cancer cells); reduction in postprandial glycemia; increased insulin sensitivity; and effects on the gut microbiome. This review highlights advances as resistant starch gains clinical relevance as a potential treatment/preventive tool for diseases such as colorectal cancer (CRC) and diabetes. Recent articles have evaluated the comparative physiological effects of different types of resistant starch and investigated the effects of resistant starch on blood lipids, body weight, and defining resistant starch-induced changes to the micriobiome that may be important in health and disease. The most novel and relevant recent data describe a role for resistant starch in ameliorating inflammation; the use of resistant starch for optimal bowel health and prevention of CRC; and, further, that the systemic effects of resistant starch may be important for the treatment of other forms of cancer, such as breast cancer. This review describes advances in resistant starch research highlighting the gastrointestinal effects that are now being linked to systemic, whole body effects with clinical relevance. These effects have important implications for overall health and the prevention or amelioration of various chronic diseases.

  5. Patients Suspected of Irritable Bowel Syndrome-Cross-Sectional Study Exploring the Sensitivity of Rome III Criteria in Primary Care

    DEFF Research Database (Denmark)

    Engsbro, Anne Line; Begtrup, Luise Mølenberg; Kjeldsen, Jens

    2013-01-01

    The Rome III criteria for irritable bowel syndrome (IBS) are recommended by guidelines to help identify the syndrome. The majority of IBS patients are managed in primary care, where a pragmatic approach to diagnosis is usually adopted, using clinical judgment and knowledge about the patient. Many...

  6. Gorlin syndrome associated with small bowel carcinoma and mesenchymal proliferation of the gastrointestinal tract: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Meyer Günther

    2010-07-01

    Full Text Available Abstract Background and Case Presentation A patient with nevoid basal cell carcinoma syndrome (Gorlin syndrome presented with two unusual clinical features, i.e. adenocarcinoma of the small bowel and extensive mesenchymal proliferation of the lower gastrointestinal tract. Conclusions We discuss the possibility that these two features are pathogenetically linked to the formerly undescribed patient's PTCH germ line mutation.

  7. Treatment of short bowel syndrome in children. Value of the Intestinal Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Uenis Tannuri

    Full Text Available Summary The main cause of acute intestinal failure is short bowel syndrome, generally as a result of resection of extensive segments of small intestine. As a result, the main symptoms are watery diarrhea, malabsorption syndrome, chronic malnutrition, and death, if the patient is not properly treated. If the length of the remaining intestine is greater than 30 cm, complete adaptation is possible and the patient may not require parenteral nutrition. The currently recommended treatment includes the use of prolonged parenteral nutrition and enteral nutrition, always aimed at constant weight gain, in conjunction with surgeries aimed at elongating the dilated bowel. This set of procedures constitutes what is called an Intestinal Rehabilitation Program. This therapy was used in 16 children in periods ranging from 8 months to 7.5 years, with survival in 75% of the cases. Finally, the last resort to be used in children with complete resection of the small bowel is an intestinal transplant. However, to date there is no record of a Brazilian child that has survived this procedure, despite it being attempted in seven patients. We conclude that the results of the intestinal rehabilitation program are encouraging for the continuation of this type of treatment and stimulate the creation of the program in other pediatric care institutions.

  8. Atypical antipsychotics as a possible treatment option for irritable bowel syndrome.

    Science.gov (United States)

    Pae, Chi-Un; Lee, Soo-Jung; Han, Changsu; Patkar, Ashwin A; Masand, Prakash S

    2013-05-01

    Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder (FGID) that is characterised by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits. Although the pathophysiology of IBS is not fully understood, it is believed that psychiatric comorbidities are highly common in such patients. A variety of psychotropic medications are widely used in the treatment of IBS, particularly older antidepressants such as tricyclic antidepressants (TCAs). With the advent of newer antidepressant classes with better safety and tolerability compared with TCAs, such as serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), clinicians now have more advanced treatment options for treating IBS. Additionally, some atypical antipsychotics (AAs) have recently received approval for treatment of major depressive disorder (MDD). Some AAs may have potentials based on their pharmacodynamic profile and proven benefit for mood symptoms, pain, anxiety and sleep disturbances. This article describes the potential rationale, clinical data and practical aspects involved in the use of AAs for patients with IBS. Atypical antipsychotics (AAs) may have a role in the treatment of irritable bowel syndrome (IBS) based on the currently available findings, although there is no clear evidence, and a number of clinical issues to be addressed in the use of AAs for the treatment of IBS.

  9. Excision of a large abdominal wall lipoma improved bowel passage in a Proteus syndrome patient

    Science.gov (United States)

    Nakayama, Yoshifumi; Kusuda, Shinichi; Nagata, Naoki; Yamaguchi, Koji

    2009-01-01

    Proteus syndrome is an extremely rare congenital disorder that produces multifocal overgrowth of tissue. This report presents a surgical case of a large lipoma in the abdominal wall of a patient with Proteus syndrome. She was diagnosed with Proteus syndrome based on certain diagnostic criteria. The neoplasm increased in size gradually, producing hemihypertrophy of her left lower extremity and trunk, and spread to her retroperitoneum and her left abdominal wall. She experienced gradually progressive constipation, nausea, vomiting, and abdominal pain. Computed tomography (CT) of the abdomen demonstrated a large mass in the subcutaneous adipose tissue of the left lower abdominal wall which measured 12 cm × 8 cm x 6 cm in diameter and encased the left colon. This mass in the abdominal wall was excised. The weight of the excised mass was 1550 g. The histopathological diagnosis of this mass was lipoma. After surgery, the encasement of the left colon was improved, and the patient was able to move her bowels twice per day. The excision of the large lipoma in the abdominal wall contributed to the improved bowel passage in this patient with Proteus syndrome. PMID:19598310

  10. The Prognostic Role of Optimal Cytoreduction in Advanced, Bowel Infiltrating Ovarian Cancer.

    Science.gov (United States)

    Bachmann, Robert; Rothmund, Ralf; Krämer, Bernhard; Brucker, Sara Y; Königsrainer, Alfred; Königsrainer, Ingmar; Beckert, Stefan; Staebler, Anette; NguyenHuu, Phuc; Grischke, Eva; Wallwiener, Diethelm; Bachmann, Cornelia

    2015-06-01

    In locally advanced ovarian cancer with bowel involvement appropriate surgical treatment is still controversial. Objective was to delineate factors to select those most likely to benefit from radical surgery in patients with locally advanced ovarian cancer. Therefore, we retrospectively evaluated 207 consecutive patients with primary stage IIB-IV ovarian cancer who underwent primary surgery between 2000 and 2007. Every patient received stage-related surgery and adjuvant platinum-based chemotherapy. Median follow-up was 53.5 months. Data collected included stage, histology, extent of cytoreduction and type of bowel resection. Univariate survival analyses were performed to investigate variables associated with outcome. Optimal cytoreduction (OCR) (R ≤ 1 cm) was achieved in 76.8%. Most patients presented histologic grade 2/3 (96.6%), serous ovarian cancers (84.1%) and lymph node involvement (52.2%). Complete cytoreduction (R = 0 mm) has significant best prognostic impact in FIGO IIB-IV (p = .026). Regarding bowel involvement, bowel resection was performed in 82 patients (39.6%). In this subgroup of patients complete cytoreduction led to significant better overall survival than R > 0 mm-1 cm, even in FIGO IIIC-IV patients (p = .027); this fact is independent of bowel resection. Noticeably, for survival bowel resection achieving residual tumor mass below 1 cm was also one main prognostic factor and even recurrence rate was associated with residual tumor mass. Our findings suggest that the major prognostic factor in patients with advanced ovarian cancer needing colorectal resection is completeness of cytoreduction. Therefore, in advanced ovarian cancer patients, multivisceral surgery is indicated to achieve OCR (R ≤ 1 cm) with or without bowel resection with best prognostic impact.

  11. Extra digestive manifestations of irritable bowel syndrome: intolerance to drugs?

    Science.gov (United States)

    Poitras, Pierre; Gougeon, Alexandre; Binn, Muriel; Bouin, Mickael

    2008-08-01

    Patients with IBS frequently complain of medication side effects. The goals of this study were to assess the prevalence of drug intolerance as an extra GI manifestation in patients with IBS and to verify the association between drug intolerance and psychological comorbidity. Female patients followed in a tertiary care center completed questionnaires assessing the presence of drug intolerance as well as somatic and psychological extra GI conditions. IBS patients (Rome II criteria; n = 71) were compared to inflammatory bowel disease patients (IBD; n = 96) or to healthy controls (HC; n = 67). The relationship to psychological comorbidity was verified in two different paradigms: (1) by looking at the statistical correlation between drug intolerance and the psychological extra GI symptoms in our IBS patients, and (2) by comparing in a meta-analysis the side effects to placebo (the nocebo effect is presumably increased due to hypervigilance or amplification in psychological disorders) in IBS patients or in patients with comparable medical conditions included in various drug trials approved by Health Canada. Our results show that prevalence of drug intolerance was significantly more elevated in IBS (41% patients) than in HC (7%) or in IBD (27%); somatic and psychological extra GI symptoms were also markedly increased in IBS. In addition, drug intolerance in our IBS patients was significantly associated with somatic comorbidities such as fatigue or multiple symptoms (P mood instability, or sleep disorder. A meta-analysis revealed that the nocebo effect was not different in patients with IBS than in control patients. In conclusion, drug intolerance is a frequent extra GI manifestation of IBS that is not associated with psychological comorbidity; thus, a somatic origin must be explored.

  12. Comparison of geographic distributions of Irritable Bowel Syndrome with Inflammatory Bowel Disease fail to support common evolutionary roots: Irritable Bowel Syndrome and Inflammatory Bowel Diseases are not related by evolution.

    Science.gov (United States)

    Szilagyi, Andrew; Xue, Xiaoqing

    2018-01-01

    Irritable Bowel Syndrome (IBS) shares overlapping symptoms and some features of pathogenesis with Inflammatory Bowel Diseases (IBD: Crohn's disease [CD], and Ulcerative Colitis [UC]). Geographic markers such as latitude/sunshine and more recently lactase population distributions are found to be correlated with IBD. As a result of clinical and pathogenic similarities between the 2 conditions, some authorities questioned whether a connection exists between them. We compare IBS directly with IBD, and indirectly with geographic markers associated with IBD, in order to evaluate possible evolutionary links between IBS and IBD. Similar correlations may link IBS as a precursor to IBD and possibly other conditions which are geographically connected with IBD. Data from four systematic reviews on IBD incidence and prevalence, IBS prevalence, and lactase distributions were included. Pearson's correlations were used for comparisons, with IBD values log-transformed because of skewed distribution. The articles provided 18-28 complete set of national data. Direct comparison between IBS and IBD showed no significant correlations (r = -0.14, r = -0.06 for CD and UC prevalence, r = -0.10 for CD incidence). Indirect comparisons also failed to show correlations of IBS with lactase distributions (r = -0.17), sunshine (r = -0.2) or latitude (r = 0.097); however, there was significant correlation between lactase distributions and CD incidence (r = -0.84), prevalence (r = -0.55) and UC prevalence (r = -0.59). Both sunshine (r= -0.53) and latitude (r = 0.58) are also significantly related to CD incidence. It is concluded that IBS and IBD do not follow similar global geographic patterns. This suggests a lack of an evolutionary genetic background coincident with emergence of lactase persistence. As well, vitamin D has no obvious impact on development of IBS. Similarities with IBD may result from sub groups (not yet identified) within the current Rome

  13. Colonoscopy surveillance for dysplasia and colorectal cancer in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Aalykke, Claus; Jensen, Michael Dam; Fallingborg, Jan

    2015-01-01

    The risk of colorectal cancer (CRC) and dysplasia in patients with inflammatory bowel disease (IBD) has been highly debated as risk estimates from different studies vary greatly. The present national Danish guideline on colonoscopy surveillance for dysplasia and colorectal cancer in patients...

  14. Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome

    DEFF Research Database (Denmark)

    Hvistendahl, Mark; Brandt, Christopher Filtenborg; Tribler, Siri

    2018-01-01

    ± SD) and with small bowel lengths of 110 ± 66 cm. The 72-hour metabolic balance studies were performed before and at the end of treatment. Food intake was unrestricted. Oral fluid intake and parenteral support volume were kept constant. The primary end point was change in the ostomy wet weight output......BACKGROUND: An impaired hormonal "ileo-colonic brake" may contribute to rapid gastric emptying, gastric hypersecretion, high ostomy losses, and the need for parenteral support in end-jejunostomy short bowel syndrome (SBS) patients with intestinal failure (IF). Liraglutide, a glucagon-like peptide 1......-colonic brake hormones in conjunction may be involved in the process of intestinal adaptation. By identification of key hormones and addressing their potential synergistic effects, better treatments may be provided to patients with SBS-IF. This trial was registered at clinicaltrialsregister.eu as 2013-005499-16....

  15. Australia's National Bowel Cancer Screening Program: does it work for Indigenous Australians?

    Directory of Open Access Journals (Sweden)

    Katzenellenbogen Judith M

    2010-06-01

    Full Text Available Abstract Background Despite a lower incidence of bowel cancer overall, Indigenous Australians are more likely to be diagnosed at an advanced stage when prognosis is poor. Bowel cancer screening is an effective means of reducing incidence and mortality from bowel cancer through early identification and prompt treatment. In 2006, Australia began rolling out a population-based National Bowel Cancer Screening Program (NBCSP using the Faecal Occult Blood Test. Initial evaluation of the program revealed substantial disparities in bowel cancer screening uptake with Indigenous Australians significantly less likely to participate in screening than the non-Indigenous population. This paper critically reviews characteristics of the program which may contribute to the discrepancy in screening uptake, and includes an analysis of organisational, structural, and socio-cultural barriers that play a part in the poorer participation of Indigenous and other disadvantaged and minority groups. Methods A search was undertaken of peer-reviewed journal articles, government reports, and other grey literature using electronic databases and citation snowballing. Articles were critically evaluated for relevance to themes that addressed the research questions. Results The NBCSP is not reaching many Indigenous Australians in the target group, with factors contributing to sub-optimal participation including how participants are selected, the way the screening kit is distributed, the nature of the test and comprehensiveness of its contents, cultural perceptions of cancer and prevailing low levels of knowledge and awareness of bowel cancer and the importance of screening. Conclusions Our findings suggest that the population-based approach to implementing bowel cancer screening to the Australian population unintentionally excludes vulnerable minorities, particularly Indigenous and other culturally and linguistically diverse groups. This potentially contributes to exacerbating

  16. Interstitial Cystitis/Painful Bladder Syndrome and Associated Medical Conditions With an Emphasis on Irritable Bowel Syndrome, Fibromyalgia and Chronic Fatigue Syndrome

    DEFF Research Database (Denmark)

    Nickel, J.C.; Tripp, D.A.; Pontari, M.

    2010-01-01

    Purpose: We characterized and compared the impact of clinical phenotypic associations between interstitial cystitis/painful bladder syndrome and controls in relation to potentially related conditions, particularly irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. Materials...... and Methods: Female patients with interstitial cystitis/painful bladder syndrome and controls with no interstitial cystitis/painful bladder syndrome completed a biopsychosocial phenotyping questionnaire battery which included demographics/history form, self-reported history of associated conditions, and 10...... validated questionnaires focused on symptoms, suffering/coping and behavioral/social factors. Results: Questionnaires were completed by 205 patients with interstitial cystitis/painful bladder syndrome and 117 controls matched for age. Prevalence of selfreported associated condition diagnosis in interstitial...

  17. Survival in Danish patients with breast cancer and inflammatory bowel disease: A nationwide cohort study

    DEFF Research Database (Denmark)

    Søgaard, Kirstine Kobberøe; Cronin-Fenton, Deirdre P; Pedersen, Lars

    2008-01-01

    Background: Incidences of inflammatory bowel disease (IBD) and of breast cancer have increased over the last decades. The influence of IBD on breast cancer prognosis, however, is unknown. We therefore examined the impact of IBD on treatment receipt and survival in breast cancer patients...... without IBD. In contrast, breast cancer patients with CD are treated with radiotherapy less often. Survival of breast cancer in patients with CD treated with chemotherapy is poorer compared to survival in patients without IBD.(Inflamm Bowel Dis 2007). Udgivelsesdato: 2007-Dec-10.......Methods: Information on breast cancer patients (stage and treatment) diagnosed between 1980 and 2004 was sourced from the Danish Cancer Registry. Data on IBD and potential confounders were extracted from the Danish National Registry of Patients covering all Danish hospitals. Cox regression was used to compute...

  18. Semiquantitative fecal calprotectin test in postinfectious and non-postinfectious irritable bowel syndrome: cross-sectional study

    OpenAIRE

    David, Liliana-Elisabeta; Surdea-Blaga, Teodora; Dumitrascu, Dan-Lucian

    2014-01-01

    CONTEXT AND OBJECTIVE:The presence of a certain degree of inflammation in the gut wall is now accepted in irritable bowel syndrome (IBS). Fecal calprotectin is considered to be a reliable test for detecting intestinal inflammation. Our aim was to assess the presence of inflammation in postinfectious IBS (PI-IBS), compared with non-postinfectious IBS (NPI-IBS). A secondary objective was to determine the usefulness of a rapid fecal calprotectin test in inflammatory bowel diseases (IBD).DESIGN A...

  19. Nutritional Support Process for a Patient with Short Bowel Syndrome in Conjunction with Panperitonitis: A Case Report

    OpenAIRE

    Kim, Sun Jung; Kim, Bo Ram; Lee, Song Mi; Kong, Hee Jung; Shin, Cheung Soo

    2013-01-01

    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...

  20. A randomised controlled trial on hypnotherapy for irritable bowel syndrome: design and methodological challenges (the IMAGINE study)

    OpenAIRE

    Flik, Carla E; van Rood, Yanda R; Laan, Wijnand; Smout, Andr? JPM; Weusten, Bas LAM; Whorwell, Peter J; de Wit, Niek J

    2011-01-01

    Abstract Background Irritable Bowel Syndrome (IBS) is a common gastro-intestinal disorder in primary and secondary care, characterised by abdominal pain, discomfort, altered bowel habits and/or symptoms of bloating and distension. In general the efficacy of drug therapies is poor. Hypnotherapy as well as Cognitive Behaviour Therapy and short Psychodynamic Therapy appear to be useful options for patients with refractory IBS in secondary care and are cost-effective, but the evidence is still li...

  1. Self-reported participation and beliefs about bowel cancer screening in New South Wales, Australia.

    Science.gov (United States)

    Varlow, Megan; Stacey, Ingrid; Dunlop, Sally; Young, Jane; Kite, James; Dessaix, Anita; McAulay, Claire

    2014-08-01

    To describe self-reported bowel cancer screening participation, beliefs and attitudes in a sample of New South Wales (NSW) adults, and to identify beliefs and demographic factors associated with self-reported bowel cancer screening participation. This study used data from the International Cancer Benchmarking Partnership Module 2, a representative population-based telephone survey. Self-reported participation in and beliefs about bowel cancer screening were measured using the Awareness and Beliefs about Cancer survey of people aged 50 years and over living in NSW, Australia (n=2001). Logistic regression modelling was used to identify explanatory variables associated with bowel cancer screening participation. Half of all women (54.1%, 95% CI: 50.8-57.4%) and two-thirds of men (65.7%, 95% CI: 61.5-69.9%) reported screening for bowel cancer within the previous 5 years. Believing that screening was only necessary when experiencing symptoms was more likely to be endorsed by people aged 65 years and over (25.5%, 95% CI: 22.2-28.7%) rather than younger (50-64 years; 16.7%, 95% CI: 13.8-19.7%), non-English-speaking migrants (35.4%, 95% CI: 26.7-44.1%) versus others (18.6%, 95% CI: 16.4-20.7%), and people in metropolitan (23.3%, 95% CI: 20.4-26.1%) versus non-metropolitan areas (16.4%, 95% CI: 12.8-20%). People who disagreed that screening was only necessary when experiencing symptoms were four times more likely to report screening participation (OR 3.96, 95% CI: 3.11-5.03). Community education about bowel cancer screening is needed to correct misperceptions regarding screening in the absence of symptoms. Tailored strategies for older, migrant and urban communities may be beneficial. SO WHAT? Education strategies that promote the need for screening in the absence of symptoms and correct misconceptions about bowel cancer screening amongst subgroups of the NSW population may improve screening rates and decrease the burden of bowel cancer in NSW.

  2. Lynch Syndrome and Cervical Cancer

    Science.gov (United States)

    Antill, Yoland C; Dowty, James G; Win, Aung Ko; Thompson, Tina; Walsh, Michael D; Cummings, Margaret C; Gallinger, Steven; Lindor, Noralane M; Le Marchand, Loïc; Hopper, John L; Newcomb, Polly A; Haile, Robert W; Church, James; Tucker, Katherine M; Buchanan, Daniel D; Young, Joanne P; Winship, Ingrid M; Jenkins, Mark A

    2015-01-01

    Carriers of germline mutations in DNA mismatch repair (MMR) genes are at increased risk of several cancers including colorectal and gynecologic cancers (Lynch syndrome). There is no substantial evidence that these mutations are associated with an increased risk of cervical cancer. A total of 369 families with at least one carrier of a mutation in a MMR gene (133 MLH1, 174 MSH2, 35 MSH6, and 27 PMS2) were ascertained via population cancer registries or via family cancer clinics in Australia, New Zealand, Canada, and USA. Personal and family histories of cancer were obtained from participant interviews. Modified segregation analysis was used to estimate the hazard ratio (incidence rates for carriers relative to those for the general population), and age-specific cumulative risks of cervical cancer for carriers. A total of 65 cases of cervical cancer were reported (including 10 verified by pathology reports). The estimated incidence was 5.6–fold (95% CI: 2.3–13.8; p=0.001) higher for carriers than for the general population with a corresponding cumulative risk to 80 years of 4.5% (95% CI: 1.9–10.7%) compared with 0.8% for the general population. The mean age at diagnosis was 43.1 years (95% CI: 40.0–46.2), 3.9 years younger than the reported USA population mean of 47.0 years (p=0.02). Women with MMR gene mutations were found to have an increased risk of cervical cancer. Due to limited pathology verification we cannot be certain that a proportion of these cases were not lower uterine segment endometrial cancers involving the endocervix, a recognized cancer of Lynch syndrome. PMID:26077226

  3. Cancer in inflammatory bowel disease 15 years after diagnosis in a population-based European Collaborative follow-up study

    DEFF Research Database (Denmark)

    Katsanos, Konstantinos H; Tatsioni, Athina; Pedersen, Natalia

    2011-01-01

    To determine the occurrence of intestinal and extraintestinal cancers in the 1993-2009 prospective European Collaborative Inflammatory Bowel Disease (EC-IBD) Study Group cohort.......To determine the occurrence of intestinal and extraintestinal cancers in the 1993-2009 prospective European Collaborative Inflammatory Bowel Disease (EC-IBD) Study Group cohort....

  4. Fibromyalgia in patients with irritable bowel syndrome. An association with the severity of the intestinal disorder.

    Science.gov (United States)

    Lubrano, E; Iovino, P; Tremolaterra, F; Parsons, W J; Ciacci, C; Mazzacca, G

    2001-08-01

    Fibromyalgia (FM) syndrome and irritable bowel syndrome (IBS) are functional disorders in which altered somatic and or visceral perception thresholds have been found. The aim of this study was to evaluate the prevalence of FM in a group of patients with IBS and the possible association of FM with patterns and severity of the intestinal disorder. One hundred thirty consecutive IBS patients were studied. The IBS was divided into four different patterns according to the predominant bowel symptom and into three levels of severity using a functional severity index. All patients underwent rheumatological evaluation for number of positive tender points, number of tender and swollen joints, markers of inflammation, and presence of headache and weakness. Moreover, patients' assessments of diffuse pain, mood and sleep disturbance, anxiety, and fatigue were also measured on a visual analogue scale. The diagnosis of FM was made based on American College of Rheumatology classification criteria. Nonparametric tests were used for statistical analysis. Fibromyalgia was found in 20% of IBS patients. No statistical association was found between the presence of FM and the type of IBS but a significant association was found between the presence of FM and severity of the intestinal disorder. The presence of FM in IBS patients seems to be associated only with the severity of IBS. This result confirms previous studies on the association between the two syndromes.

  5. Use of rifaxamin in patients of irritable bowel syndrome with pre dominant diarrhea

    International Nuclear Information System (INIS)

    Rathor, R.; Butt, N.F.; Iqbal, A.; Alam, I.

    2013-01-01

    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)

  6. [Estimation of small intestinal bacterial overgrowth in patients with constipation and diarrhea irritable bowel syndrome].

    Science.gov (United States)

    Łokieć, Katarzyna; Klupińska, Grazyna; Walecka-Kapica, Ewa; Błońska, Aleksandra

    2014-05-01

    Irritable bowel syndrome (IBS) is one of the most common reason for gastroenterology consultations. The diverse in symptomatology of the disease comes from its rich etiopathogenesis. Recently studies talk about infectious etiology of IBS and because of that it is necessary to expand its diagnostics by small intestinal bacterial overgrowth (SIBO) test. The aim of this study was to evaluate the prevalence of small intestinal bacterial overgrowth in patients with constipation (IBS-C) and diarrhea (IBS-D) irritable bowel syndrome with regard to nutrition. The study involved 46 subjects (33 women and 13 men) in average age of 44 years, which were divided into two groups: diarrhea and constipation IBS. All patients underwent hydrogen breath test studying bacterial overgrowth in the small intestine. In addition, each person had fulfilled a feeding questionnaire. Student's t-test, Pearson test. It has been shown that there is no statistical significances between the prevalence of SIBO in form of diarrheal IBS and constipation IBS and gender. Average value of increments of hydrogen in breath during the test was higher in IBS-C in comparison with IBS-D, which was the highest in the intestine bacterial overgrowth in patients with IBS-C. STATISTICAL ANALYSIS showed that there is no relationship between the type and frequency of consumption of milk, meat, fruit and vegetables, sweets and coffee and the prevalence of SIBO in form of diarrhea and constipation IBS. The occurrence of constipation or diarrhea irritable bowel syndrome is not related to gender. SIBO is more common in patients with IBS-C than in IBS-D group. There is no relationship between the type of food consumed and the amount of SIBO in people with IBS. Type of food intake do not affect the status of the intestinal flora of people with IBS.

  7. Investigation of the blastocystis hominis frequency in patients with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Bayram Pektaş

    2014-06-01

    Full Text Available AimIn this study, it was aimed to investigate the relationship between Blastocystis hominis infection and inflammatory bowel syndrome (IBS. Methods: In this study, the frequency of B. hominis in the stool samples of 52 patients applied to Microbiology laboratory and pre-diagnosed with irritable bowel syndrome in January 2013-June 2013 was investigated, retrospectively. Microscopic investigations were evaluated after macroscopic examination. For this purpose, the stool samples of the diarrheal cases were investigated by trichrome staining after they were prepared by native-lugol and formol ethyl acetate concentration method. The results were compared with the examination of 2160 stool samples sent to our laboratory during the same period. Results: Stool samples of 52 patients pre-diagnosed with IBS were accepted to our laboratory in January 2013-June 2013. 13 of the patients were found as B. hominis positive. Weight loss and anorexia was identified only in one patient while abdominal pain, diarrhea and gas complaints were identified in all of the IBH and B. hominis positive patients. During the same period, parasites were detected in 96 (4.4% of 2160 stool samples sent to our laboratory and the most common was B. hominis 48 (2.2%. 452 of these patients applied with diarrhea symptoms and B. hominis was detected in 36 samples (7.96%. Conclusion: The limited studies investigating the presence of B. hominis in patients with irritable bowel syndrome are far from illuminating the role of this agent in disease pathogenesis. We believe that further investigations should be performed. In this study, 25% of the patients were found as positive. J Clin Exp Invest 2014; 5 (2: 242-245

  8. Inflammatory bowel disease and cancer: The role of inflammation, immunosuppression, and cancer treatment.

    Science.gov (United States)

    Axelrad, Jordan E; Lichtiger, Simon; Yajnik, Vijay

    2016-05-28

    In patients with inflammatory bowel disease (IBD), chronic inflammation is a major risk factor for the development of gastrointestinal malignancies. The pathogenesis of colitis-associated cancer is distinct from sporadic colorectal carcinoma and the critical molecular mechanisms underlying this process have yet to be elucidated. Patients with IBD have also been shown to be at increased risk of developing extra-intestinal malignancies. Medical therapies that diminish the mucosal inflammatory response represent the foundation of treatment in IBD, and recent evidence supports their introduction earlier in the disease course. However, therapies that alter the immune system, often used for long durations, may also promote carcinogenesis. As the population of patients with IBD grows older, with longer duration of chronic inflammation and longer exposure to immunosuppression, there is an increasing risk of cancer development. Many of these patients will require cancer treatment, including chemotherapy, radiation, hormonal therapy, and surgery. Many patients will require further treatment for their IBD. This review seeks to explore the characteristics and risks of cancer in patients with IBD, and to evaluate the limited data on patients with IBD and cancer, including management of IBD after a diagnosis of cancer, the effects of cancer treatment on IBD, and the effect of IBD and medications for IBD on cancer outcomes.

  9. Teduglutide, a novel glucagon-like peptide 2 analog, in the treatment of patients with short bowel syndrome

    DEFF Research Database (Denmark)

    Jeppesen, Palle Bekker

    2012-01-01

    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...... 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' duration, teduglutide appears to be safe and well tolerated. Treatment with teduglutide was associated with enhancement...

  10. Postoperative mechanical bowel obstruction after pharyngolaryngectomy for hypopharyngeal cancer: Retrospective analysis using a Japanese inpatient database.

    Science.gov (United States)

    Suzuki, Sayaka; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Ando, Mizuo; Yamasoba, Tatsuya

    2018-03-14

    Data have been limited on donor-site mechanical bowel obstruction after pharyngolaryngectomy with free jejunum graft reconstruction. Using a nationwide Japanese inpatient database, we extracted data on patients who underwent pharyngolaryngectomy for hypopharyngeal cancer between July 2007 and March 2014. A Cox proportional hazard model was used to determine the association between background characteristics and the occurrence of mechanical bowel obstruction. Among the 3320 eligible patients from 332 hospitals, 108 patients (3.3%) developed mechanical bowel obstruction after a median 88 (interquartile range 26-217) postoperative days. Multivariable Cox regression analysis revealed that older age (≥60 years old) was independently associated with an increased risk of mechanical bowel obstruction, whereas sex, body mass index [BMI], smoking status, comorbidity at admission, blood transfusion, history of surgery, and hospital type were not. In pharyngolaryngectomy, careful attention should be paid to the risk of abdominal complications and, thus, to the graft choice, especially in elderly patients. © 2018 Wiley Periodicals, Inc.

  11. D-Lactic Acidosis: An Underrecognized Complication of Short Bowel Syndrome

    OpenAIRE

    Kowlgi, N. Gurukripa; Chhabra, Lovely

    2015-01-01

    D-lactic acidosis or D-lactate encephalopathy is a rare condition that occurs primarily in individuals who have a history of short bowel syndrome. The unabsorbed carbohydrates act as a substrate for colonic bacteria to form D-lactic acid among other organic acids. The acidic pH generated as a result of D-lactate production further propagates production of D-lactic acid, hence giving rise to a vicious cycle. D-lactic acid accumulation in the blood can cause neurologic symptoms such as delirium...

  12. Pharmacologic options for intestinal rehabilitation in patients with short bowel syndrome

    DEFF Research Database (Denmark)

    Jeppesen, Palle B

    2014-01-01

    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...... intestinal growth: a glucagon-like peptide 2 analog (teduglutide) and recombinant human growth hormone (somatropin). In two phase III clinical trials (N=169), 24 weeks of teduglutide administered to outpatients with SBS resulted in significant decreases in PN/IV volume requirements of 2.5-4.4 L...

  13. Bovine Colostrum to Children With Short Bowel Syndrome: A Randomized, Double-Blind, Crossover Pilot Study

    DEFF Research Database (Denmark)

    Aunsholt, L.; Jeppesen, Palle Bekker; Lund, P.

    2014-01-01

    Background: Management of short bowel syndrome (SBS) aims to achieve intestinal autonomy to prevent fluid, electrolyte, and nutrient deficiencies and maintain adequate development. Remnant intestinal adaptation is required to obtain autonomy. In the newborn pig, colostrum has been shown to support...... of enteral fluid intake was replaced with bovine colostrum or a mixed milk diet for 4 weeks, separated by a 4-week washout period. Intestinal absorption of energy and wet weight was used to assess intestinal function and the efficacy of colostrum. Results: Colostrum did not improve energy or wet weight...

  14. Guillain-Barré syndrome, tuberculosis and inflammatory bowel disease: a multiple association

    Directory of Open Access Journals (Sweden)

    de la Torre Ricardo

    2010-07-01

    Full Text Available Abstract Guillain-Barré syndrome (GBS has been associated with both infective or non-infective aetiologies. GBS is usually preceded by acute respiratory or gastrointestinal infection but its association with tuberculosis has been exceptionally reported. Inflammatory bowel disease (IBD is associated with clinical manifestations involving the neurological system, peripheral neuropathy is known to be related to IBD and, either demyelinating or axonal involvement of peripheral nerves have been described. We report an unusual case of GBS associated with lymph node tuberculosis and ulcerative colitis.

  15. Disturbances of motility and visceral hypersensitivity in irritable bowel syndrome: biological markers or epiphenomenon.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2012-02-03

    Motility and visceral hypersentitivity are regarded as the primary mechanisms of symptom development in irritable bowel syndrome(IBS). While a variety of motor abnormalities have been described throughout the gastrointestinal tract in IBS, their specificity and relationship to symptoms remain unclear. Visceral hypersensitivity is ubiquitous in functional gastrointestinal disease and is especially common in IBS. Again, however, its specificity for IBS has been questioned. Many factors, including stress and psychopathology,complicate the interpretation of these phenomena and new re-search suggests that mucosal inflammation and luminal factors may be more fundamental to the etiology of this common disorder.

  16. Group hypnotherapy for irritable bowel syndrome with long-term follow-up.

    Science.gov (United States)

    Gerson, Charles D; Gerson, Jessica; Gerson, Mary-Joan

    2013-01-01

    This study tested whether group gut-focused hypnotherapy would improve irritable bowel syndrome (IBS). Several possible outcome predictors were also studied. Before treatment, 75 patients completed a Symptom Severity Scale, a Mind-Body attribution questionnaire, and a Quality of Relationship Inventory (QRI). The symptom scale was completed posttreatment, 3, 6, and 12 months later. There was significant symptom reduction at each data point (p hypnotherapy, while attribution of symptoms to mind (emotional) causation was inversely correlated (p = .0056). The authors conclude that group hypnotherapy is effective in patients with IBS.

  17. Effectiveness of trimebutine maleate on modulating intestinal hypercontractility in a mouse model of postinfectious irritable bowel syndrome.

    Science.gov (United States)

    Long, Yanqin; Liu, Ying; Tong, Jingjing; Qian, Wei; Hou, Xiaohua

    2010-06-25

    Trimebutine maleate, which modulates the calcium and potassium channels, relieves abdominal pain in patients with irritable bowel syndrome. However, its effect on postinfectious irritable bowel syndrome is not clarified. The aim of this study was to investigate the effectiveness of trimebutine maleate on modulating colonic hypercontractility in a mouse model of postinfectious irritable bowel syndrome. Mice infected up to 8 weeks with T. spiralis underwent abdominal withdrawal reflex to colorectal distention to evaluate the visceral sensitivity at different time points. Tissues were examined for histopathology scores. Colonic longitudinal muscle strips were prepared in the organ bath under basal condition or to be stimulated by acetylcholine and potassium chloride, and consecutive concentrations of trimebutine maleate were added to the bath to record the strip responses. Significant inflammation was observed in the intestines of the mice infected 2 weeks, and it resolved in 8 weeks after infection. Visceral hyperalgesia and colonic muscle hypercontractility emerged after infection, and trimebutine maleate could effectively reduce the colonic hyperreactivity. Hypercontractility of the colonic muscle stimulated by acetylcholine and high K(+) could be inhibited by trimebutine maleate in solution with Ca(2+), but not in Ca(2+) free solution. Compared with 8-week postinfectious irritable bowel syndrome group, 2-week acute infected strips were much more sensitive to the stimulators and the drug trimebutine maleate. Trimebutine maleate was effective in reducing the colonic muscle hypercontractility of postinfectious irritable bowel syndrome mice. The findings may provide evidence for trimebutine maleate to treat postinfectious irritable bowel syndrome patients effectively. (c) 2010 Elsevier B.V. All rights reserved.

  18. Role of Omega-3 Fatty Acids in Irritable Bowel Syndrome (IBS

    Directory of Open Access Journals (Sweden)

    Javed Yakoob

    2016-08-01

    Full Text Available Background: Dietary supplementation with Omega-3 (ω-3 fatty acids (FAs has been demonstrated to elicit several effects ranging from decrease in blood pressure, anti-arrhythmic effect and decrease in inflammation in inflammatory bowel disease, asthma and rheumatoid arthritis. Irritable bowel syndrome (IBS is a chronic disorder characterized by abdominal pain and irregular bowel habit. It is associated with visceral hypersensitivity, increased mucosal permeability and a low-grade mucosal inflammation. Commercially available omega (ω-3 polyunsaturated fatty acids (PUFA are being prescribed as empirical treatment for many chronic ailments including IBS.Aim: To examine literature available support use of ω-3 PUFA in IBS.Methods: We conducted a search using “Omega 3 fatty acids supplementation” on the PubMed, Scopus, and databases (e.g. MEDLINE, CINAHL, EMBASE, and Science Citation Index Expanded from 1966 to December, 2015. Result: The gut microbiota in IBS is associated with an imbalance of Firmicutes/Bacteroidetes ratio. This imbalance has an impact on gas and metabolite production such as short chain fatty acids. Omega-3 FAs are anti-inflammatory, while ω-6 FAs are proinflammatory.Conclusion: The benefit of ω-3 FAs for IBS requires more clarification by prospective studies. Current claims of long chain PUFA supplementation in IBS should be viewed with caution

  19. Gastrointestinal pH profile in subjects with irritable bowel syndrome.

    Science.gov (United States)

    Lalezari, David

    2012-01-01

    To investigate the small bowel pH profile and small intestine transit time (SITT) in healthy controls and patients with irritable bowel syndrome (IBS). Nine IBS patients (3 males, mean age 35 yr) and 10 healthy subjects (6 males, mean age 33 yr) were studied. Intestinal pH profile and SITT were assessed by a wireless motility pH and pressure capsule (Smart Pill). Mean pH values were measured in the small intestine (SI) and compared both within and between groups. Data presented as mean or median, ANOVA, P pH for the first (Q1), second (Q2), third (Q3), and fourth quartile (Q4) of the SI in healthy versus IBS patients was 5.608 ± 0.491 vs. 5.667 ± 0.297, 6.200 ± 0.328 vs. 6.168 ± 0.288, 6.679 ± 0.316 vs. 6.741 ± 0.322, and 6.884 ± 0.200 vs. 6.899 ± 0.303, respectively. We found no significant group difference in pH per quartile (P=0.7979). The proximal SI was significantly more acidic, compared to distal segments, in both healthy subjects and IBS patients (PpH along the SI, in both IBS and healthy subjects, the distal being less acidic. These finding may be of importance in small bowel homeostasis.

  20. Effects of a proprietary Bacillus coagulans preparation on symptoms of diarrhea-predominant irritable bowel syndrome.

    Science.gov (United States)

    Dolin, B J

    2009-12-01

    Symptoms of irritable bowel syndrome (IBS) have a profound impact on quality of life for many patients and current treatments are sometimes unsatisfactory. This controlled pilot study was conducted to evaluate effects of the proprietary GanedenBC(30) (Bacillus coagulans GBI-30, 6086) probiotic on IBS symptoms, in a randomized, double-blind, placebo-controlled clinical trial including patients with diarrhea-predominant IBS (IBS-D). Patients were randomized to receive either B. coagulans GBI-30, 6086 or placebo once a day for 8 weeks. Patients filled out a quality-of-life questionnaire, and self-assessment diaries were provided to record stool count and consistency, symptom severity, and medication consumption. Of the 61 patients enrolled, six did not meet the inclusion criteria and three were lost to follow-up. Of the remaining 52 patients with IBS-D, the average number of bowel movements per day was significantly reduced for patients treated with B. coagulans GBI-30, 6086 when compared to placebo (P = 0.042). Large variability in baseline scores prevented the assessment of severity scores and quality of life. This small pilot study provides evidence that the proprietary B. coagulans GBI-30, 6086 probiotic is safe and effective for reducing daily bowel movements in patients with IBS-D. Copyright 2009 Prous Science, S.A.U. or its licensors. All rights reserved.

  1. Convergence of neuro-endocrine-immune pathways in the pathophysiology of irritable bowel syndrome.

    Science.gov (United States)

    Buckley, Maria M; O'Mahony, Siobhain M; O'Malley, Dervla

    2014-07-21

    Disordered signalling between the brain and the gut are generally accepted to underlie the functional bowel disorder, irritable bowel syndrome (IBS). However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusive. This common gastrointestinal disorder is characterised by alterations in bowel habit such as diarrhoea and/or constipation, bloating and abdominal pain, and symptom exacerbation has been linked with periods of stress, both psychosocial and infection-related. Indeed, a high level of comorbidity exists between IBS and stress-related mood disorders such as anxiety and depression. Moreover, studies have observed alterations in autonomic output and neuro-endocrine signalling in IBS patients. Accumulating evidence indicates that a maladaptive stress response, probably mediated by the stress hormone, corticotropin-releasing factor contributes to the initiation, persistence and severity of symptom flares. Other risk factors for developing IBS include a positive family history, childhood trauma, dietary factors and prior gastrointestinal infection. An emerging role has been attributed to the importance of immune factors in the pathophysiology of IBS with evidence of altered cytokine profiles and increased levels of mucosal immune cells. These factors have also been shown to have direct effects on neural signalling. This review discusses how pathological changes in neural, immune and endocrine pathways, and communication between these systems, contribute to symptom flares in IBS.

  2. Role of anxiety in the pathophysiology of irritable bowel syndrome: importance of the amygdala

    Directory of Open Access Journals (Sweden)

    Brent Myers

    2009-06-01

    Full Text Available A common characteristic of irritable bowel syndrome (IBS is that symptoms, including abdominal pain and abnormal bowel habits, are often triggered or exacerbated during periods of stress and anxiety. However, the impact of anxiety and affective disorders on the gastrointestinal (GI tract is poorly understood and may in part explain the lack of effective therapeutic approaches to treat IBS. The amygdala is an important structure for regulating anxiety with the central nucleus of the amygdala (CeA facilitating the activation of the hypothalamic-pituitary-adrenal (HPA axis and the autonomic nervous system in response to stress. Moreover, chronic stress enhances function of the amygdala and promotes neural plasticity throughout the amygdaloid complex. This review outlines the latest findings obtained from human studies and animal models related to the role of the emotional brain in the regulation of enteric function, specifically how increasing the gain of the amygdala to induce anxiety-like behavior using corticosterone (CORT or chronic stress increases responsiveness to both visceral and somatic stimuli in rodents. A focus of the review is the relative importance of mineralocorticoid receptor (MR and glucocorticoid receptor (GR-mediated mechanisms within the amygdala in the regulation of anxiety and nociceptive behaviors that are characteristic features of IBS. This review also discusses several outstanding questions important for future research on the role of the amygdala in the generation of abnormal GI function that may lead to potential targets for new therapies to treat functional bowel disorders such as IBS.

  3. Role of anxiety in the pathophysiology of irritable bowel syndrome: importance of the amygdala.

    Science.gov (United States)

    Myers, Brent; Greenwood-Van Meerveld, Beverley

    2009-01-01

    A common characteristic of irritable bowel syndrome (IBS) is that symptoms, including abdominal pain and abnormal bowel habits, are often triggered or exacerbated during periods of stress and anxiety. However, the impact of anxiety and affective disorders on the gastrointestinal (GI) tract is poorly understood and may in part explain the lack of effective therapeutic approaches to treat IBS. The amygdala is an important structure for regulating anxiety with the central nucleus of the amygdala facilitating the activation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system in response to stress. Moreover, chronic stress enhances function of the amygdala and promotes neural plasticity throughout the amygdaloid complex. This review outlines the latest findings obtained from human studies and animal models related to the role of the emotional brain in the regulation of enteric function, specifically how increasing the gain of the amygdala to induce anxiety-like behavior using corticosterone or chronic stress increases responsiveness to both visceral and somatic stimuli in rodents. A focus of the review is the relative importance of mineralocorticoid receptor and glucocorticoid receptor-mediated mechanisms within the amygdala in the regulation of anxiety and nociceptive behaviors that are characteristic features of IBS. This review also discusses several outstanding questions important for future research on the role of the amygdala in the generation of abnormal GI function that may lead to potential targets for new therapies to treat functional bowel disorders such as IBS.

  4. Hormone replacement therapy, oral contraceptive use, and distal large bowel cancer: a population-based case-control study.

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    Long, Millie D; Martin, Christopher F; Galanko, Joseph A; Sandler, Robert S

    2010-08-01

    Lower incidence rates of distal large bowel cancer in women when compared with men support the protective role of female hormones. We aimed to determine the associations between hormone replacement therapy, oral contraceptive use, and distal large bowel cancer. We conducted a population-based case-control study of incident distal large bowel cancer in North Carolina between 2001 and 2006. Data on hormone replacement therapy, oral contraceptive use, demographics, and risk factors were obtained through in-person interviews. Odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between oral contraceptive use, hormone replacement therapy, and distal large bowel cancer were estimated through unconditional logistic regression models overall, by duration of use, and within strata of race. There were a total of 443 women with distal large bowel cancer and 405 controls. Ever use of hormone replacement therapy was strongly associated with a reduced risk of distal large bowel cancer (OR 0.52, 95% CI 0.38-0.72). Further reduction of distal large bowel cancer risk occurred with increased duration of use (or=15 years (OR 0.34, 95% CI 0.20-0.58)). Ever use of oral contraceptives was not associated with reduced incidence of distal large bowel cancer (OR 0.95, 95% CI 0.67-1.34) nor was duration of use. There were no differences by race. Hormone replacement therapy is associated with a lower risk of distal large bowel cancer. This risk is further reduced with increased duration of use. Hormone replacement therapy may be partially responsible for the reduced incidence of distal large bowel cancer in women compared with men.

  5. Surgical management of short bowel syndrome by construction of an isoperistaltic intestinal valve: an experimental study in dogs.

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    Papaziogas, T; Tassiopoulos, A; Papaziogas, B; Koutsias, S; Alexandrakis, A; Sakellaridis, D; Galanis, N

    1999-08-01

    To develop of an isoperistaltic invaginated valve for the treatment of short bowel syndrome. Randomised experimental study University Hospital, Greece 8 mongrel dogs 90% resection of the small bowel, followed by construction of an invaginated valve one month later. weight loss, fat excretion in the faeces, radiographic and histological examination of the valve, pressure curve along the valve. Weight loss and steatorrhoea were reversed over a period of 2-3 months without evidence of intestinal obstruction in any of the animals. The construction of an isoperistaltic invaginated valve could be a solution to the management of the short gut syndrome.

  6. Long-term cognitive functions in neonatal short bowel syndrome patients.

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    Huang, J; Cai, W; Tang, Q; Feng, Y; Tao, Y; Wang, Y; Wu, J

    2008-04-01

    The aim of the study was to evaluate the long-term effects of neonatal short bowel syndrome on cognitive functions during development. Nine patients diagnosed with short bowel syndrome during the neonatal period were enrolled in this study. Their medical records were reviewed; anthropometric measurements and blood tests were assayed; IQ tests (the Chinese versions of WAIS-R, WPPSI-R and WISC-R) were performed depending on their age, and a BSID assessment was carried out in those patients less than 4 years old. Eight of 9 patients were followed up except for one patient who died in a car accident at the age of three. All patients had been weaned off parenteral nutrition for more than 2 years. The average residual small bowel length was 58.1 cm (range 35-70 cm), and the mean parenteral nutrition (PN) duration was 73.1 days (43-147 days). The mean duration of the period without PN was 7.4 years (range 2.1-17.1 years). Weight, height and BMI for age were normal in 7 children except for 1 child, who was overweight. Hemoglobin and albumin concentrations were normal in all 8 patients. Evaluation of cognitive development showed normal results for all 8 patients while a verbal/performance discrepancy was found in 2. Patients with neonatal SBS who were weaned off PN for more than 2 years were found to have normal growth and cognitive development during this long-term follow-up. There was no evidence for a strong correlation between SBS and nutritional/cognition disorder. Longer term and controlled studies with a larger sample size are warranted.

  7. Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date

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    Nanayakkara WS

    2016-06-01

    Full Text Available Wathsala S Nanayakkara,1 Paula ML Skidmore,1 Leigh O'Brien,2 Tim J Wilkinson,3 Richard B Gearry,31Department of Human Nutrition, University of Otago, Dunedin, New Zealand; 2Dietary Specialists, Christchurch, New Zealand; 3Department of Medicine, University of Otago, Christchurch, New Zealand Abstract: This review summarizes the published clinical studies concerning the management of irritable bowel syndrome (IBS using restriction of Fermentable Oligosaccharide, Disaccharide, Monosaccharide, and Polyols in the diet (low FODMAP diet. In recent years, the data supporting low FODMAP diet for the management of IBS symptoms have emerged, including several randomized controlled trials, case-control studies, and other observational studies. Unlike most dietary manipulations tried in the past to alleviate gastrointestinal symptoms of IBS, all studies on low FODMAP diet have consistently shown symptomatic benefits in the majority of patients with IBS. However, dietary adherence by the patients and clear dietary intervention led by specialized dietitians appear to be vital for the success of the diet. Up to 86% of patients with IBS find improvement in overall gastrointestinal symptoms as well as individual symptoms such as abdominal pain, bloating, constipation, diarrhea, abdominal distention, and flatulence following the diet. FODMAP restriction reduces the osmotic load and gas production in the distal small bowel and the proximal colon, providing symptomatic relief in patients with IBS. Long-term health effects of a low FODMAP diet are not known; however, stringent FODMAP restriction is not recommended owing to risks of inadequate nutrient intake and potential adverse effects from altered gut microbiota. In conclusion, the evidence to date strongly supports the efficacy of a low FODMAP diet in the treatment of IBS. Further studies are required to understand any potential adverse effects of long-term restriction of FODMAPs. Keywords: irritable bowel

  8. Increased serum free tryptophan in patients with diarrhea-predominant irritable bowel syndrome.

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    Christmas, David M; Badawy, Abdulla A-B; Hince, Dana; Davies, Simon J C; Probert, Christopher; Creed, Tom; Smithson, John; Afzal, Muhammad; Nutt, David J; Potokar, John P

    2010-10-01

    Irregularities of serotonin function in irritable bowel syndrome (IBS) may be due to changes in the metabolism of the serotonin precursor l-tryptophan. Dietary alteration of tryptophan intake may impact upon the mood and bowel symptoms of IBS. We hypothesized that diarrhea-predominant irritable bowel syndrome (d-IBS) patients would exhibit an increase in plasma tryptophan due to alterations in tryptophan metabolism. We also hypothesized that a diet low in tryptophan would reverse this change and reduce symptoms. Thirteen patients with d-IBS had fasting serum free and total tryptophan, large neutral amino acids, and 6 kynurenine metabolites measured before and after 2 weeks of a strict dairy-free diet. Baseline tryptophan parameters were compared with an age- and sex-matched control group. Changes in the specific tryptophan parameters before and after dairy-free diet were correlated with symptoms of IBS and mood. Compared with the control group, d-IBS patients at baseline exhibited significantly higher free serum tryptophan (10.5 ± 4.35 vs 4.75 ± 2.43 μmol/L [means ± standard deviation], P = .006) and significantly lower tryptophan dioxygenase and total tryptophan oxidation as measured by the kynurenine to free tryptophan and total kynurenines to free tryptophan ratios (23.37 ± 10.12 vs 55.33 ± 16.02, P < .001 and 49.34 ± 17.84 vs 258.46 ± 98.67, P < .001, respectively). Dairy-free diet did not modulate metabolites of the kynurenine pathway or symptoms. Tryptophan metabolism along the kynurenine pathway is inhibited in d-IBS, and a dairy-free diet does not alter this. Our findings are consistent with possible enhanced serotonin activity in d-IBS. Copyright © 2010 Elsevier Inc. All rights reserved.

  9. [A case of small bowel cancer with positive peritoneal cytology and five-year recurrence-free survival].

    Science.gov (United States)

    Matsumura, Atsushi; Shimizu, Keiji; Nishibeppu, Keiji; Matsuyama, Takehisa; Ogino, Shiro; Takemura, Manabu; Mugitani, Tatsuro; Ishida, Hidekazu; Akami, Toshikazu; Okano, Shinji

    2014-11-01

    Small bowel cancer is frequently detected at an advanced stage and its prognosis is poor. We report on a patient with small bowel cancer with positive peritoneal cytology who survived for 5 years without recurrence after surgery.The case involved a 73-year-old woman who had undergone partial resection of the small intestine and lymphadenectomy for a small bowel tumor with obstruction. Pathological examination confirmed papillary adenocarcinoma with partial serosal invasion. Ascites cytology indicated a class V tumor. Adjuvant chemotherapy with TS-1 was administered for 20 months, and the patient has survived without evidence of disease for over 5 years.In this case, it is possible that TS-1 chemotherapy was effective for prevention against small bowel cancer recurrence.Furthermore , peritoneal cytology in patients with small bowel cancer should be evaluated as a predictor of prognosis.

  10. Segmental small bowel necrosis associated with antiphospholipid syndrome: a case report.

    Science.gov (United States)

    Wang, Qun-Ying; Ye, Xiao-Hua; Ding, Jin; Wu, Xiao-Kang

    2015-04-07

    Antiphospholipid syndrome is a multi-system disease characterized by the formation of thromboembolic complications and/or pregnancy morbidity, and with persistently increased titers of antiphospholipid antibodies. We report the case of a 50-year-old, previously healthy man who presented with fever and new-onset, dull abdominal pain. A contrast-enhanced computed tomography scan showed segmental small bowel obstruction, for which an emergency laparotomy was performed. Histopathologic examination of resected tissues revealed multiple intestinal and mesenteric thromboses of small vessels. Laboratory tests for serum antiphospholipid (anticardiolipin IgM) and anti-β2-glycoprotein I antibodies were positive. Despite proactive implementation of anticoagulation, steroid, and antibiotic therapies, the patient's condition rapidly deteriorated, and he died 22 d after admission. This case highlights that antiphospholipid syndrome should be suspected in patients with unexplainable ischemic bowel and intestinal necrosis presenting with insidious clinical features that may be secondary to the disease, as early diagnosis is critical to implement timely treatments in order to ameliorate the disease course.

  11. Recommendations on Chronic Constipation (Including Constipation Associated with Irritable Bowel Syndrome Treatment

    Directory of Open Access Journals (Sweden)

    Pierre Paré

    2007-01-01

    Full Text Available While chronic constipation (CC has a high prevalence in primary care, there are no existing treatment recommendations to guide health care professionals. To address this, a consensus group of 10 gastroenterologists was formed to develop treatment recommendations. Although constipation may occur as a result of organic disease, the present paper addresses only the management of primary CC or constipation associated with irritable bowel syndrome. The final consensus group was assembled and the recommendations were created following the exact process outlined by the Canadian Association of Gastroenterology for the following areas: epidemiology, quality of life and threshold for treatment; definitions and diagnostic criteria; lifestyle changes; bulking agents and stool softeners; osmotic agents; prokinetics; stimulant laxatives; suppositories; enemas; other drugs; biofeedback and behavioural approaches; surgery; and probiotics. A treatment algorithm was developed by the group for CC and constipation associated with irritable bowel syndrome. Where possible, an evidence-based approach and expert opinions were used to develop the statements in areas with insufficient evidence. The nature of the underlying pathophysiology for constipation is often unclear, and it can be tricky for physicians to decide on an appropriate treatment strategy for the individual patient. The myriad of treatment options available to Canadian physicians can be confusing; thus, the main aim of the recommendations and treatment algorithm is to optimize the approach in clinical care based on available evidence.

  12. Prevalence and Predictive Factors of Irritable Bowel Syndrome in a Community-dwelling Population in Japan.

    Science.gov (United States)

    Satake, Ryu; Sugawara, Norio; Sato, Ken; Takahashi, Ippei; Nakaji, Shigeyuki; Yasui-Furukori, Norio; Fukuda, Shinsaku

    2015-01-01

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by chronic, relapsing abdominal pain or discomfort and is associated with disturbed defecation. The pathogenesis of IBS is multifactorial. The aim of this study was to investigate the prevalence of IBS using the Rome III criteria and to assess the effects of mental and lifestyle factors on IBS in a community-dwelling population in Japan. The diagnosis of irritable bowel syndrome was based on the Japanese version of the Rome III Questionnaire. The questionnaire was administered to 993 volunteers who participated in the Iwaki Health Promotion Project 2013. Diet was assessed with a validated brief-type self-administered diet history questionnaire. Dietary patterns based on 52 predefined food groups [energy-adjusted food (g/d)] were extracted using a principal component analysis. The Center for Epidemiologic Studies Depression Scale with a cut-off point of 16 was used to assess the prevalence of depression. A total of 61 subjects (6.1%) were classified as having IBS. Three dietary patterns were identified: "Healthy", "Western" and "Alcohol and accompanying" dietary patterns. After adjusting for potential confounders, the "Alcohol and accompanying" dietary pattern and depression were related to the risk of IBS. We found that an "Alcohol and accompanying" dietary pattern and depression were related to the risk of IBS in a Japanese community population. However, we could not rule out the possibility of some selection bias. Further studies with longitudinal observations are therefore warranted.

  13. Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for effective dietary management.

    Science.gov (United States)

    Shepherd, Susan J; Gibson, Peter R

    2006-10-01

    Dietary fructose induces abdominal symptoms in patients with fructose malabsorption, but there are no published guidelines on its dietary management. The objective was to retrospectively evaluate a potentially successful diet therapy in patients with irritable bowel syndrome and fructose malabsorption. Tables detailing the content of fructose and fructans in foods were constructed. A dietary strategy comprising avoidance of foods containing substantial free fructose and short-chain fructans, limitation of the total dietary fructose load, encouragement of foods in which glucose was balanced with fructose, and co-ingestion of free glucose to balance excess free fructose was devised. Sixty-two consecutively referred patients with irritable bowel syndrome and fructose malabsorption on breath hydrogen testing underwent dietary instruction. Dietary adherence and effect on abdominal symptoms were evaluated via telephone interview 2 to 40 months (median 14 months) later. Response to the diet was defined as improvement of all symptoms by at least 5 points on a -10- to 10-point scale. Forty-eight patients (77%) adhered to the diet always or frequently. Forty-six (74%) of all patients responded positively in all abdominal symptoms. Positive response overall was significantly better in those adherent than nonadherent (85% vs 36%; Pfructose malabsorption dietary therapy achieves a high level of sustained adherence and good symptomatic response.

  14. The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study.

    Science.gov (United States)

    de Roest, R H; Dobbs, B R; Chapman, B A; Batman, B; O'Brien, L A; Leeper, J A; Hebblethwaite, C R; Gearry, R B

    2013-09-01

    Current treatment for irritable bowel syndrome (IBS) is suboptimal. Fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) may trigger gastrointestinal symptoms in IBS patients. Our aim was to determine whether a low FODMAP diet improves symptoms in IBS patients. Irritable bowel syndrome patients, who had performed hydrogen/methane breath testing for fructose and lactose malabsorption and had received dietary advice regarding the low FODMAP diet, were included. The effect of low FODMAP diet was prospectively evaluated using a symptom questionnaire. Furthermore, questions about adherence and satisfaction with symptom improvement, dietary advice and diet were assessed. Ninety patients with a mean follow up of 15.7 months were studied. Most symptoms including abdominal pain, bloating, flatulence and diarrhoea significantly improved (p fructose, lactose malabsorption or small intestinal bacterial overgrowth respectively. Fructose malabsorption was significantly associated with symptom improvement (abdominal pain odds ratio (OR) 7.09 [95% confidence interval (CI) 2.01-25.0], bloating OR 8.71 (95% CI 2.76-27.5), flatulence OR 7.64 (95% CI 2.53-23.0) and diarrhoea OR 3.39 (95% CI 1.17-9.78), p 0.27, p < 0.011). Most patients (72.1%) were satisfied with their symptoms. The low FODMAP diet shows efficacy for IBS patients. The current strategy of breath testing and dietary advice provides a good basis to understand and adhere to the diet. © 2013 John Wiley & Sons Ltd.

  15. Irritable Bowel Syndrome and Nickel Allergy: What Is the Role of the Low Nickel Diet?

    Science.gov (United States)

    Rizzi, Angela; Nucera, Eleonora; Laterza, Lucrezia; Gaetani, Eleonora; Valenza, Venanzio; Corbo, Giuseppe M; Inchingolo, Riccardo; Buonomo, Alessandro; Schiavino, Domenico; Gasbarrini, Antonio

    2017-01-30

    Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain or discomfort accompanied by abnormal bowel movements. In sensitized subjects, ingested nickel (Ni) may induce gastrointestinal symptoms similar to IBS, in addition to typical systemic cutaneous lesions (systemic nickel allergy syndrome [SNAS]). A low nickel diet could improve the systemic manifestations. We evaluated prevalence of nickel allergy in IBS and effects of low Ni diet on (1) gastrointestinal symptoms control, (2) intestinal barrier function, (3) quality of life, and (4) psychological status of patients with IBS and Ni-sensitized patients. Twenty consecutive patients affected by IBS and suspected SNAS underwent intestinal permeability tests. Gastrointestinal symptoms were evaluated using the visual analogue scale before and after 3 months low Ni diet. Subjects with increased intestinal permeability at baseline repeated nuclear examination after the diet. The most frequent profile was diarrhea-predominant IBS (8/20). The low Ni diet induced a significant and constant improvement of gastrointestinal symptoms and an equally significant improvement of visual analogue scale. Mean urinary output of ⁵¹Chromium ethylene-diamine-tetra-acetate (⁵¹Cr-EDTA) was 5.91%/24 hr (± 2.08), significantly different from the control group (2.20%/24 hr ± 0.60, P < 0.0001). This pilot study shows that low Ni diet improves gastrointestinal symptoms in patients with IBS and SNAS.

  16. Linaclotide in the treatment of patients with irritable bowel syndrome and constipation: analysis of an opportunity

    Directory of Open Access Journals (Sweden)

    Fernando Carballo

    2013-06-01

    Full Text Available Linaclotide is a secretagogue that provides a combined effect on visceral pain. The European Medicines Agency has authorized its indication for the symptomatic treatment of moderate to severe irritable bowel syndrome with constipation in adults. The purpose of this review is to discuss the clinical framework for linaclotide use in our setting, the drug's characteristics and pre-clinical development, and the clinical studies supporting its use in order to establish relevant views regarding its validity and clinical applicability. The results suggest that the only -non-severe- adverse effect associated with this drug is diarrhea. As regards effectiveness, linaclotide consistently shows favorable, significant differences in absolute risk versus placebo for all objective outcome variables described by regulatory agencies, with a combined pain and constipation response between 12.6% and 22.8% according to the variable and trial under consideration. This response is sustained and drug-related, as it goes away upon discontinuation. To conclude, linaclotide has a safety and efficacy profile that, from a clinical perspective, warrants its use for patients meeting irritable bowel syndrome and constipation criteria, with significant symptoms that cannot be relieved with other less specific measures. In the absence of predictive rules for response, it is recommended that, should the patient fail to respond, he or she should be considered not eligible for linaclotide therapy, and both indication and treatment continuity should be reserved for objective responders alone.

  17. Descending pain modulation in irritable bowel syndrome (IBS): a systematic review and meta-analysis.

    Science.gov (United States)

    Chakiath, Rosemary J; Siddall, Philip J; Kellow, John E; Hush, Julia M; Jones, Mike P; Marcuzzi, Anna; Wrigley, Paul J

    2015-12-10

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. While abdominal pain is a dominant symptom of IBS, many sufferers also report widespread hypersensitivity and present with other chronic pain conditions. The presence of widespread hypersensitivity and extra-intestinal pain conditions suggests central nervous dysfunction. While central nervous system dysfunction may involve the spinal cord (central sensitisation) and brain, this review will focus on one brain mechanism, descending pain modulation. We will conduct a comprehensive search for the articles indexed in the databases Ovid MEDLINE, Ovid Embase, Ovid PsycINFO and Cochrane Central Register of Controlled Trial (CENTRAL) from their inception to August 2015, that report on any aspect of descending pain modulation in irritable bowel syndrome. Two independent reviewers will screen studies for eligibility, assess risk of bias and extract relevant data. Results will be tabulated and, if possible, a meta-analysis will be carried out. The systematic review outlined in this protocol aims to summarise current knowledge regarding descending pain modulation in IBS. PROSPERO CRD42015024284.

  18. The Place of Stress and Emotions in the Irritable Bowel Syndrome.

    Science.gov (United States)

    Pellissier, S; Bonaz, B

    2017-01-01

    Our emotional state can have many consequences on our somatic health and well-being. Negative emotions such as anxiety play a major role in gut functioning due to the bidirectional communications between gut and brain, namely, the brain-gut axis. The irritable bowel syndrome (IBS), characterized by an unusual visceral hypersensitivity, is the most common disorder encountered by gastroenterologists. Among the main symptoms, the presence of current or recurrent abdominal pain or discomfort associated with bloating and altered bowel habits characterizes this syndrome that could strongly alter the quality of life. This chapter will present the physiopathology of IBS and explain how stress influences gastrointestinal functions (permeability, motility, microbiota, sensitivity, secretion) and how it could be predominantly involved in IBS. This chapter will also describe the role of the autonomic nervous system and the hypothalamic-pituitary axis through vagal tone and cortisol homeostasis. An analysis is made about how emotions and feelings are involved in the disruption of homeostasis, and we will see to what extent the balance between vagal tone and cortisol may reflect dysfunctions of the brain-gut homeostasis. Finally, the interest of therapeutic treatments focused on stress reduction and vagal tone enforcement is discussed. © 2017 Elsevier Inc. All rights reserved.

  19. Inflammatory bowel disease, cancer and medication: Cancer risk in the Dutch population-based IBDSL cohort.

    Science.gov (United States)

    van den Heuvel, Tim R A; Wintjens, Dion S J; Jeuring, Steven F G; Wassink, Maartje H H; Romberg-Camps, Marielle J L; Oostenbrug, Liekele E; Sanduleanu, Silvia; Hameeteman, Wim H; Zeegers, Maurice P; Masclee, Ad A; Jonkers, Daisy M; Pierik, Marie J

    2016-09-15

    The management of inflammatory bowel disease (IBD) has changed since the mid-1990s (e.g., use of thiopurines/anti-TNFα agents, improved surveillance programs), possibly affecting cancer risk. To establish current cancer risk in IBD, updates are warranted from cohorts covering this time span, and detailed enough to study associations with phenotype and medication. We studied intestinal-, extra-intestinal- and overall cancer risk in the Dutch population-based IBDSL cohort. In total, 1,157 Crohn's disease (CD) and 1,644 ulcerative colitis (UC) patients were diagnosed between 1991 and 2011, and followed until 2013. Standardized incidence ratios (SIRs) were calculated for CD and UC separately, as well as for gender-, phenotype-, disease duration-, diagnosis era- and medication groups. We found an increased risk for colorectal cancer in CD patients with colon involvement (SIR 2.97; 95% CI 1.08-6.46), but not in the total CD or UC population. In addition, CD patients were at increased risk for hematologic- (2.41; 1.04-4.76), overall skin- (1.55; 1.06-2.19), skin squamous cell- (SCC; 3.83; 1.83-7.04) and overall cancer (1.28; 1.01-1.60), whereas UC patients had no increased risk for extra-intestinal- and overall cancer. Finally, in a medication analysis on CD and UC together, long-term immunosuppression exposure (>12 months) was associated with an increased risk for hematologic cancer, non-Hodgkin lymphoma, SCC and overall cancer, and this increase was mainly attributed to thiopurines. IBD patients with long-term immunosuppression exposure can be considered as having a higher cancer risk, and our data support the advice in recent IBD guidelines to consider skin cancer screening in these patients. © 2016 UICC.

  20. Risk of cancer, with special reference to extra-intestinal malignancies, in patients with inflammatory bowel disease.

    Science.gov (United States)

    Algaba, Alicia; Guerra, Iván; Castaño, Angel; de la Poza, Gema; Castellano, Víctor M; López, Montserrat; Bermejo, Fernando

    2013-12-28

    To determine the incidence and characteristics of intestinal and extra-intestinal cancers among patients with inflammatory bowel disease in a Spanish hospital and to compare them with those of the local population. This was a prospective, observational, 7-year follow-up, cohort study. Cumulative incidence, incidence rates based on person-years of follow-up and relative risk were calculated for patients with inflammatory bowel disease and compared with the background population. The incidence of cancer was determined using a hospital-based data registry from Hospital Universitario de Fuenlabrada. Demographic data and details about time from diagnosis of inflammatory bowel disease to occurrence of cancer, disease extent, inflammatory bowel disease treatment, cancer therapy and cancer evolution were also collected in the inflammatory bowel disease cohort. Eighteen of 590 patients with inflammatory bowel disease developed cancer [cumulative incidence = 3% (95%CI: 1.58-4.52) vs 2% (95%CI: 1.99-2.11) in the background population; RR = 1.5; 95%CI: 0.97-2.29]. The cancer incidence among inflammatory bowel disease patients was 0.53% (95%CI: 0.32-0.84) per patient-year of follow-up. Patients with inflammatory bowel disease had a significantly increased relative risk of urothelial carcinoma (RR = 5.23, 95%CI: 1.95-13.87), appendiceal mucinous cystadenoma (RR = 36.6, 95%CI: 7.92-138.4), neuroendocrine carcinoma (RR = 13.1, 95%CI: 1.82-29.7) and rectal carcinoid (RR = 8.94, 95%CI: 1.18-59.7). Colorectal cancer cases were not found. The overall risk of cancer did not significantly increase in our inflammatory bowel disease patients. However, there was an increased risk of urinary bladder cancer and, with less statistical power, an increased risk of appendiceal mucinous cystadenoma and of neuroendocrine tumors. Colorectal cancer risk was low in our series.

  1. Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: a review of case-control studies.

    Science.gov (United States)

    Martínez-Martínez, Laura-Aline; Mora, Tania; Vargas, Angélica; Fuentes-Iniestra, Mario; Martínez-Lavín, Manuel

    2014-04-01

    Fibromyalgia often coexists and overlaps with other syndromes such as chronic fatigue, irritable bowel syndrome, and interstitial cystitis. Chronic stress has been implicated in the pathogenesis of these illnesses. The sympathetic nervous system is a key element of the stress response system. Sympathetic dysfunction has been reported in these syndromes, raising the possibility that such dysautonomia could be their common clustering underlying pathogenesis. The objective of this study was to carry out a review of all published comparative case-control studies investigating sympathetic nervous system performance in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. Online databases PubMed and EMBASE were accessed using the following key words: autonomic (OR) sympathetic (AND) fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. All entries up to December 10th 2012 were reviewed by 2 independent investigators searching for case-control studies in humans. The Method for Evaluating Research and Guidelines Evidence adapted to the Scottish Intercollegiate Guidelines Network was used to rank the level of evidence contained in the selected articles. A total of 196 articles are included in this review. The most often used methods to assess sympathetic functionality were heart rate variability analysis, sympathetic skin response, tilt table testing, and genetic studies. The majority of studies (65%) described sympathetic nervous system predominance in these overlapping syndromes. In contrast, 7% of the studies found parasympathetic predominance. This review demonstrates that sympathetic nervous system predominance is common in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. This concordance raises the possibility that sympathetic dysfunction could be their common underlying pathogenesis that brings on overlapping clinical features. The recognition of

  2. Acupuncture for enhancing early recovery of bowel function in cancer: Protocol for a systematic review.

    Science.gov (United States)

    Liu, Yi-Hua; Ye, Yang; Zheng, Jia-Bin; Wang, Xue-Qian; Zhang, Ying; Lin, Hong-Sheng

    2017-04-01

    Cancer patients undergoing surgical procedure often suffer from bowel dysfunction and postoperative ileus (POI). Cancer management for early recovery of bowel function is still a challenging topic. Acupuncture has been commonly used in a variety of gastrointestinal diseases. The aim of this study is to evaluate the effects of acupuncture therapy to reduce the duration of POI and enhance bowel function in cancer patients. We will systematically screen all randomized controlled trials (RCTs) published through electronically and hand searching. The following search engines including Medline, EMBASE, Cochrane CENTRAL, the Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, VIP Information, Wanfang Data, one Japanese database (Japan Science and Technology Information Aggregator, Electronic) and 2 Korean Medical Databases (Korean Studies Information, and Data Base Periodical Information Academic) will be retrieved. Supplementary sources will be searched including gray literature, conference proceedings, and potential identified publications. Two reviewers will independently conduct the trial inclusion, data extraction and assess the quality of studies. The time to first passing flatus and time to first bowel motion will be assessed as the primary outcomes. Adverse effects, time to first bowel sound, visual analog scale (VAS) pain score, hospital stay, and postoperative analgesic requirement will be measured as secondary outcomes. Methodological quality will be evaluated according to the Cochrane risk of bias. Details of interventions will be assessed by the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist. All analyses will be applied by RevMan (version 5.3) and StataSE (version 12). This systematic review will provide up-to-date information on acupuncture therapy for early recovery of

  3. Outcomes of surgical management of bowel obstruction in relapsed epithelial ovarian cancer (EOC).

    Science.gov (United States)

    Kolomainen, D F; Daponte, A; Barton, D P J; Pennert, K; Ind, T E J; Bridges, J E; Shepherd, J H; Gore, M E; Kaye, S B; Riley, J

    2012-04-01

    To describe the outcomes of surgical management of bowel obstruction in relapsed epithelial ovarian cancer (EOC) so as to define the criteria for patient selection for palliative surgery. 90 women with relapsed EOC underwent palliative surgery for bowel obstruction between 1992 and 2008. Median age at time of surgery for bowel obstruction was 57 years (range, 26 to 85 years). All patients had received at least one line of platinum-based chemotherapy. Median time from diagnosis of primary disease to documented bowel obstruction requiring surgery was 19.5 months (range, 29 days-14 years). Median interval from date of completed course of chemotherapy preceding surgery for bowel obstruction was 3.8 months (range, 5 days-14 years). Ascites was present in 38/90(42%). 49/90(54%) underwent emergency surgery for bowel obstruction. The operative mortality and morbidity rates were 18% and 27%, respectively. Successful palliation, defined as adequate oral intake at least 60 days postoperative, was achieved in 59/90(66%). Only the absence of ascites was identified as a predictor for successful palliation (p=0.049). The median overall survival (OS) was 90.5 days (range, bowel obstruction (p>0.05). Surgery for bowel obstruction in relapsed EOC is associated with a high morbidity and mortality rate especially in emergency cases when compared to other gynaecological oncological procedures. Palliation can be achieved in almost two thirds of cases, is equally likely in elective and emergency cases but is less likely in those with ascites. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Effects of high treatability information on preventative intention of bowel cancer

    NARCIS (Netherlands)

    Wu, Yingqiu; Dijkstra, Arie; Dalley, Simon

    2017-01-01

    Background: The information that indicates a disease is highly treatable is called ‘high treatability information’ (HTI). This HTI may decrease people’s preventative intention of the disease. The current study examined the effects of HTI on preventative intention of bowel cancer. Procedure of

  5. Effects of high treatability information on preventative intention of bowel cancer

    NARCIS (Netherlands)

    Wu, Yingqiu; Dijkstra, Arie; Dalley, Simon E.

    2017-01-01

    The information that indicates a disease is highly treatable is called ‘high treatability information’ (HTI). This study examined the effects of HTI on preventative intention of bowel cancer. Self-affirmation was used to reduce the defensive responses to HTI. We employed a 3(control versus low

  6. Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Munkholm, P

    2003-01-01

    Although colorectal cancer (CRC), complicating ulcerative colitis and Crohn's disease, only accounts for 1-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 15% of all deaths in inflammatory bowel disease (IBD) ...

  7. Incidence, management, and course of cancer in patients with inflammatory bowel disease.

    Science.gov (United States)

    Algaba, Alicia; Guerra, Iván; Marín-Jiménez, Ignacio; Quintanilla, Elvira; López-Serrano, Pilar; García-Sánchez, María Concepción; Casis, Begoña; Taxonera, Carlos; Moral, Ignacio; Chaparro, María; Martín-Rodríguez, Daniel; Martín-Arranz, María Dolores; Manceñido, Noemí; Menchén, Luis; López-Sanromán, Antonio; Castaño, Ángel; Bermejo, Fernando

    2015-04-01

    Patients with inflammatory bowel disease [IBD] are at increased risk for developing some types of neoplasia. Our aims were to determin the risk for cancer in patients with IBD and to describe the relationship with immunosuppressive therapies and clinical management after tumor diagnosis. Retrospective, multicenter, observational, 5-year follow-up, cohort study. Relative risk [RR] of cancer in the IBD cohort and the background population, therapeutic strategies, and cancer evolution were analyzed. A total of 145 cancers were diagnosed in 133 of 9100 patients with IBD (global cumulative incidence 1.6% vs 2.4% in local population; RR = 0.67; 95% confidence interval [CI]: 0.57-0.78). Patients with IBD had a significantly increased RR of non-melanoma skin cancer [RR = 3.85; 2.53-5.80] and small bowel cancer [RR = 3.70; 1.23-11.13]. After cancer diagnosis, IBD treatment was maintained in 13 of 27 [48.1%] patients on thiopurines, in 2 of 3 on methotrexate [66.6%], none on anti-TNF-α monotherapy [n = 6] and 4 of 12 [33.3%] patients on combined therapy. Rate of death and cancer remission during follow-up did not differ [p > 0.05] between patients who maintained the treatment compared with patients who withdrew [5% vs 8% and 95% vs 74%, respectively]. An association between thiopurines [p = 0.20] or anti-TNF-α drugs [p = 0.77] and cancer was not found. Patients with IBD have an increased risk for non-melanoma skin cancer and small bowel cancer. Immunosuppresive therapy is not related to a higher overall risk for cancer or worse tumor evolution in patients who maintain these drugs after cancer diagnosis. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. Gut-directed hypnotherapy in children with irritable bowel syndrome or functional abdominal pain (syndrome): A randomized controlled trial on self exercises at home using CD versus individual therapy by qualified therapists

    NARCIS (Netherlands)

    J.M.T.M. Rutten (Juliette); A.M. Vlieger (Arine M.); C. Frankenhuis (Carla); E.K. George (Elvira K.); M. Groeneweg (Michael); O.F. Norbruis (Obbe); W.E. Tjon A ten; H. Van Wering (Herbert); M.G.W. Dijkgraaf (Marcel); M.P. Merkus; M.A. Benninga (Marc)

    2014-01-01

    textabstractBackground: Irritable bowel syndrome (IBS) and functional abdominal pain (syndrome) (FAP(S)) are common pediatric disorders, characterized by chronic or recurrent abdominal pain. Treatment is challenging, especially in children with persisting symptoms. Gut-directed hypnotherapy (HT)

  9. Evaluation of latent links between irritable bowel syndrome and sleep quality

    Science.gov (United States)

    Bellini, Massimo; Gemignani, Angelo; Gambaccini, Dario; Toti, Simona; Menicucci, Danilo; Stasi, Cristina; Costa, Francesco; Mumolo, Maria Gloria; Ricchiuti, Angelo; Bedini, Remo; de Bortoli, Nicola; Marchi, Santino

    2011-01-01

    AIM: To examine the links between quality of sleep and the severity of intestinal symptoms in irritable bowel syndrome (IBS). METHODS: One hundred and forty-two outpatients (110 female, 32 male) who met the Rome III criteria for IBS with no psychiatric comorbidity were consecutively enrolled in this study. Data on age, body mass index (BMI), and a set of life-habit variables were recorded, and IBS symptoms and sleep quality were evaluated using the questionnaires IBS Symptom Severity Score (IBS-SSS) and Pittsburgh Sleep Quality Index (PSQI). The association between severity of IBS and sleep disturbances was evaluated by comparing the global IBS-SSS and PSQI score (Pearson’s correlation and Fisher’s exact test) and then analyzing the individual items of the IBS-SSS and PSQI questionnaires by a unitary bowel-sleep model based on item response theory (IRT). RESULTS: IBS-SSS ranged from mild to severe (120-470). The global PSQI score ranged from 1 to 17 (median 5), and 60 patients were found to be poor sleepers (PSQI > 5). The correlation between the global IBS-SSS and PSQI score indicated a weak association (r = 0.2 and 95% CI: -0.03 to 0.35, P < 0.05), which becomes stronger using our unitary model. Indeed, the IBS and sleep disturbances severities, estimated as latent variables, resulted significantly high intra-subject correlation (posterior mean of r = 0.45 and 95% CI: 0.17 to 0.70, P < 0.05). Moreover, the correlations between patient features (age, sex, BMI, daily coffee and alcohol intake) and IBS and sleep disturbances were also analyzed through our unitary model. Age was a significant regressor, with patients ≤ 50 years old showing more severe bowel disturbances (posterior mean = -0.38, P < 0.05) and less severe sleep disturbances (posterior mean = 0.49, P < 0.05) than older patients. Higher daily coffee intake was correlated with a lower severity of bowel disturbances (posterior mean = -0.31, P < 0.05). Sex (female) and daily alcohol intake (modest

  10. Disability and participation in breast and bowel cancer screening in England: a large prospective study.

    Science.gov (United States)

    Floud, S; Barnes, I; Verfürden, M; Kuper, H; Gathani, T; Blanks, R G; Alison, R; Patnick, J; Beral, V; Green, J; Reeves, G K

    2017-11-21

    There is limited information about participation in organised population-wide screening programmes by people with disabilities. Data from the National Health Service routine screening programmes in England were linked to information on disability reported by the Million Women Study cohort participants. Of the 473 185 women offered routine breast or bowel cancer screening, 23% reported some disability. Women with disabilities were less likely than other women to participate in breast cancer screening (RR=0.64, 95% CI: 0.62-0.65) and in bowel cancer screening (RR=0.75, 0.73-0.76). Difficulties with self-care or vision were associated with the greatest reduction in screening participation. Participation in routine cancer screening programmes in England is reduced in people with disabilities and participation varies by type of disability.

  11. Irritable Bowel Syndrome on the US Mexico Border: A Survey in an Indigent Population Using Rome III Criteria.

    Science.gov (United States)

    Zuckerman, Marc J; Schmulson, Max J; Bashashati, Mohammad; Jia, Yi; Dwivedi, Alok; Ortiz, Melchor; Casner, Nancy; Byrd, Theresa; Shokar, Navkiran

    2017-08-04

    To investigate the prevalence of irritable bowel syndrome (IBS), and its association with health perception and health care-seeking behavior in this Mexican American population. The prevalence of IBS ranges from 3% to 20.4% in the United States and 4.4% to 16% in Mexico, based on Rome III and II criteria. However, its epidemiological profile in the US Mexico border is unknown. We conducted a survey in a randomly selected indigent population (N=521) recruited into a colon cancer screening program (ACCION). The prevalence of IBS was estimated and a multivariable logistic regression was carried out to determine the associated risk factors. Results are summarized using odds ratio and 95% confidence interval (CI). A total of 464 (89%) completed the survey (mean age, 56.7 y; female, 74.8%). Country of birth was Mexico in 90.5% and the United States in 8.2% and acculturation was more Spanish (94.8%) than English (5.2%). Overall, 5.6% (95% CI, 3.7-8.1) fulfilled criteria for IBS with a predominance among women (6.9%) versus men (1.7%) (P=0.03). On the basis of multivariable analysis, lower number of bowel movements/week (odds ratio, 0.89; 95% CI, 0.80-1.00), having a primary care physician: 4.09 (1.51-11.12), using herbal treatments: 2.76 (1.08-7.06) and a previous IBS diagnosis: 23.11 (3.44-155.45), were significantly associated with the presence of IBS. The prevalence of IBS on the US Mexico border is comparable with data obtained from studies in both countries. Consulting a primary care physician as an associated factor may reveal the high rate of health-care seeking in IBS patients, while herbal treatments may reflect a cultural influence.

  12. Racial and ethnic variation in the incidence of small-bowel cancer subtypes in the United States, 1995-2008.

    Science.gov (United States)

    Goodman, Marc T; Matsuno, Rayna K; Shvetsov, Yurii B

    2013-04-01

    Small-bowel cancer is uncommon and, accordingly, little is known about the epidemiology of this malignancy, especially by race and subtype. The objective of this analysis was to describe the distribution of small-bowel cancer in the United States by demographic, pathological, and clinical features. This study was retrospective in design. Data from 26 population-based cancer registries in the United States from 1995 to 2008 were used. Patients diagnosed with small-bowel cancer (topography codes C17.0-17.3 and C17.8-17.9) were included. The primary outcomes measured were race- and histology-specific incidence (age-adjusted rate trends and age-specific rates) of small-bowel cancer. A total of 56,223 men and women diagnosed with small-bowel cancer were identified. The overall age-adjusted incidence rates for small-bowel cancer were 26.1 in men and 17.7 in women. Neuroendocrine tumors were the most common histological types of small-bowel cancer in men and women, followed by carcinoma, lymphoma, and sarcoma. In comparison with whites, the rate of small-bowel cancer was 42% greater in black men, 46% greater in black women, 34% lower in Asian-Pacific Islander men, and 37% lower in Asian-Pacific Islander women. Rates of small-bowel cancer were 24% lower in Hispanic men and 15% lower in Hispanic women than rates in non-Hispanics. The excess of small-bowel cancer in blacks and the deficit in Asian-Pacific Islanders were attributable mainly to the incidence of adenocarcinoma and carcinoid tumors. The incidence of GI stromal tumor was significantly higher among Asian-Pacific Islanders. This is one of the largest studies of small-bowel cancer to date. These cancer registry data showed substantial racial and ethnic variation in the incidence of histological subtypes of small-bowel malignancy that suggest possible etiologic diversity and/or disparities in detection.

  13. Psyllium fiber reduces abdominal pain in children with irritable bowel syndrome in a randomized, double-blind trial

    Science.gov (United States)

    We sought to determine the efficacy of psyllium fiber treatment on abdominal pain and stool patterns in children with irritable bowel syndrome (IBS). We evaluated effects on breath hydrogen and methane production, gut permeability, and microbiome composition. We also investigated whether psychologic...

  14. Self-perceived food intolerances are common and associated with clinical severity in childhood irritable bowel syndrome

    Science.gov (United States)

    Adults with irritable bowel syndrome (IBS) frequently identify foods as exacerbating their gastrointestinal symptoms. In children with IBS, the prevalence of perceived food intolerances and their impact are unknown. Our aim was to determine the prevalence of self-perceived food intolerances and the ...

  15. The mast cell stabiliser ketotifen decreases visceral hypersensitivity and improves intestinal symptoms in patients with irritable bowel syndrome

    NARCIS (Netherlands)

    Klooker, Tamira K.; Braak, Breg; Koopman, Karin E.; Welting, Olaf; Wouters, Mira M.; van der Heide, Sicco; Schemann, Michael; Bischoff, Stephan C.; van den Wijngaard, Rene M.; Boeckxstaens, Guy E.

    Background Mast cell activation is thought to be involved in visceral hypersensitivity, one of the main characteristics of the irritable bowel syndrome (IBS). A study was therefore undertaken to investigate the effect of the mast cell stabiliser ketotifen on rectal sensitivity and symptoms in

  16. Concomitant functional dyspepsia and irritable bowel syndrome decrease health-related quality of life in gastroesophageal reflux disease

    NARCIS (Netherlands)

    de Vries, Durk R.; van Herwaarden, Margot A.; Baron, Astrid; Smout, André J. P. M.; Samsom, Melvin

    2007-01-01

    OBJECTIVE: Previous studies have reported an overlap between gastroesophageal reflux symptoms, functional dyspepsia (FD) and irritable bowel syndrome (IBS). The aim of this study was to investigate the prevalence of FD and IBS in gastroesophageal reflux disease (GERD) and the effect on

  17. The epidemiology of irritable bowel syndrome in Denmark. A population-based survey in adults ≤50 years of age

    DEFF Research Database (Denmark)

    Krogsgaard, Laura Rindom; Engsbro, Anne Line; Bytzer, Peter

    2013-01-01

    OBJECTIVE: Our aims were to investigate the prevalence and subtype distribution of irritable bowel syndrome (IBS) according to the Rome III criteria in Denmark, to describe the difference in symptom reporting between those with gastrointestinal (GI) symptoms not fulfilling Rome III for IBS compared...

  18. Serotonin signalling is altered in irritable bowel syndrome with diarrhea but not in functional dyspepsia in pediatric age patients

    OpenAIRE

    Faure, C.; Patey, N.; Gauthier, C.; Brooks, E.M.; Mawe, G.M.

    2010-01-01

    In adults, irritable bowel syndrome (IBS) and functional dyspepsia (FD) are chronic conditions that often start during childhood. We investigated mucosal serotonin (5-HT) signalling in children with the idea that data from subjects with a shorter history may improve our understanding of underlying pathophysiological mechanisms.

  19. Gut-directed hypnotherapy for functional abdominal pain or irritable bowel syndrome in children: a systematic review

    NARCIS (Netherlands)

    Rutten, Juliette M. T. M.; Reitsma, Johannes B.; Vlieger, Arine M.; Benninga, Marc A.

    2013-01-01

    Gut directed hypnotherapy (HT) is shown to be effective in adult functional abdominal pain (FAP) and irritable bowel syndrome (IBS) patients. We performed a systematic review to assess efficacy of HT in paediatric FAP/IBS patients. We searched Medline, Embase, PsychINFO, Cumulative Index to Nursing

  20. The mast cell stabiliser ketotifen decreases visceral hypersensitivity and improves intestinal symptoms in patients with irritable bowel syndrome

    NARCIS (Netherlands)

    Klooker, T.K.; Braak, B.; Koopman, K.E.; Welting, O.; Wouters, M.M.; van der Heide, S.; Schemann, M.; Bischoff, S.C.; van den Wijngaard, R.M.; Boeckxstaens, G.E.

    2010-01-01

    Background Mast cell activation is thought to be involved in visceral hypersensitivity, one of the main characteristics of the irritable bowel syndrome (IBS). A study was therefore undertaken to investigate the effect of the mast cell stabiliser ketotifen on rectal sensitivity and symptoms in

  1. Development and validation of the disease-specific Short Bowel Syndrome-Quality of Life (SBS-QoL) scale

    DEFF Research Database (Denmark)

    Berghöfer, P; Fragkos, K C; Baxter, J P

    2013-01-01

    Subjects with short bowel syndrome (SBS) have impaired quality of life (QoL). No disease-specific instrument has been available to measure treatment-induced changes in QoL over time. Therefore, the aim was to develop and validate an SBS-specific QoL scale....

  2. No Change in Rectal Sensitivity After Gut-Directed Hypnotherapy in Children With Functional Abdominal Pain or Irritable Bowel Syndrome

    NARCIS (Netherlands)

    Vlieger, A. M.; van den Berg, M. M.; Menko-Frankenhuis, C.; Bongers, M. E. J.; Tromp, E.; Benninga, M. A.

    2010-01-01

    OBJECTIVES: Gut-directed hypnotherapy (HT) has recently been shown to be highly effective in treating children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS). This study was conducted to determine the extent to which this treatment success is because of an improvement in

  3. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children.

    Science.gov (United States)

    Kline, R M; Kline, J J; Di Palma J; Barbero, G J

    2001-01-01

    In a randomized, double-blind controlled trial, 42 children with irritable bowel syndrome (IBS) were given pH-dependent, enteric-coated peppermint oil capsules or placebo. After 2 weeks, 75% of those receiving peppermint oil had reduced severity of pain associated with IBS. Peppermint oil may be used as a therapeutic agent during the symptomatic phase of IBS.

  4. Histamine Receptor H1-Mediated Sensitization of TRPV1 Mediates Visceral Hypersensitivity and Symptoms in Patients With Irritable Bowel Syndrome

    NARCIS (Netherlands)

    Wouters, Mira M.; Balemans, Dafne; van Wanrooy, Sander; Dooley, James; Cibert-Goton, Vincent; Alpizar, Yeranddy A.; Valdez-Morales, Eduardo E.; Nasser, Yasmin; van Veldhoven, Paul P.; Vanbrabant, Winde; van der Merwe, Schalk; Mols, Raf; Ghesquière, Bart; Cirillo, Carla; Kortekaas, Inge; Carmeliet, Peter; Peetermans, Willy E.; Vermeire, Séverine; Rutgeerts, Paul; Augustijns, Patrick; Hellings, Peter W.; Belmans, Ann; Vanner, Stephen; Bulmer, David C.; Talavera, Karel; Vanden Berghe, Pieter; Liston, Adrian; Boeckxstaens, Guy E.

    2016-01-01

    Histamine sensitizes the nociceptor transient reporter potential channel V1 (TRPV1) and has been shown to contribute to visceral hypersensitivity in animals. We investigated the role of TRPV1 in irritable bowel syndrome (IBS) and evaluated if an antagonist of histamine receptor H1 (HRH1) could

  5. Mast cells: a possible link between psychological stress, enteric infection, food allergy and gut hypersensitivity in the irritable bowel syndrome.

    Science.gov (United States)

    Gui, X Y

    1998-10-01

    Intestinal mast cell activation (degranulation), which results from previous enteric infection and/or intestinal allergy, may play a central role in the gut hypersensitivity in both motor response and visceral perception in the Irritable Bowel syndrome. This occurs through various mediators acting on enteric neurons and smooth muscle cells. Psychological stress may trigger this sensitive alarm system via the brain-gut axis.

  6. Beliefs and Attitudes to Bowel Cancer Screening in Patients with CKD: A Semistructured Interview Study.

    Science.gov (United States)

    James, Laura J; Wong, Germaine; Craig, Jonathan C; Ju, Angela; Williams, Narelle; Lim, Wai H; Cross, Nicholas; Tong, Allison

    2017-04-03

    Bowel cancer is a leading cause of cancer-related death in people with CKD. Shared decision making regarding cancer screening is particularly complex in CKD and requires an understanding of patients' values and priorities, which remain largely unknown. Our study aimed to describe the beliefs and attitudes to bowel cancer screening in patients with CKD. Face to face, semistructured interviews were conducted from April of 2014 to December of 2015 with 38 participants ages 39-78 years old with CKD stages 3-5, on dialysis, or transplant recipients from four renal units in Australia and New Zealand. Thematic analysis was used to analyze the transcripts. Five themes were identified: invisibility of cancer (unspoken stigma, ambiguity of risk, and absence of symptomatic prompting); prioritizing kidney disease (preserving the chance of transplantation, over-riding attention to kidney disease, protecting graft survival, and showing loyalty to the donor); preventing the crisis of cancer (evading severe consequences and cognizant of susceptibility); cognitive resistance (reluctance to perform a repulsive procedure, intensifying disease burden threshold, anxiety of a positive test, and accepting the inevitable); and pragmatic accessibility (negligible financial effect, convenience, and protecting anonymity). Patients with CKD understand the potential health benefits of bowel cancer screening, but they are primarily committed to their kidney health. Their decisions regarding screening revolve around their present health needs, priorities, and concerns. Explicit consideration of the potential practical and psychosocial burdens that bowel cancer screening may impose on patients in addition to kidney disease and current treatment is suggested to minimize decisional conflict and improve patient satisfaction and health care outcomes in CKD. Copyright © 2017 by the American Society of Nephrology.

  7. Perceived Threat and Internet Use Predict Intentions to Get Bowel Cancer Screening (Colonoscopy): Longitudinal Questionnaire Study.

    Science.gov (United States)

    Becker, Daniela; Grapendorf, Johannes; Greving, Hannah; Sassenberg, Kai

    2018-02-07

    Many people use the Internet for health-related information search, which is known to help regulate their emotional state. However, not much is known yet about how Web-based information search together with negative emotional states (ie, threat of cancer diagnosis) relate to preventive medical treatment decisions (ie, colonoscopy intentions). The aim of this study was to investigate how frequency of health-related Internet use together with perceived threat of a possible (bowel) cancer diagnosis influences intentions to get a colonoscopy. Previous research has shown that people who experience threat preferentially process positive information in an attempt to downregulate the aversive emotional state. The Internet can facilitate this regulatory strategy through allowing self-directed, unrestricted, and thus biased information search. In the context of threat regarding a possible bowel cancer diagnosis, feelings of threat can still be effectively reduced through cancer screening (ie, colonoscopy). We, therefore, predict that in that particular context, feelings of threat should be related to stronger colonoscopy intentions, and that this relationship should be enhanced for people who use the Internet often. A longitudinal questionnaire study was conducted among healthy participants who were approaching or just entering the bowel cancer risk group (aged 45-55 years). Perceived threat of a possible (bowel) cancer diagnosis, frequency of health-related Internet use, and intentions to have a colonoscopy were assessed at 2 time points (6-month time lag between the 2 measurement points T1 and T2). Multiple regression analyses were conducted to test whether threat and Internet use at T1 together predicted colonoscopy intentions at T2. In line with our predictions, we found that the threat of a possible (bowel) cancer diagnosis interacted with the frequency of Internet use (both T1) to predict colonoscopy intentions (T2; B=.23, standard error [SE]=0.09, P=.01). For people

  8. A global perspective on irritable bowel syndrome: a consensus statement of the World Gastroenterology Organisation Summit Task Force on irritable bowel syndrome.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2012-08-15

    Irritable bowel syndrome (IBS) is common in western Europe and North America, and many aspects of its epidemiology, risk factors, and natural history have been described in these regions. Recent data suggest, however, that IBS is also common in the rest of the world and there has been some evidence to suggest some differences in demographics and presenting features between IBS in the west and as it is experienced elsewhere. The World Gastroenterology Organization, therefore, established a Task Force comprising experts on the topic from all parts of the world to examine IBS from a global perspective. IBS does, indeed, seem to be common worldwide though with some significant variations in prevalence rates between regions and countries and there may well be some potentially interesting variations in presenting symptoms and sex distribution. The global map of IBS is far from complete; community-based prevalence data is not available from many areas. Furthermore, while some general trends are evident in terms of IBS impact and demographics, international comparisons are hampered by differences in diagnostic criteria, study location and methodology; several important unanswered questions have been identified that should form the basis for future collaborative research and have the potential to shed light on this challenging disorder.

  9. Indications and techniques for bowel preparation in colorectal cancer.

    Science.gov (United States)

    Keighley, M R; Lee, J R; Ambrose, N S

    1983-01-01

    A satisfactory bowel preparation is essential for adequate double contrast barium enema and colonoscopy. Efficient preparation is also important for reducing the risk of anastomotic dehiscence and sepsis in elective colorectal surgery. Traditional preparation by starvation, purgation and enemas is time consuming, unpleasant for patients, and in our experience results in a satisfactory preparation in only 23% of patients. Elemental diets are inefficient when used for only five days. Whole bowel irrigation with a nasogastric tube enables patients to be in hospital for only one day before operation and provides a satisfactory result in 61% of patients. Whole bowel irrigation is not recommended for stenosing tumours. Irrigation with saline causes sodium and water retention and the use of a balanced electrolyte solution (eg, Ringer's lactate) reduces the risk of these side effects. Oral mannitol has become popular but in our experience results in a satisfactory preparation in only 41% of patients. Mannitol is fermented by E coli to potentially explosive gas mixtures unless oral antimicrobials (neomycin and metronidazole) are used immediately before operation. Polyethylene glycol also causes osmotic catharsis without the risk of explosion. We currently favour nasogastric irrigation with polyethylene glycol and a balanced electrolyte solution, but there is still a place for traditional preparation over five days for patients with stenosing tumours of the left colon.

  10. Does digestibility of meat protein help explain large bowel cancer risk?

    Science.gov (United States)

    Silvester, K R; Cummings, J H

    1995-01-01

    An association between meat eating and large bowel cancer risk has been shown in a variety of epidemiologic studies. One reason could be that meat is less well digested than other protein foods and leads to greater amounts of protein entering the large bowel and being metabolized by colonic bacteria to potential carcinogens. To test this hypothesis, five subjects with ileostomies were fed, for five days, a basal diet to which were added test meals of cheese, a small or a large fried beef steak, and a large steak with resistant starch (RS). Ileal true nitrogen digestibility was similar for all five diets: control, 86.3%; cheese, 89.4%; low beef, 88.6%; high beef, 89.6%; and high beef + RS, 88.7%. Beef, at both low and high intake levels, was as well digested as cheese, suggesting that poor digestibility of meat does not explain the association between meat intake and large bowel cancer risk. Ileal starch output on the high beef + RS diet was 27% greater than expected on the basis of the measurement of dietary RS in vitro (p = 0.005 for linear trend), and this was confirmed by a meta analysis with eight other published studies. The relation between meat and large bowel cancer may reflect higher protein intakes in meat eaters or may be explained by other mechanisms.

  11. Effect of pelvic radiotherapy for prostrate cancer on bowel, bladder and sexual functions

    International Nuclear Information System (INIS)

    Saif-ur-Rahman; Ali, N.

    2002-01-01

    Objective: To study the effects of pelvic radiotherapy for prostate cancer on sexual, bowel and urinary functions. Study Design: a prospective cohort study. Place and duration of study: The study was conducted at Shaukat Khanum Memorial Cancer Hospital, Lahore from July 1998 to January 2000. Patients and Method: This study included 52 patients with diagnosis of prostate cancer who were given external beam pelvic radiotherapy. The effects of pelvic radiotherapy on their sexual, bowel and bladder functions were calculated at 6, 12 and 18 months and mean composite scores for each entity were examined. Results: Decrease in sexual function (up to 35%) was most significant observation followed by bowel dysfunction (10-12%). Bladder function deranged early during radiotherapy but there was no remarkable bladder dysfunction, overall a good proportion of patients (70 - 72%) felt satisfied with their treatment by external beam radiotherapy. By lapse of time there was gradual worsening of erectile function especially after a couple of months of pelvic radiotherapy, while bowel and bladder functions improved 8-12 months post radiotherapy. Conclusion: Proper counselling of patients regarding potential side effects of pelvic radiotherapy can make them understand the outcome of treatment. (author)

  12. Efficacy and Safety of Antidepressants for the Treatment of Irritable Bowel Syndrome: A Meta-Analysis

    Science.gov (United States)

    Wang, Yunfeng; Yu, Ting; Wang, Yun; Jiang, Liuqin; Lin, Lin

    2015-01-01

    Aim The aim of this meta-analysis was to analyze the efficacy and safety of antidepressants for the treatment of irritable bowel syndrome. Methods We searched MEDLINE, EMBASE, Scopus and The Cochrane Library for randomized controlled trials investigating the efficacy and safety of antidepressants in the treatment of irritable bowel syndrome. Article quality was evaluated by Jadad score. RevMan 5.0 and Stata 12.0 were used for the meta-analysis. Results Twelve randomized controlled trials were included in this study and most of these trials were of high quality (Jadad score ≥4). Five articles focused on tricyclic antidepressants, six articles involved selective serotonin reuptake inhibitors, and one article investigated both types of treatment. The pooled risk ratio showed antidepressant treatment can improve global symptoms (RR = 1.38, 95% CI 1.08, 1.77). In the subgroup analysis, treatment with tricyclic antidepressants showed an improvement in global symptoms (RR = 1.36, 95% CI 1.07, 1.71), while treatment with selective serotonin reuptake inhibitors showed no statistically significant difference in global symptoms compared with the control groups (RR = 1.38, 95% CI 0.83, 2.28). The pooled risk ratio of dropout due to side effects following antidepressant treatment was 1.71 with 95% CI (0.98, 2.99). The subgroup analysis showed the pooled risk ratio of dropout in the tricyclic antidepressants group was 1.92 with 95% CI (0.89, 4.17). In the selective serotonin reuptake inhibitors group, the pooled risk ratio of dropout was 1.5 with 95% CI (0.67, 3.37). Selective serotonin reuptake inhibitors showed no benefit in alleviating abdominal pain and improving quality of life. There was no difference in the incidence of common adverse events between treatment and control groups. Conclusions TCAs can improve global symptoms of irritable bowel syndrome, while there was no strong evidence to confirm the effectiveness of SSRIs for the treatment of IBS. PMID:26252008

  13. Efficacy and Safety of Antidepressants for the Treatment of Irritable Bowel Syndrome: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Chen Xie

    Full Text Available The aim of this meta-analysis was to analyze the efficacy and safety of antidepressants for the treatment of irritable bowel syndrome.We searched MEDLINE, EMBASE, Scopus and The Cochrane Library for randomized controlled trials investigating the efficacy and safety of antidepressants in the treatment of irritable bowel syndrome. Article quality was evaluated by Jadad score. RevMan 5.0 and Stata 12.0 were used for the meta-analysis.Twelve randomized controlled trials were included in this study and most of these trials were of high quality (Jadad score ≥4. Five articles focused on tricyclic antidepressants, six articles involved selective serotonin reuptake inhibitors, and one article investigated both types of treatment. The pooled risk ratio showed antidepressant treatment can improve global symptoms (RR = 1.38, 95% CI 1.08, 1.77. In the subgroup analysis, treatment with tricyclic antidepressants showed an improvement in global symptoms (RR = 1.36, 95% CI 1.07, 1.71, while treatment with selective serotonin reuptake inhibitors showed no statistically significant difference in global symptoms compared with the control groups (RR = 1.38, 95% CI 0.83, 2.28. The pooled risk ratio of dropout due to side effects following antidepressant treatment was 1.71 with 95% CI (0.98, 2.99. The subgroup analysis showed the pooled risk ratio of dropout in the tricyclic antidepressants group was 1.92 with 95% CI (0.89, 4.17. In the selective serotonin reuptake inhibitors group, the pooled risk ratio of dropout was 1.5 with 95% CI (0.67, 3.37. Selective serotonin reuptake inhibitors showed no benefit in alleviating abdominal pain and improving quality of life. There was no difference in the incidence of common adverse events between treatment and control groups.TCAs can improve global symptoms of irritable bowel syndrome, while there was no strong evidence to confirm the effectiveness of SSRIs for the treatment of IBS.

  14. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis

    Science.gov (United States)

    Didari, Tina; Mozaffari, Shilan; Nikfar, Shekoufeh; Abdollahi, Mohammad

    2015-01-01

    AIM: To investigate the efficacy of probiotics in irritable bowel syndrome (IBS) patients. METHODS: PubMed, Cochrane library, Scopus, Google Scholar, and Clinicaltrial.gov databases were searched for literature published between September 2007 and December 2013. The applied Mesh terms were “probiotics,” “irritable bowel syndrome,” and “irritable bowel syndrome treatment.” The collected data contained24 clinical trials, of which 15 were eligible for meta-analysis and nine were reviewed systematically. All studies were randomized placebo-controlled trials in patients with IBS that investigated the efficacy of probiotics in IBS improvement. The Jadad score was used to assess the methodological quality of trials. The quality scale ranges from 0 to 5 points, with a score ≤ 2 indicating a low quality report, and a score of ≥ 3 indicating a high quality report. Relative risk (RR), standardized effect size, and 95%CI were calculated using the DerSimonian-Laird method. The Cochran Q test was used to test heterogeneity with P probiotics to placebo was 1.96 (95%CI: 1.14-3.36; P = 0.01). RR of responders to therapies based on a global symptom score in IBS patients for two included trials comparing probiotics with placebo was 2.43 (95%CI: 1.13-5.21; P = 0.02). For adequate improvement of general symptoms in IBS patients, the RR of seven included trials (six studies) comparing probiotics with placebo was 2.14 (95%CI: 1.08-4.26; P = 0.03). Distension, bloating, and flatulence were evaluated using an IBS severity scoring system in three trials (two studies) to compare the effect of probiotic therapy in IBS patients with placebo, the standardized effect size of mean differences for probiotics therapy was -2.57 (95%CI: -13.05--7.92). CONCLUSION: Probiotics reduce pain and symptom severity scores. The results demonstrate the beneficial effects of probiotics in IBS patients in comparison with placebo. PMID:25780308

  15. A Study on the Relationship between Dietary Patterns and Prevalence of Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    O. Sadeghi

    2015-10-01

    Full Text Available Introduction & Objective: Although several dietary factors have been reported to alleviate or ag-gravate the symptoms of irritable bowel syndrome (IBS, no information is available linking dietary patterns to irritable bowel syndrome. Objective: This study was undertaken to assess the association between dietary patterns and the risk of irritable bowel syndrome among Ira-nian adults. Materials & Methods: In this cross-sectional study, data on 3846 Iranian general adults working in 50 different health centers were examined. Dietary intake of the participants was assessed using a 106-item self-administered Dish-based Semi-quantitative Food Frequency Question-naire (DS-FFQ which was designed and validated specifically for Iranian adults. A modified Persian version of the Rome III questionnaire was used for assessment of FGIDs, including IBS, which was defined according to ROME III criteria. To identify major dietary patterns based on the 39 food groups, we used principal component analysis. Results: We identified four major dietary patterns: 1 “fast food” dietary pattern; 2 “tradi-tional” dietary pattern; 3 “lacto-vegetarian” dietary pattern; 4 “western” dietary pattern. Af-ter adjustment for potential confounders, we found that those in the highest quartile of “fast food” dietary pattern tended to have higher risk of IBS than those in the lowest quartile (1.32; 0.99, 1.75, Ptrend=0.05. An inverse association was found between “lacto-vegetarian” die-tary pattern and risk of IBS; such that even after adjustment for potential confounders, those in top quartile of this dietary pattern were 24% less likely to have IBS (0.76; 0.59, 0.98; Ptrend=0.02. No overall significant associations were observed between “traditional” and “western” dietary patterns and risk of IBS, either before or after adjustment for covariates. Conclusion: We found that “lacto-vegetarian” dietary pattern was associated with reduced risk , while

  16. Distribution of residual cancer cells in the bowel wall after neoadjuvant chemoradiation in patients with rectal cancer.

    Science.gov (United States)

    Duldulao, Marjun P; Lee, Wendy; Streja, Leanne; Chu, Peiguo; Li, Wenyan; Chen, Zhenbin; Kim, Joseph; Garcia-Aguilar, Julio

    2013-02-01

    The standard treatment for locally advanced rectal cancer is preoperative chemoradiation and total mesorectal excision. After surgery, tumors are classified according to the depth of tumor invasion, nodal involvement, and tumor regression grade. However, these staging systems do not provide information about the distribution of residual cancer cells within the bowel wall. This study aimed to determine the distribution of residual cancer cells in each layer of the bowel wall in rectal cancer specimens. This was a secondary analysis of data from a prospective phase II study. This study was performed in a multi-institutional setting. Included were 153 patients with stage II or stage III rectal cancer. Patients were treated with chemoradiation and surgery. The surgical specimen tumor tissue was analyzed, and the distribution of residual cancer cells in each layer of the bowel wall was determined. Statistical analysis was used to examine the correlation of residual cancer cells in each layer of the bowel wall with the clinical/pathologic stage and tumor regression grade. Forty-two of 153 (27%) patients had complete response in the bowel wall (ypT0). Of the remaining 111 patients who had residual cancer cells, 5 (3%) were ypTis, 12 (8%) were ypT1, 41 (27%) were ypT2, 50 (33%) were ypT3, and 3 (2%) were ypT4. Of the 94 patients with ypT2-4 tumors, 12 (13%) had cancer cells in the mucosa, and 53 (56%) had cancer cells in the submucosa; 92 (98%) had cancer cells in the muscularis propria. Pretreatment cT correlated with the distribution of residual cancer cells. Tumor regression grade was not associated with the distribution of residual cancer cells after chemoradiation. : Patients received different chemotherapy regimens. Residual cancer cells in rectal cancer specimens after chemoradiation are preferentially located close to the invasive front. This should be considered when designing strategies to diagnose complete pathologic response and when investigating the

  17. Corticotropin-releasing hormone receptor 1 gene variants in irritable bowel syndrome.

    Directory of Open Access Journals (Sweden)

    Naoko Sato

    Full Text Available BACKGROUND: Corticotropin-releasing hormone (CRH acts mainly via the CRH receptor 1 (CRH-R1 and plays a crucial role in the stress-induced pathophysiology of irritable bowel syndrome (IBS. Several studies have demonstrated that variants of the CRH-R1 gene carry a potential risk for depression, but evidence for an association between CRH-R1 genotypes and IBS is lacking. We tested the hypothesis that genetic polymorphisms and haplotypes of CRH-R1 moderate the IBS phenotype and negative emotion in IBS patients. METHODS: A total of 103 patients with IBS and 142 healthy controls participated in the study. Three single-nucleotide polymorphisms of the CRH-R1 gene (rs7209436, rs242924, and rs110402 were genotyped. Subjects' emotional states were evaluated using the Perceived-Stress Scale, the State-Trait Anxiety Inventory, and the Self-rating Depression Scale. RESULTS: The TT genotype of rs7209436 (P = 0.01 and rs242924 (P = 0.02 was significantly more common in patients with IBS than in controls. Total sample analysis showed significant association between bowel pattern (normal, diarrhea, constipation, or mixed symptoms and the T allele of rs7209436 (P = 0.008, T allele of rs242924 (P = 0.019, A allele of rs110402 (P = 0.047, and TAT haplocopies (P = 0.048. Negative emotion was not associated with the examined CRH-R1 SNPs. CONCLUSION: These findings suggest that genetic polymorphisms and the CRH-R1 haplotypes moderate IBS and related bowel patterns. There was no clear association between CRH-R1 genotypes and negative emotion accompanying IBS. Further studies on the CRH system are therefore warranted.

  18. Exogenous Cushing syndrome

    Science.gov (United States)

    ... syndrome occurs when a person takes man-made (synthetic) glucocorticoid medicines to treat a disease. Glucocorticoids are given for many diseases, such as lung diseases, skin conditions, inflammatory bowel disease, cancer, brain tumors, and ...

  19. Effects of an irritable bowel syndrome educational class on health-promoting behaviors and symptoms.

    Science.gov (United States)

    Colwell, L J; Prather, C M; Phillips, S F; Zinsmeister, A R

    1998-06-01

    The degree to which patient education in the areas of diet, exercise, and stress management can improve symptoms of irritable bowel syndrome (IBS) through healthier lifestyle behaviors is unknown. The aim of this study was to determine the effects of outpatient education on the short and long term outcomes, and the association between health-promoting behaviors and symptoms. Pender's Health Promotion Model provided the theoretical framework. The study had a prospective longitudinal design. A consecutive sample of 52 adult outpatients with IBS attended a structured class that taught health-promoting modifications of lifestyle. Participants completed the Health-Promoting Lifestyle Profile (HPLP) and selected items from a Bowel Disease Questionnaire (BDQ) before the class and 1 month and 6 months later. Spearman rank correlations were used to assess the association between HPLP and symptom scores. Wilcoxon rank sum tests compared changes in scores versus their baseline values. Response rates at 1 and 6 months were 75% and 83%, respectively. Results revealed significant 1- and 6 month-improvements in pain and Manning symptoms (p health-promoting behaviors. However, relationships among specific behaviors and specific symptoms did not consistently correspond with this improvement.

  20. [Comparative study on irritable bowel syndrome treated with acupuncture and western medicine].

    Science.gov (United States)

    Shi, Zhi-Min; Zhu, Ye-Shan; Wang, Qing-Xian; Lei, Miao-Na

    2011-07-01

    To compare the differences in the therapeutic effect on irritable bowel syndrome (IBS) between acupuncture at Tianshu (ST 25) and Dachangshu (BL 25) and western medication with Trimebutine Maleate. Forty cases were divided randomly into an acupuncture group and a western medication group, 20 cases in each one. In acupuncture group, acupuncture was applied to Tianshu (ST 25) and Dachangshu (BL 25). Ziwu Daojiu needling technique was adopted, once daily. In western medication group, Trimebutine Maleate capsule was administered, 2 capsules in each time, 3 times per day. The assessment on the therapeutic effect was performed in 4 weeks of treatment in two groups. As compared with those before treatment, the time of abdominal pain, the frequency of abdominal pain, the morbidity of abnormal stool appearance, the morbidity of defecation abnormality, the morbidity of mucus stool and the score of bloating or abdominal pain on bowel movement were all reduced after treatment in two groups (all P acupuncture group were much more significant than those in western medication group (the total score: 16.70 +/- 2.40 vs 15.70 +/- 3.01, P acupuncture group was 95.0% (19/20), which was superior to that of 70.0% (14/20) in western medication group (P Acupuncture at Tianshu (ST 25) and Dachangshu (BL 25) may remarkably relieve the clinical symptoms of IBS and its efficacy is superior to that of oral medication with Trimebutine Maleate.

  1. Involvement of Corticotropin-Releasing Factor and Receptors in Immune Cells in Irritable Bowel Syndrome.

    Science.gov (United States)

    Chatoo, Mahanand; Li, Yi; Ma, Zhiqiang; Coote, John; Du, Jizeng; Chen, Xuequn

    2018-01-01

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder defined by ROME IV criteria as pain in the lower abdominal region, which is associated with altered bowel habit or defecation. The underlying mechanism of IBS is not completely understood. IBS seems to be a product of interactions between various factors with genetics, dietary/intestinal microbiota, low-grade inflammation, and stress playing a key role in the pathogenesis of this disease. The crosstalk between the immune system and stress in IBS mechanism is increasingly recognized. Corticotropin-releasing factor (CRF), a major mediator in the stress response, is involved in altered function in GI, including inflammatory processes, colonic transit time, contractile activity, defecation pattern, pain threshold, mucosal secretory function, and barrier functions. This mini review focuses on the recently establish local GI-CRF system, its involvement in modulating the immune response in IBS, and summarizes current IBS animal models and mapping of CRF, CRFR1, and CRFR2 expression in colon tissues. CRF and receptors might be a key molecule involving the immune and movement function via brain-gut axis in IBS.

  2. Involvement of Corticotropin-Releasing Factor and Receptors in Immune Cells in Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Mahanand Chatoo

    2018-02-01

    Full Text Available Irritable bowel syndrome (IBS is a common functional gastrointestinal disorder defined by ROME IV criteria as pain in the lower abdominal region, which is associated with altered bowel habit or defecation. The underlying mechanism of IBS is not completely understood. IBS seems to be a product of interactions between various factors with genetics, dietary/intestinal microbiota, low-grade inflammation, and stress playing a key role in the pathogenesis of this disease. The crosstalk between the immune system and stress in IBS mechanism is increasingly recognized. Corticotropin-releasing factor (CRF, a major mediator in the stress response, is involved in altered function in GI, including inflammatory processes, colonic transit time, contractile activity, defecation pattern, pain threshold, mucosal secretory function, and barrier functions. This mini review focuses on the recently establish local GI-CRF system, its involvement in modulating the immune response in IBS, and summarizes current IBS animal models and mapping of CRF, CRFR1, and CRFR2 expression in colon tissues. CRF and receptors might be a key molecule involving the immune and movement function via brain–gut axis in IBS.

  3. Mechanisms Underlying the Analgesic Effect of Moxibustion on Visceral Pain in Irritable Bowel Syndrome: A Review

    Directory of Open Access Journals (Sweden)

    Renjia Huang

    2014-01-01

    Full Text Available Irritable bowel syndrome (IBS is a functional bowel disorder that causes recurrent abdominal (visceral pain. Epidemiological data show that the incidence rate of IBS is as high as 25%. Most of the medications may lead to tolerance, addiction and toxic side effects. Moxibustion is an important component of traditional Chinese medicine and has been used to treat IBS-like abdominal pain for several thousand years in China. As a mild treatment, moxibustion has been widely applied in clinical treatment of visceral pain in IBS. In recent years, it has played an irreplaceable role in alternative medicine. Extensive clinical studies have demonstrated that moxibustion for treatment of visceral pain is simple, convenient, and inexpensive, and it is being accepted by an increasing number of patients. There have not been many studies investigating the analgesic mechanisms of moxibustion. Studies exploring the analgesic mechanisms have mainly focused on visceral hypersensitivity, brain-gut axis neuroendocrine system, and immune system. This paper reviews the latest developments in moxibustion use for treatment of visceral pain in IBS from these perspectives. It also evaluates potential problems in relevant studies on the mechanisms of moxibustion therapy to promote the application of moxibustion in the treatment of IBS.

  4. Extensive Intestinal Resection Triggers Behavioral Adaptation, Intestinal Remodeling and Microbiota Transition in Short Bowel Syndrome

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    Camille Mayeur

    2016-03-01

    Full Text Available Extensive resection of small bowel often leads to short bowel syndrome (SBS. SBS patients develop clinical mal-absorption and dehydration relative to the reduction of absorptive area, acceleration of gastrointestinal transit time and modifications of the gastrointestinal intra-luminal environment. As a consequence of severe mal-absorption, patients require parenteral nutrition (PN. In adults, the overall adaptation following intestinal resection includes spontaneous and complex compensatory processes such as hyperphagia, mucosal remodeling of the remaining part of the intestine and major modifications of the microbiota. SBS patients, with colon in continuity, harbor a specific fecal microbiota that we called “lactobiota” because it is enriched in the Lactobacillus/Leuconostoc group and depleted in anaerobic micro-organisms (especially Clostridium and Bacteroides. In some patients, the lactobiota-driven fermentative activities lead to an accumulation of fecal d/l-lactates and an increased risk of d-encephalopathy. Better knowledge of clinical parameters and lactobiota characteristics has made it possible to stratify patients and define group at risk for d-encephalopathy crises.

  5. Acupuncture-moxibustion in treating irritable bowel syndrome: how does it work?

    Science.gov (United States)

    Ma, Xiao-Peng; Hong, Jue; An, Cai-Ping; Zhang, Dan; Huang, Yan; Wu, Huan-Gan; Zhang, Cui-Hong; Meeuwsen, Sian

    2014-05-28

    Irritable bowel syndrome (IBS) is a functional intestinal disease characterized by abdominal pain or discomfort and altered bowel habits. It has drawn great attention because of its high prevalence, reoccurring symptoms, and severe influence on patients' lives. Many clinical studies have demonstrated the efficacy of acupuncture-moxibustion in treating IBS. Increasing attention has been paid to research regarding the action mechanisms of acupuncture-moxibustion for IBS, and the adoption of modern techniques has achieved some progress. This article reviews the latest advances among action mechanism studies from the perspectives of gastrointestinal motility, visceral hypersensitivity, the brain-gut axis, the neuroendocrine system, and the immune system. It is shown that acupuncture-moxibustion can effectively regulate the above items, and thus, this treatment should have a high efficacy in the treatment of IBS. This article also identifies existing problems in current mechanism research and raises several ideas for future studies. Further revelations regarding these action mechanisms will promote the application of acupuncture-moxibustion in treating IBS.

  6. [Probiotic supplement (Lactobacillus acidophilus and bulgaricus) utility in the treatment of irritable bowel syndrome].

    Science.gov (United States)

    Diaz Ferrer, Javier; Parra, Victor; Bendaño, Teofilo; Montes, Pedro; Solorzano, Paola

    2012-01-01

    Irritable bowel syndrome (IBS) is a very common functional condition and a frequent cause of consultation in gastroenterology. With a multifactorial pathophysiology IBS is characterized by abdominal pain, distension and altered bowel habits. Loperamide, antispasmodics and antidepressants are symptomatic relievers of this disorder. Recently probiotics were incorporated to therapy, and could improve the symptomatology. multicenter randomized placebo-controlled trial that included IBS patients, diagnosed with Rome III criteria. The patients were given pinaverium bromure and placebo or pinaverium bromure and probiotics for 3 weeks. The intensity of symptoms and the effect of therapy were evaluated with the Francis Score, before and after the treatment. Statistics were done with SPSS 12.0 (C.I 95%). 51 patients were evaluated, with an average age of 43 years old, mostly mestizo, 75% (38) married and 55% (28) female. There were statistical differences in four variables: abdominal pain, intensity of pain, days of pain and total score at the end of therapy. Probiotics used as supplement are effective in improving symptomatology of IBS.

  7. Bowel exposure in rectal cancer IMRT using prone, supine, or a belly board.

    Science.gov (United States)

    Nijkamp, Jasper; Doodeman, Barry; Marijnen, Corrie; Vincent, Andrew; van Vliet-Vroegindeweij, Corine

    2012-01-01

    To investigate bowel exposure using prone, supine, or two different belly boards for rectal cancer intensity modulated RT plans using a full bladder protocol. For 11 volunteers four MR scans were acquired, on a flat table in prone, supine, and on two different belly boards (IT-V Medizintechnik GmbH® (BB1) and CIVCO® (BB2)), using a full bladder protocol. On each scan a 25×2 Gy IMRT plan was calculated. BB2 led to an average bowel area volume reduction of 20-30% at any dose level compared to prone. BB1 showed a smaller dose reduction effect, while no differences between prone and supine were found. Differences between BB2 and prone, supine or BB1 were significant up to a level of respectively, 45, 35, and 30 Gy. The reducing effect varied among individuals, except for the 50 Gy region, where no effect was found. An increase in bladder volume of 100 cc led to a significant bowel area V15 reduction of 16% independent of scan type. In the low and intermediate dose region a belly board still attributes to a significant bowel dose reduction when using IMRT and a full bladder protocol. A larger bladder volume resulted in a significant decreased bowel area dose. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. The metabolic syndrome in cancer survivors

    NARCIS (Netherlands)

    de Haas, Esther C.; Oosting, Sjoukje F.; Lefrandt, Joop D.; Wolffenbuttel, Bruce H. R.; Sleijfer, Dirk Th; Gietema, Jourik A.

    The metabolic syndrome, as a cluster of cardiovascular risk factors, may represent an important connection between cancer treatment and its common late effect of cardiovascular disease. Insight into the aetiology of the metabolic syndrome after cancer treatment might help to identify and treat

  9. Use of azathioprine and the risk of cancer in inflammatory bowel disease.

    Science.gov (United States)

    Pasternak, Björn; Svanström, Henrik; Schmiegelow, Kjeld; Jess, Tine; Hviid, Anders

    2013-06-01

    Increased risks of lymphoma and skin cancer associated with thiopurine use among patients with inflammatory bowel disease have been shown, but data on the overall cancer risk are limited. We conducted a historical cohort study of 45,986 patients with inflammatory bowel disease (of whom, 5,197 (11%) used azathioprine) in Denmark from 1997 to 2008. We linked registry data on filled drug prescriptions, cancer diagnoses, and covariates and compared rates of overall incident cancer and cancer subgroups between users and nonusers of azathioprine, adjusting for propensity scores. During a median 7.9 (interquartile range: 3.5-12.0) person-years of follow-up, 2,596 incident cases of cancer were detected. Azathioprine use was associated with an increased risk of overall cancer (rate ratio = 1.41, 95% confidence interval: 1.15, 1.74), whereas former use of azathioprine (rate ratio = 1.02, 95% confidence interval: 0.83, 1.25) or increasing cumulative received doses (increase in rate ratio per 365 additional defined daily doses = 1.06, 95% confidence interval: 0.89, 1.27) were not. In subgroup analyses, azathioprine use was associated with increased risk of lymphoid tissue cancer (rate ratio = 2.40, 95% confidence interval: 1.13, 5.11) and urinary tract cancer (rate ratio = 2.84, 95% confidence interval: 1.24, 6.51). In conclusion, azathioprine use was associated with an increased risk of overall cancer in patients with inflammatory bowel disease, although these data cannot establish causality.

  10. Patients' bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer.

    Science.gov (United States)

    Landers, Margaret; McCarthy, Geraldine; Livingstone, Vicki; Savage, Eileen

    2014-08-01

    To investigate patients' bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer and the relationship between bowel symptom experiences and the self-care strategies used. Earlier diagnosis of rectal cancer allows for less invasive surgical treatments such as sphincter-saving procedures to be performed. Although a permanent stoma is generally not required, patients experience changes in bowel function following this surgery. However, limited research exists on patients' bowel symptom experiences and the self-care strategies used to manage symptoms following sphincter-saving surgery of rectal cancer. Quantitative descriptive correlational. A convenience sample of 143 patients aged 30 to over 70 years was used. Data were collected (April 2010-December 2010) using the Illness Perception Questionnaires, the Difficulties of Life Scale and a researcher developed Self-care Strategy Measure. The research was underpinned by the Symptom Management Theory. Relating to the four most effective self-care strategies used respondents reporting more bowel symptom were more likely to use the self-care strategy proximity/knowing the location of a toilet at all times. Females, respondents with high timeline cyclical scores and respondents with high physiological responses scores were more likely to use protective clothing. Respondents reporting more bowel symptom and with high social responses scores were more likely to use bowel medication. Females were more likely to wear incontinence pads. This research provides insights into the daily bowel symptom experiences of patients following sphincter-saving surgery for rectal cancer. It demonstrates the range of self-care strategies that individuals use to manage their bowel symptoms and the self-care-strategies that were most effective for them. Patients should be encouraged to report on-going bowel problems following sphincter-saving surgery for rectal cancer. Supportive care for patients

  11. Using eHealth strategies in delivering dietary and other therapies in patients with irritable bowel syndrome and inflammatory bowel disease

    DEFF Research Database (Denmark)

    Ankersen, Dorit Vedel; Carlsen, Katrine; Marker, Dorte

    2017-01-01

    in a traffic light system and empower patients to screen for disease activity, enabling them to respond appropriately to their symptoms. The eHealth screening procedure for monitoring both pediatric and adult IBD patients is based on a self-obtained symptom score, together with a fecal biomarker...... for inflammation (fecal calprotectin) that the patients can measure independently using their smart phone, providing both patient and physician with an immediate disease status that they can react to instantaneously. Likewise, web applications for IBD patients, web applications for irritable bowel syndrome (IBS...

  12. Disability in Children and Adolescents With Irritable Bowel Syndrome and/or Fibromyalgia.

    Science.gov (United States)

    Otu-Nyarko, Charles G; Gedalia, Abraham; Karpinski, Aryn C; Kolomensky, Andrew; Hyman, Paul E

    2015-11-01

    To compare disability and emotional health in individuals with irritable bowel syndrome (IBS), fibromyalgia, or both, patients completed the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III, childhood Functional Disability Inventory (FDI), and the Behavior Assessment System for Children, Second Edition. Patients' (age range 8-18 years, 19 IBS, 12 fibromyalgia, and 12 both) FDI scores showed greater disability than scores from historically healthy patients. Fibromyalgia (FDI 22.5 ± 12.7, P = 0.018) and patients with both (FDI 26.2 ± 13.8, P = 0.001) averaged greater disability than those with IBS (FDI 10.6 ± 7.9). Disability was correlated with anxiety and depression symptoms. Disability and psychological symptoms are important when evaluating individuals with fibromyalgia and IBS.

  13. Food intolerance and skin prick test in treated and untreated irritable bowel syndrome

    Science.gov (United States)

    Jun, Dae-Won; Lee, Oh-Young; Yoon, Ho-Joo; Lee, Seok-Hwa; Lee, Hang-Lak; Choi, Ho-Soon; Yoon, Byung-Chul; Lee, Min-Ho; Lee, Dong-Hoo; Cho, Sang-Hoen

    2006-01-01

    AIM: To correlate the clinical features of treated and untreated patients with irritable bowel syndrome (IBS) to the results of skin prick test (SPT) for food and inhalant allergens. METHODS: We recruited 105 subjects to form three different target groups: treated group (n = 44) undergoing treatment for IBS, untreated group (n = 31) meeting the Rome II criteria without treatment for IBS, control group (n = 30) with no IBS symptoms. RESULTS: SPT results were different among the three groups in which SPT was positive in 17 (38.6%) treated patients, in 5 (16.1%) untreated patients and in 1 (3.3%) control (P food SPTs was higher in the treated IBS group than in the untreated IBS group (P = 0.03). CONCLUSION: Positive food SPT is higher in IBS patients than in controls. PMID:16688829

  14. Low internal radiation alters innate immune status in children with clinical symptom of irritable bowel syndrome.

    Science.gov (United States)

    Sheikh Sajjadieh, Mohammad Reza; Kuznetsova, L V; Bojenko, V B

    2010-09-01

    Adverse health effect of low radiation is clear. The aim of this study was to determine effect of internal low radiation on innate immune status in Ukrainian children with spastic colitis as a result of Chernobyl disaster. The test population consisted of 95 participants: 75 rural participants with clinical symptom of irritable bowel syndrome, aged 4 to 18, who lived in a contaminated area exposed to radio nucleotide due to the disaster in reactor in Chernobyl nuclear power plant (categorized in three groups) and 20 healthy urban participants from Kiev, aged 5 to 15, as the control group. Internal radiation activity has been measured by gamma-ray spectrometry. Peripheral blood leukocytes were analyzed for CD16(+) subset, serum concentration of circulation immune complex was measured by the polyethylene glycol method. Phagocytic activity function was assessed by using latex article and phagocytic index were calculated. p control group (p control group (p control group (p reactor in Chernobyl nuclear power plant.

  15. Factors Associated With Response to Teduglutide in Patients With Short-Bowel Syndrome and Intestinal Failure

    DEFF Research Database (Denmark)

    Jeppesen, Palle Bekker; Gabe, Simon M; Seidner, Douglas L

    2018-01-01

    with intestinal failure, according to the European Society for Clinical Nutrition and Metabolism classification system, who received teduglutide or placebo between November 25, 2008, and January 4, 2011, at 27 sites in 10 countries. Changes in parenteral support volume were evaluated according to baseline......BACKGROUND & AIMS: Clinical studies showed teduglutide to increase urine production and reduce need for parenteral support volume in patients with short bowel syndrome (SBS) with intestinal failure, increasing intestinal wet weight absorption and reducing diarrhea. However, the effects...... simple linear regression models, with unadjusted r2values reported. Two-sided t tests were used for comparisons between treatment groups. RESULTS: We correlated parenteral support volume reduction with teduglutide treatment and baseline parenteral support volume (y = -0.3870x + 90.0279, r2 = 0.61; P...

  16. Eluxadoline in the treatment of diarrhea-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Özdener AE

    2017-09-01

    Full Text Available Ayşe Elif Özdener, Anastasia Rivkin School of Pharmacy and Health Sciences, Fairleigh Dickinson University, Florham Park, NJ, USA Abstract: Eluxadoline is a novel drug approved for the management of diarrhea predominant irritable bowel syndrome (IBS-D. It has unique pharmacology and works on three different opioid receptors. Several Phase II and III clinical trials have demonstrated eluxadoline’s efficacy in reducing symptoms related to IBS-D. Clinical trial results and postmarketing reports show a risk of pancreatitis in patients without a gallbladder or those abusing alcohol. This review article will include information on clinical trial results related to IBS-D management as well as eluxadoline’s limitations. Keywords: IBS-D, eluxadoline, diarrhea, gastrointestinal, Viberzi

  17. New approaches to the treatments of short bowel syndrome-associated intestinal failure

    DEFF Research Database (Denmark)

    Jeppesen, Palle B

    2014-01-01

    preceding the US Food and Drug Administration and the European Medicines Agency approval of subcutaneous teduglutide for this orphan condition. RECENT FINDINGS: In a 3-week, phase 2, metabolic balance study, teduglutide increased intestinal wet weight absorption by approximately 700 g/day and reduced fecal...... with the known mechanism of action. SUMMARY: Teduglutide will add incremental benefit to the limited medical treatment armamentarium in SBS patients by maximizing intestinal absorption, decreasing fecal losses, thereby decreasing or even eliminating the need for parenteral support. Future research should target......PURPOSE OF REVIEW: Teduglutide, a recombinant analog of human glucagon-like peptide 2, has recently been approved in the US and Europe (Gattex and Revestive, respectively) as the first targeted treatment of short bowel syndrome-associated intestinal failure (SBS-IF). Glucagon-like peptide 2...

  18. Role of negative affects in pathophysiology and clinical expression of irritable bowel syndrome.

    Science.gov (United States)

    Muscatello, Maria Rosaria A; Bruno, Antonio; Scimeca, Giuseppe; Pandolfo, Gianluca; Zoccali, Rocco A

    2014-06-28

    Irritable bowel syndrome (IBS) is regarded as a multifactorial disease in which alterations in the brain-gut axis signaling play a major role. The biopsychosocial model applied to the understanding of IBS pathophysiology assumes that psychosocial factors, interacting with peripheral/central neuroendocrine and immune changes, may induce symptoms of IBS, modulate symptom severity, influence illness experience and quality of life, and affect outcome. The present review focuses on the role of negative affects, including depression, anxiety, and anger, on pathogenesis and clinical expression of IBS. The potential role of the autonomic nervous system, stress-hormone system, and immune system in the pathophysiology of both negative affects and IBS are taken into account. Psychiatric comorbidity and subclinical variations in levels of depression, anxiety, and anger are further discussed in relation to the main pathophysiological and symptomatic correlates of IBS, such as sensorimotor functions, gut microbiota, inflammation/immunity, and symptom reporting.

  19. Efficacy and safety of PPC-5650 on experimental rectal pain in patients with irritable bowel syndrome

    DEFF Research Database (Denmark)

    Nielsen, Lecia Møller; Olesen, Anne Estrup; Andresen, Trine

    2015-01-01

    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...... bowel syndrome (IBS). In patients with IBS, the aims of the study were: (1) to assess the efficacy of a single bolus of PPC-5650 locally applied in the rectum using multi-modal stimulations of the recto sigmoid and (2) to assess the safety profile of PPC-5650. The study was a randomized, double...... to placebo. The overall safety and tolerability of PPC-5650 was acceptable....

  20. Characteristics of acute pain attacks in patients with irritable bowel syndrome meeting Rome III criteria

    DEFF Research Database (Denmark)

    Hellström, P.M.; Saito, Y.A.; Bytzer, P.

    2011-01-01

    the survey were women with a mean age of 41 years and time since IBS diagnosis of 5 years. The median pain attack frequency was 5.4 attacks per month and was significantly higher in the IBS with diarrhea (IBS-D, 6.4 per month) group vs. the IBS with constipation (4.4 per month) and the IBS with mixed pattern......Objectives: An international multicenter, prospective, non-interventional, 2-month study characterized acute pain attacks in patients with irritable bowel syndrome (IBS). Methods: Adult patients meeting the Rome III IBS diagnostic criteria with a history of 3 pain attacks per month participated...... in a survey that captured daily and episodic information regarding IBS symptoms and pain attacks for 2 months. Acute pain attacks were defined as a sudden onset or increase in the intensity of IBS abdominal pain with a minimum intensity of 4 (0-10 scale). Results: The majority (84%) of the 158 patients taking...

  1. Nurse-led hypnotherapy: an innovative approach to Irritable Bowel Syndrome.

    Science.gov (United States)

    Bremner, Helen

    2013-08-01

    Irritable Bowel Syndrome (IBS) is a common, chronic functional illness, which can greatly reduce patients' quality of life, and consumes healthcare resources. Standard treatments include dietary changes and medication, though these are often ineffective. Clinical studies of hypnotherapy demonstrate improvement in symptoms and quality of life in over 80% of subjects with intractable IBS. Our experience of a nurse-led hypnotherapy service for IBS in a community setting provides evidence of comparable efficacy for symptom control, improved quality of life, reduced dependence on medication and improved general health measures. We address the challenges of setting up and maintaining the service in a changing healthcare environment. This model of care could act as a template for providers of gastroenterology and functional disease services wishing to provide IBS care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Multicultural considerations in the diagnosis and management of irritable bowel syndrome: a selective summary.

    Science.gov (United States)

    Ballou, Sarah K; Keefer, Laurie

    2013-10-01

    Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that is characterized by chronic and recurrent abdominal symptoms with no associated organic abnormalities. Although IBS has traditionally been considered to be more common in western cultures, a review of the literature reveals that IBS is truly a worldwide illness, affecting people in many different cultural and geographic areas. According to this review, a reasonable range for the worldwide prevalence of IBS is between 5 and 15%. Several theories for varying prevalence rates around the world are presented in this paper and methodological difficulties are discussed. Finally, this short review provides an analysis of cultural, biological, and socioeconomic differences in IBS presentation and treatment around the world.

  3. Cognitive-behavioral hypnotherapy in the treatment of irritable-bowel-syndrome-induced agoraphobia.

    Science.gov (United States)

    Golden, William L

    2007-04-01

    There are a number of clinical reports and a body of research on the effectiveness of hypnotherapy in the treatment of irritable bowel syndrome (IBS). Likewise, there exists research demonstrating the efficacy of cognitive-behavioral therapy (CBT) in the treatment of IBS. However, there is little written about the integration of CBT and hypnotherapy in the treatment of IBS and a lack of clinical information about IBS-induced agoraphobia. This paper describes the etiology and treatment of IBS-induced agoraphobia. Cognitive, behavioral, and hypnotherapeutic techniques are integrated to provide an effective cognitive-behavioral hypnotherapy (CBH) treatment for IBS-induced agoraphobia. This CBH approach for treating IBS-induced agoraphobia is described and clinical data are reported.

  4. Gut hormones in the treatment of short-bowel syndrome and intestinal failure

    DEFF Research Database (Denmark)

    Jeppesen, Palle B

    2015-01-01

    PURPOSE OF REVIEW: The approval of teduglutide, a recombinant analog of human glucagon-like peptide (GLP) 2, by the US Food and Drug Administration (Gattex) and the European Medicines Agency (Revestive) has illustrated the potential of selected gut hormones as treatments in patients with short......-bowel syndrome and intestinal failure. Gut hormones may improve the structural and functional intestinal adaptation following intestinal resection by decreasing a rapid gastric emptying and hypersecretion, by increasing the intestinal blood flow, and by promoting intestinal growth. This review summarizes...... the findings from phase 2 and 3 teduglutide studies, and pilot studies employing GLP-1 and agonists for this orphan condition. RECENT FINDINGS: In a 3-week, phase 2, metabolic balance study, teduglutide increased the intestinal wet weight absorption by approximately 700 g/day and reduced fecal energy losses...

  5. What does irritable bowel syndrome share with non-alcoholic fatty liver disease?

    Science.gov (United States)

    Scalera, Antonella; Di Minno, Matteo Nicola Dario; Tarantino, Giovanni

    2013-09-07

    Non-alcoholic fatty liver disease (NAFLD) and irritable bowel syndrome (IBS) are two very common diseases in the general population. To date, there are no studies that highlight a direct link between NAFLD and IBS, but some recent reports have found an interesting correlation between obesity and IBS. A systematic PubMed database search was conducted highlighting that common mechanisms are involved in many of the local and systemic manifestations of NAFLD, leading to an increased cardiovascular risk, and IBS, leading to microbial dysbiosis, impaired intestinal barrier and altered intestinal motility. It is not known when considering local and systemic inflammation/immune system activation, which one has greater importance in NAFLD and IBS pathogenesis. Also, the nervous system is implicated. In fact, inflammation participates in the development of mood disorders, such as anxiety and depression, characteristics of obesity and consequently of NAFLD and, on the other hand, in intestinal hypersensitivity and dysmotility.

  6. The possible role of gastrointestinal endocrine cells in the pathophysiology of irritable bowel syndrome.

    Science.gov (United States)

    El-Salhy, Magdy; Hausken, Trygve; Gilja, Odd Helge; Hatlebakk, Jan Gunnar

    2017-02-01

    The etiology of irritable bowel syndrome (IBS) is unknown, but several factors appear to play a role in its pathophysiology, including abnormalities of the gastrointestinal endocrine cells. The present review illuminates the possible role of gastrointestinal hormones in the pathophysiology of IBS and the possibility of utilizing the current knowledge in treating the disease. Areas covered: Research into the intestinal endocrine cells and their possible role in the pathophysiology of IBS is discussed. Furthermore, the mechanisms underlying the abnormalities in the gastrointestinal endocrine cells in IBS patients are revealed. Expert commentary: The abnormalities observed in the gastrointestinal endocrine cells in IBS patients explains their visceral hypersensitivity, gastrointestinal dysmotility, and abnormal intestinal secretion, as well as the interchangeability of symptoms over time. Clarifying the role of the intestinal stem cells in the pathophysiology of IBS may lead to new treatment methods for IBS.

  7. Chemical and molecular factors in irritable bowel syndrome: current knowledge, challenges, and unanswered questions.

    Science.gov (United States)

    Camilleri, Michael; Oduyebo, Ibironke; Halawi, Houssam

    2016-11-01

    Several chemical and molecular factors in the intestine are reported to be altered and to have a potentially significant role in irritable bowel syndrome (IBS), particularly in IBS with diarrhea. These include bile acids; short-chain fatty acids; mucosal barrier proteins; mast cell products such as histamine, proteases, and tryptase; enteroendocrine cell products; and mucosal mRNAs, proteins, and microRNAs. This article reviews the current knowledge and unanswered questions in the pathobiology of the chemical and molecular factors in IBS. Evidence continues to point to significant roles in pathogenesis of these chemical and molecular mechanisms, which may therefore constitute potential targets for future research and therapy. However, it is still necessary to address the interaction between these factors in the gut and to appraise how they may influence hypervigilance in the central nervous system in patients with IBS. Copyright © 2016 the American Physiological Society.

  8. Hot Topics in Primary Care: Individualizing Pharmacologic Management of Irritable Bowel Syndrome.

    Science.gov (United States)

    Kuritzky, Louis

    2015-12-01

    Irritable bowel syndrome is a common gastrointestinal disorder with constipation, diarrhea, and mixed subtypes. The diagnosis is generally based on a detailed history utilizing the Rome III criteria. Alarm signals necessitate more extensive diagnostic evaluation. Nonpharmacologic options and over-the-counter remedies (e.g., loperamide) might not be supported by strong evidence, but are often chosen as initial treatment for their safety and tolerability. Psychological interventions may be beneficial. Newer pharmacologic agents such as alosetron, eluxadoline, linaclotide, lubiprostone, and rifaximin are supported by higher quality evidence than older agents such as antispasmodics and laxatives. Patients with IBS commonly report that clinicians offer insufficient empathy and validation of their symptoms. Physicians therefore should strive to improve communication methods that specifically provide such reassurance. Individualizing treatment based on patient values and preferences is essential.

  9. Gastrointestinal dysfunction in a community sample of subjects with symptoms of irritable bowel syndrome

    DEFF Research Database (Denmark)

    Lanng, Charlotte; Mortensen, Dennis; Friis, Merete

    2003-01-01

    BACKGROUND/AIM: Irritable bowel syndrome (IBS) affects about 15-20% of the population of the Western countries. Traditionally, IBS has been an exclusion diagnosis, but recently definitions have emerged from population-based research. The aim of this population-based study was to evaluate any...... evaluation. IBS was defined as more than weekly experience of abdominal pain and distension, and in addition either borborygmia or altering stool consistency. The diagnostic work-up consisted of gastroscopy, manometry and 23-hour pH and pressure recordings of the oesophagus, lactose tolerance test, barium...... enema, measurement of colonic transit time, and rectoscopy. RESULTS: Compared to the group without abdominal complaints significantly more subjects with IBS had spasms of the colon (OR = 10.2 (1.2-87.3)), and abnormal contractions of the oesophagus at manometry (OR = 9.1 (1.1-78.2)). Furthermore...

  10. Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome

    NARCIS (Netherlands)

    Kaiser, T; Langhorst, J; Wittkowski, H; Becker, K; Friedrich, A W; Rueffer, A; Dobos, G J; Roth, J; Foell, D

    2007-01-01

    OBJECTIVE: S100A12 is a pro-inflammatory protein that is secreted by granulocytes. S100A12 serum levels increase during inflammatory bowel disease (IBD). We performed the first study analysing faecal S100A12 in adults with signs of intestinal inflammation. METHODS: Faecal S100A12 was determined by

  11. Pharmacological Approach for Managing Pain in Irritable Bowel Syndrome: A Review Article

    Science.gov (United States)

    Chen, Longtu; Ilham, Sheikh J.; Feng, Bin

    2017-01-01

    Context Visceral pain is a leading symptom for patients with irritable bowel syndrome (IBS) that affects 10% - 20 % of the world population. Conventional pharmacological treatments to manage IBS-related visceral pain is unsatisfactory. Recently, medications have emerged to treat IBS patients by targeting the gastrointestinal (GI) tract and peripheral nerves to alleviate visceral pain while avoiding adverse effects on the central nervous system (CNS). Several investigational drugs for IBS also target the periphery with minimal CNS effects. Evidence of Acquisition In this paper, reputable internet databases from 1960 - 2016 were searched including Pubmed and ClinicalTrials.org, and 97 original articles analyzed. Search was performed based on the following keywords and combinations: irritable bowel syndrome, clinical trial, pain, visceral pain, narcotics, opioid, chloride channel, neuropathy, primary afferent, intestine, microbiota, gut barrier, inflammation, diarrhea, constipation, serotonin, visceral hypersensitivity, nociceptor, sensitization, hyperalgesia. Results Certain conventional pain managing drugs do not effectively improve IBS symptoms, including NSAIDs, acetaminophen, aspirin, and various narcotics. Anxiolytic and antidepressant drugs (Benzodiazepines, TCAs, SSRI and SNRI) can attenuate pain in IBS patients with relevant comorbidities. Clonidine, gabapentin and pregabalin can moderately improve IBS symptoms. Lubiprostone relieves constipation predominant IBS (IBS-C) while loperamide improves diarrhea predominant IBS (IBS-D). Alosetron, granisetron and ondansetron can generally treat pain in IBS-D patients, of which alosetron needs to be used with caution due to cardiovascular toxicity. The optimal drugs for managing pain in IBS-D and IBS-C appear to be eluxadoline and linaclotide, respectively, both of which target peripheral GI tract. Conclusions Conventional pain managing drugs are in general not suitable for treating IBS pain. Medications that target

  12. Probiotic for irritable bowel syndrome in pediatric patients: a randomized controlled clinical trial.

    Science.gov (United States)

    Kianifar, Hamidreza; Jafari, Seyed Ali; Kiani, Mohammadali; Ahanchian, Hamid; Ghasemi, Seyed Vahid; Grover, Zubin; Mahmoodi, Leili Zarif; Bagherian, Rita; Khalesi, Maryam

    2015-09-01

    Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in children. Recently, probiotics have been suggested as a treatment option for gastrointestinal disorders. The most effective species and the most appropriate doses are still unknown. The aim of this study was to assess the effects of Lactobacillus GG (LGG) for treating IBS in pediatric patients. In a controlled, double blind, randomized trial, patients with IBS diagnosed by Rome III criteria from August 2012 to September 2012 at Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Iran, were assigned to one of two groups, i.e., intervention and control groups. For four weeks, the intervention group received a probiotic in capsule form that contained LGG at a concentration of 1×10(10) cfu/ml bacteria. For the same period, the control group received a placebo capsule that had the same shape and color but only contained inulin, which also was present in the LGG capsules. The primary outcome was any change in the severity of the patients' pain, and we used a five-point Likert scale to evaluate the severity of their pain. Secondary outcomes were ghanges of the functional scale, stool patterns, and associated problems. Fifty-two patients participated in the study, and 26 patients were assigned randomly to each of the two groups. The severity of the patients' pain decreased significantly in the intervention group after one, two, three, and four weeks of treatment, as indicated by P-values of 0.01, 0.00, 0.00, and 0.00, respectively. Also, there was significant improvement in the functional scale after two weeks of treatment (P-value ≤ 0.00). Lactobacillus GG at a concentration of 1×10(10) cfu/ml for a period of four weeks can lessen the severity of the patients' pain and improve the functional scale in patients with irritable bowel syndrome. Probiotics can have therapeutic effects for IBS patients.

  13. Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights

    Directory of Open Access Journals (Sweden)

    Kinsinger SW

    2017-07-01

    Full Text Available Sarah W Kinsinger Behavioral Medicine for Digestive Health, Division of Gastroenterology and Nutrition, Loyola University Medical Center, Maywood, IL, USA Abstract: Irritable bowel syndrome (IBS is a chronic gastrointestinal (GI condition associated with significant health care utilization and quality-of-life impairment. Latest research indicates that the brain–gut axis plays a key role in the disorder, and the presence of psychological factors and central processing deficits contribute to symptom severity and disability. Psychological therapies as a whole have demonstrated good efficacy in reducing the severity of IBS symptoms. Cognitive-behavioral therapy (CBT has been tested most rigorously in multiple randomized controlled trials and consistently demonstrates significant and durable effects on IBS symptoms and quality of life. Various protocols for treating IBS have been developed, and most recent advances in the field include exposure-based treatments to target symptom-specific anxiety as well as modified delivery methods, including internet-based treatment models. Despite the well-documented advantages of CBT for IBS, it has been poorly disseminated and few patients have access to this treatment. The primary barrier to dissemination is the limited number of therapists with adequate training in GI psychology to provide this evidence-based intervention. Future developments in the field need to focus on training opportunities to equip more therapists to competently provide CBT for this population. Further efforts to develop telemedicine platforms for delivering this intervention will also improve accessibility for patients. Keywords: irritable bowel syndrome, functional gastrointestinal disorders, cognitive-behavioral therapy

  14. Gender-related differences in irritable bowel syndrome: Potential mechanisms of sex hormones

    Science.gov (United States)

    Meleine, Mathieu; Matricon, Julien

    2014-01-01

    According to epidemiological studies, twice as many women as men are affected by irritable bowel syndrome (IBS) in western countries, suggesting a role for sex hormones in IBS pathophysiology. Despite growing evidence about the implications of sex hormones in IBS symptom modulation, data on mechanisms by which they influence disease development are sparse. This review aims to determine the state of knowledge about the role of sex hormones in sensorimotor dysfunctions and to address the possible interplay of sex hormones with common risk factors associated with IBS. The scientific bibliography was searched using the following keywords: irritable bowel syndrome, sex, gender, ovarian hormone, estradiol, progesterone, testosterone, symptoms, pain, sensitivity, motility, permeability, stress, immune system, brain activity, spinal, supraspinal, imaging. Ovarian hormones variations along the menstrual cycle affect sensorimotor gastrointestinal function in both healthy and IBS populations. They can modulate pain processing by interacting with neuromodulator systems and the emotional system responsible for visceral pain perception. These hormones can also modulate the susceptibility to stress, which is a pivotal factor in IBS occurrence and symptom severity. For instance, estrogen-dependent hyper-responsiveness to stress can promote immune activation or impairments of gut barrier function. In conclusion, whereas it is important to keep in mind that ovarian hormones cannot be considered as a causal factor of IBS, they arguably modulate IBS onset and symptomatology. However, our understanding of the underlying mechanisms remains limited and studies assessing the link between IBS symptoms and ovarian hormone levels are needed to improve our knowledge of the disease evolution with regard to gender. Further studies assessing the role of male hormones are also needed to understand fully the role of sex hormones in IBS. Finally, investigation of brain-gut interactions is critical

  15. Review article: transient receptor potential channels as possible therapeutic targets in irritable bowel syndrome.

    Science.gov (United States)

    Beckers, A B; Weerts, Z Z R M; Helyes, Z; Masclee, A A M; Keszthelyi, D

    2017-11-01

    Abdominal pain in irritable bowel syndrome (IBS) remains challenging to treat effectively. Researchers have attempted to elucidate visceral nociceptive processes in order to guide treatment development. Transient receptor potential (TRP) channels have been implied in the generation (TRPV1, TRPV4, TRPA1) and inhibition (TRPM8) of visceral pain signals. Pathological changes in their functioning have been demonstrated in inflammatory conditions, and appear to be present in IBS as well. To provide a comprehensive review of the current literature on TRP channels involved in visceral nociception. In particular, we emphasise the clinical implications of these nociceptors in the treatment of IBS. Evidence to support this review was obtained from an electronic database search via PubMed using the search terms "visceral nociception," "visceral hypersensitivity," "irritable bowel syndrome" and "transient receptor potential channels." After screening the abstracts the articles deemed relevant were cross-referenced for additional manuscripts. Recent studies have resulted in significant advances in our understanding of TRP channel mediated visceral nociception. The diversity of TRP channel sensitization pathways is increasingly recognised. Endogenous TRP agonists, including poly-unsaturated fatty acid metabolites and hydrogen sulphide, have been implied in augmented visceral pain generation in IBS. New potential targets for treatment development have been identified (TRPA1 and TRPV4,) and alternative means of affecting TRP channel signalling (partial antagonists, downstream targeting and RNA-based therapy) are currently being explored. The improved understanding of mechanisms involved in visceral nociception provides a solid basis for the development of new treatment strategies for abdominal pain in IBS. © 2017 John Wiley & Sons Ltd.

  16. Changes in the Abundance of Faecalibacterium prausnitzii Phylogroups I and II in the Intestinal Mucosa of Inflammatory Bowel Disease and Patients with Colorectal Cancer.

    Science.gov (United States)

    Lopez-Siles, Mireia; Martinez-Medina, Margarita; Surís-Valls, Romà; Aldeguer, Xavier; Sabat-Mir, Miriam; Duncan, Sylvia H; Flint, Harry J; Garcia-Gil, L Jesús

    2016-01-01

    Faecalibacterium prausnitzii comprises 2 phylogroups, whose abundance in healthy and diseased gut and in conjunction with Escherichia coli has not yet been studied. This work aims to determine the contribution of F. prausnitzii phylogroups I and II in intestinal disease and to assess their potential diagnostic usefulness as biomarkers for gut diseases. Total F. prausnitzii, its phylogroups, and E. coli loads were determined by quantitative polymerase chain reaction targeting the 16S rRNA gene on biopsies from 31 healthy controls (H), 45 patients with Crohn's disease (CD), 25 patients with ulcerative colitis, 10 patients with irritable bowel syndrome, and 20 patients with colorectal cancer. Data were normalized to total bacterial counts and analyzed according to patients' disease location and clinical characteristics. Lower levels of both total F. prausnitzii and phylogroup I were found in subjects with CD, ulcerative colitis, and colorectal cancer (P bowel disease location. Phylogroup I was lower in active patients with CD, whereas those CD with intestinal resection showed a reduction in phylogroup II. Treatments with mesalazine and immunosuppressants did not result in the recovery of F. prausnitzii phylogroups abundance. F. prausnitzii phylogroup I was depleted in CD, ulcerative colitis, and colorectal cancer, whereas phylogroup II was specifically reduced in CD. Quantification of F. prausnitzii phylogroups and E. coli may help to identify gut disorders and to classify inflammatory bowel disease location.

  17. Socioeconomic status as an independent risk factor for severe late bowel toxicity after primary radiotherapy for cervical cancer.

    Science.gov (United States)

    Laan, J J; van Lonkhuijzen, L R C W; van Os, R M; Tytgat, K M; Dávila Fajardo, R; Pieters, B R; Stalpers, L J A; Westerveld, G H

    2017-12-01

    To evaluate the frequency of and risk factors for severe late bowel toxicity after curative radiotherapy in women treated for locally advanced cervical cancer. Included were 515 women treated for locally advanced cervical cancer with primary radiotherapy with curative intent from 1992 to 2013. Bowel toxicity was graded according to the Common Terminology Criteria for Adverse Events. Associations between risk factors and severe late bowel toxicity were assessed using Cox proportional hazards regression models. Median follow-up was 78months. Fifty-nine patients developed severe late bowel toxicity. The actuarial 3-year and 5-year severe late bowel toxicity rates were both 13%. In the multivariable analysis, factors significantly associated with severe late bowel toxicity were: smoking (HR 2.59 [1.48-4.55]), severe acute bowel toxicity (HR 2.46 [1.24-4.49]), previous major abdominal surgery (HR 2.35 [1.20-4.60]), hypertension (HR 2.33 [1.23-4.40]), parametrial boost (HR 2.18 [1.10-4.33]), low socioeconomic status (HR 2.05 [1.17-3.59]) and low BMI (HR 0.93 [0.88-0.99]). First symptoms of severe late bowel toxicity were reported after a median follow-up of 9months, but occurred up to 10years after end of treatment. Only one third of the patients with severe late bowel toxicity were referred to a gastroenterologist. Severe late bowel toxicity is a frequent complication of definitive radiotherapy for cervical cancer. Several independent risk factors were found which warrant further research. A standardized and structured approach in the early diagnostics and management of bowel toxicity is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Bowel Obstruction Caused by Colorectal Cancer Masquerading as Extrinsic Compression of Benign Gynecologic Tumors: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Wen-Chiung Hsu

    2004-03-01

    Conclusion: Although a lower abdominal tumor with bowel obstruction can be considered to be a result of a gynecologic tumor by physical examination and sonography, colorectal cancer should be included in the differential diagnosis.

  19. Secondary metastasis in the lymph node of the bowel invaded by colon cancer: a report of three cases.

    Science.gov (United States)

    Takiyama, Aki; Nozawa, Hiroaki; Ishihara, Soichiro; Takiyama, Hirotoshi; Murono, Koji; Yasuda, Koji; Otani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Hata, Keisuke; Watanabe, Toshiaki

    2016-10-26

    Secondary metastasis to regional lymph nodes for adjacent bowel invaded by colorectal cancers (CRCs) has not been extensively reviewed. We herein present three such cases. The first case is a cancer involving the cecum and sigmoid colon, and its primary site could not be determined even by pathological evaluation. Nodal involvement was revealed both in the mesocolon of the cecum and sigmoid. The second and third cases are a sigmoid colon cancer invading the jejunum and an ascending colon cancer invading the jejunum, respectively. These patients harbored secondary metastases to lymph nodes draining from the invaded small bowel segments. In spite of complete resection, all three patients metachronously developed liver metastases or recurrent disseminated nodules in the pelvis and subsequently died. In cases of CRC invading another bowel segment, bowel resection with regional lymphadenectomy for both involved segments should be considered to achieve complete resection. However, the radical surgery did not necessarily provide a long-term survival.

  20. Targeted therapy for hereditary cancer syndromes: hereditary breast and ovarian cancer syndrome, Lynch syndrome, familial adenomatous polyposis, and Li-Fraumeni syndrome.

    Science.gov (United States)

    Agarwal, Rishi; Liebe, Sarah; Turski, Michelle L; Vidwans, Smruti J; Janku, Filip; Garrido-Laguna, Ignacio; Munoz, Javier; Schwab, Richard; Rodon, Jordi; Kurzrock, Razelle; Subbiah, Vivek

    2014-12-01

    Cancer genetics has rapidly evolved in the last two decades. Understanding and exploring the several genetic pathways in the cancer cell is the foundation of targeted therapy. Several genomic aberrations have been identified and their role in carcinogenesis is being explored. In contrast to most cancers where these mutations are acquired, patients with hereditary cancer syndromes have inherited genomic aberrations. The understanding of the molecular pathobiology in hereditary cancer syndromes has advanced dramatically. In addition, many molecularly targeted therapies have been developed that could have potential roles in the treatment of patients with hereditary cancer syndromes. In this review, we outline the presentation, molecular biology, and possible targeted therapies for two of the most widely recognized hereditary cancer syndromes -- hereditary breast and ovarian cancer syndrome and hereditary non-polyposis colorectal cancer syndrome (Lynch syndrome). We will also discuss other syndromes such as familial adenomatous polyposis and Li-Fraumeni syndrome (TP53).

  1. GLP-2 administration results in increased proliferation but paradoxically an adverse outcome in a juvenile piglet model of short bowel syndrome

    DEFF Research Database (Denmark)

    Pereira-Fantini, Prue M; Nagy, Eva S; Thomas, Sarah L

    2008-01-01

    OBJECTIVE: The objective of the present study was to examine the effect of glucagon-like peptide-2 (GLP-2) administration in a piglet, juvenile model of short bowel syndrome. MATERIALS AND METHODS: Four-week-old piglets underwent either a sham operation or 75% small bowel resection. Postoperative...

  2. Results of optimal debulking surgery with bowel resection in patients with advanced ovarian cancer.

    Science.gov (United States)

    Derlatka, Pawel; Sienko, Jacek; Grabowska-Derlatka, Laretta; Palczewski, Piotr; Danska-Bidzinska, Anna; Bidzinski, Mariusz; Czajkowski, Krzysztof

    2016-02-29

    The surgical treatment of patients with advanced-stage ovarian cancer is based on maximal cytoreduction with widening the debulking on the extra-ovarian tissues and infiltrated organs. The purpose of the study was to assess the outcome after optimal cytoreduction with partial bowel resection and to find the risk factors of relapse. Another goal was the quantitative and qualitative assessment of intra- and postoperative complications in the studied group. The analysis of debulking procedures with intestinal resection and postoperative period in 33 ovarian cancer patients, The International Federation of Gynecology and Obstetrics (FIGO) stages III and IV, was performed. The optimal cytoreduction defined as less than 1.0 cm residual disease was achieved in all patients including the following: 26 patients (78.8%) with no macroscopic residual disease, 4 patients (12.1%) with the largest residual tumor less than 0.5, and 3 patients (9.1%) with 0.5 cm to less than 1.0 cm residual disease. The rectosigmoid resection was the most common surgical procedure (n = 27). The risk of relapse was significantly higher in subjects who had the macroscopic residual tumor left during the primary operation (57.1 vs. 11.5%, P = 0.035). A primary bowel tumor size was another predictor of relapse. The maximum tumor diameter was significantly larger (14.9 ± 6.7 cm vs. 10.3 ± 4.7 cm, P = 0.047) in patients who developed the relapse. As presented in the article, our outcomes and other authors' observations indicate that debulking surgery with bowel resection in patients with advanced ovarian cancer brings good results. Complications connected with bowel surgery are to be accepted. The interesting thing is that a primary bowel tumor size was a predictor of relapse.

  3. Effectiveness of osteopathic manipulative therapy for managing symptoms of irritable bowel syndrome: a systematic review.

    Science.gov (United States)

    Müller, Axel; Franke, Helge; Resch, Karl-Ludwig; Fryer, Gary

    2014-06-01

    Irritable bowel syndrome (IBS) is a common and often lifelong functional gastrointestinal disorder. There is a scarcity of effective management options for IBS. To assess the effectiveness of osteopathic manipulative therapy (OMTh) for managing the symptoms of IBS. Articles without language or publication-date restriction were searched in PubMed, Embase, Cochrane Library, PEDro, OSTMED.DR, and Osteopathic Research Web. Search terms included irritable bowel syndrome, IBS, functional colonic disease, colon irritable, osteopath*, osteopathic manipulation, osteopathic medicine, clinical trial, and randomized clinical trial. Experts in the field of visceral osteopathy were also contacted to identify additional studies. The authors evaluated randomized controlled trials (RCTs) of OMTh for IBS in adults in whom IBS was diagnosed using Rome (I-III) criteria. If OMTh was not the sole intervention in the intervention group and if the same additional interventions were not applied to the control group, the study was excluded. Citation identification, study selection, and data extraction were independently undertaken by 2 reviewers with a data extraction form from the Cochrane Collaboration. A consensus method was used to resolve disagreements concerning the assessment of the methodologic quality of the RCTs that were reviewed. The search identified 10 studies that examined OMTh for patients with IBS; 5 studies (204 patients) met the inclusion criteria. All studies were assessed as having low risk of bias according to the Cochrane Collaboration criteria, although there was heterogeneity in the outcome measures and control interventions. Three studies used visual analog scales for abdominal pain, whereas others used the IBS severity score and the Functional Bowel Disorder Severity Index. A variety of secondary outcomes were used. All studies reported more pronounced short-term improvements with OMTh compared with sham therapy or standard care only. These differences remained

  4. Challenging diagnostic issues in adenomatous polyps with epithelial misplacement in bowel cancer screening: 5 years' experience of the Bowel Cancer Screening Programme Expert Board.

    Science.gov (United States)

    Griggs, Rebecca K L; Novelli, Marco R; Sanders, D Scott A; Warren, Bryan F; Williams, Geraint T; Quirke, Philip; Shepherd, Neil A

    2017-02-01

    The diagnostic difficulties of differentiating epithelial misplacement from invasive cancer in colorectal adenomatous polyps have been recognised for many years. Nevertheless, the introduction of population screening in the UK has resulted in extraordinary diagnostic problems. Larger sigmoid colonic adenomatous polyps, which are those most likely to show epithelial misplacement, are specifically selected into such screening programmes, because these polyps are likely to bleed and screening is based on the detection of occult blood. The diagnostic challenges associated with this particular phenomenon have necessitated the institution of an 'Expert Board': this is a review of the first five years of its practice, during which time 256 polyps from 249 patients have been assessed. Indeed, the Expert Board contains three pathologists, because those pathologists do not necessarily agree, and a consensus diagnosis is required to drive appropriate patient management. However, this study has shown substantial levels of agreement between the three Expert Board pathologists, whereby the ultimate diagnosis has been changed, from that of the original referral diagnosis, by the Expert Board for half of all the polyps, in the substantial majority from malignant to benign. In 3% of polyp cases, the Expert Board consensus has been the dual diagnosis of both epithelial misplacement and adenocarcinoma, further illustrating the diagnostic difficulties. The Expert Board of the Bowel Cancer Screening Programme in the UK represents a unique and successful development in response to an extraordinary diagnostic conundrum created by the particular characteristics of bowel cancer screening. © 2016 John Wiley & Sons Ltd.

  5. Treatment and Survival of Small-bowel Adenocarcinoma in the United States: A Comparison With Colon Cancer.

    Science.gov (United States)

    Young, John I; Mongoue-Tchokote, Solange; Wieghard, Nicole; Mori, Motomi; Vaccaro, Gina M; Sheppard, Brett C; Tsikitis, Vassilki L

    2016-04-01

    Small-bowel adenocarcinoma is rare and fatal. Because of data paucity, there is a tendency to extrapolate treatment from colon cancer, particularly in the adjuvant stetting. The purpose of this study was to evaluate the current surgical and adjuvant treatments of small-bowel adenocarcinoma and compare with colon cancer. This was a retrospective cohort study. The linked Surveillance, Epidemiology, and End Results and Medicare database was used at a tertiary referral hospital. Patients with small-bowel adenocarcinoma and colon cancer identified from 1992 to 2010, using International Classification of Diseases for Oncology, 3 Revision, site, behavior, and histology codes were included. Overall survival and cancer-specific survival were estimated using the Kaplan-Meier method and competing risk analysis. A total of 2123 patients with small-bowel adenocarcinoma and 248,862 patients with colon cancer were identified. Five-year overall survival rates for patients with small-bowel adenocarcinoma and colon cancer were 34.9% and 51.5% (p bowel adenocarcinoma (73.0%) underwent surgery, compared with 177,017 patients with colon cancer (71.1%). The proportion of patients who received chemotherapy was similar, at 21.3% for small bowel and 20.0% for colon. In contrast to colon cancer, chemotherapy did not improve overall or cancer-specific survival for patients with small-bowel adenocarcinoma, regardless of stage. Predictors of poor survival for small-bowel adenocarcinoma on multivariate analysis included advanced age, black race, advanced stage, poor tumor differentiation, high comorbidity index, and distal location. Chemotherapy did not confer additional survival benefit compared with surgery alone (HR, 1.04 (95% CI, 0.90-1.22)). This was a retrospective review. The reliance on Medicare data limited granularity and may have affected the generalizability of the results. The prognosis for small-bowel adenocarcinoma is worse than that for colon cancer, and only surgery improves

  6. Incidence of, phenotypes of and survival from small bowel cancer in Denmark, 1994-2010

    DEFF Research Database (Denmark)

    Bojesen, Rasmus Dahlin; Andersson, Mikael; Riis, Lene Buhl

    2016-01-01

    BACKGROUND: Small bowel cancer (SBC) is a rare and highly heterogeneous disease in respect to both anatomical distribution and histological morphology. We aimed to conduct a Danish nationwide population-based cohort study of the incidence of, phenotypes of, stage of, synchronous/metachronous cancer...... to the anatomical origin and morphological subtype. Patients were followed up from the date of cancer diagnosis to the date of emigration, death or the end of the study (31 December 2010). RESULTS: SBC was diagnosed in 1088 patients during 1994-2010. The total annual incidence of SBC was 1.10 per 100,000 [95...

  7. Progression of Inflammatory Bowel Disease to Cancer: Is the Patient Better Off without Lymphatic Vessels or Nodes (or Angiopoietin 2)?

    Science.gov (United States)

    2013-12-01

    Inflammatory bowel disease (IBD) is a well-recognized risk factor for colorectal cancer (CRC) [~15-20% lifetime risk in ulcerative colitis ( UC )] but the...for colo- rectal cancer (CRC) [~15-20% lifetime risk in ulcerative colitis ( UC )]. The lymphatic system has been implicated in both IBD pathophysiology...inflammatory bowel disease (IBD). Multiple factors have been implicated in the progression of ulcerative/granulomatous (Crohn’s) colitis to colorectal

  8. Exploring the Potential of Anticipated Regret as an Emotional Cue to Improve Bowel Cancer Screening Uptake

    Directory of Open Access Journals (Sweden)

    Ian T. Zajac

    2017-01-01

    Full Text Available Objective. Bowel cancer is currently the second leading cause of cancer-related death in Australia and screening participation is suboptimal. This study examined the role of emotion in the form of anticipated regret (AR and its relationship to screening intentions. Methods. N=173 persons aged 45 to 80 years completed a survey measuring demographic variables, readiness to screen, relative importance of health by comparison to other life priorities, satisfaction with current health, and AR if not participating in future bowel cancer screening. Results. AR was a significant predictor of future screening intentions. Those with higher levels of AR were seven times more likely (OR = 7.18 to intend to screen in the future compared to those with lower AR. This relationship was not compromised when controlling for other variables including gender and satisfaction with one’s health. AR levels were significantly lower in people who had been screened previously and in those with full health insurance. Conclusions. These results demonstrate that AR is uniquely related to future bowel cancer screening intentions. Future studies should continue to consider this as a useful target for behavioural interventions and identify new ways of delivering these interventions to improve their reach.

  9. Does depression influence symptom severity in irritable bowel syndrome? Case study of a patient with irritable bowel syndrome and bipolar disorder.

    Science.gov (United States)

    Crane, Catherine; Martin, Maryanne; Johnston, Derek; Goodwin, Guy M

    2003-01-01

    Irritable bowel syndrome (IBS) is frequently associated with mood disorder. However, it is typically difficult to distinguish between disturbed mood as a causal agent and disturbed mood as a consequence of the experience of IBS. This report considers the association between mood and symptom severity in a patient with diarrhea-predominant IBS and stable, rapid cycling bipolar disorder with a predominantly depressive course. Such a case provides an important opportunity to determine the direction of the relationship between mood and IBS symptom severity because the fluctuations of mood in bipolar disorder are assumed to be driven largely by biological, rather than psychosocial, processes. The study was carried out prospectively, with ratings of mood and IBS symptom severity made daily by the patient for a period of almost 12 months. The patient experienced regular and substantial changes in mood as well as fluctuations in the level of IBS symptoms during the study period. Contrary to expectation, the correlation between mood and IBS symptom severity on the same day suggested that the patient experienced less severe IBS symptoms during periods of more severe depression. However, time series analysis revealed no significant association between these two processes when serial dependence within each series was controlled for. The unusual co-occurrence of IBS with bipolar disorder provides direct evidence to indicate that depression does not necessarily lead to an increase in the reported severity of IBS, at least in the context of bipolar disorder, and may under certain circumstances actually be associated with a reduction in the severity of IBS symptoms. Factors that might moderate the relationship between depression and symptom severity are discussed.

  10. State-of-the-Art Treatment of Irritable Bowel Syndrome – Recent Advances and Emerging Therapeutic Alternatives

    Directory of Open Access Journals (Sweden)

    Magnus Simrén

    2013-11-01

    Full Text Available Irritable bowel syndrome (IBS is a highly prevalent functional disorder characterised by chronic and recurrent abdominal pain and altered bowel habit. Numerous pharmacological and non pharmacological treatment options have proven to have some benefit in the condition, and a multidisciplinary approach should ensure that treatment is tailored to the individual. Recently, an enhanced understanding of the pathophysiological processes underlying the condition has led to the development of new therapies, including prokinetic agents targeting serotonin (5-HT pathways, and pro-secretory agents. Many are still at an early stage of clinical development, however, some have demonstrated improved outcomes in clinical trials and have gained regulatory approval. Lubiprostone, a calcium channel activator and linaclotide, a novel secretagogue that activates the guanylate cyclase C receptor, have demonstrated improvement of abdominal pain as well as improved bowel function in patients with IBS with constipation (IBS-C in a series of randomised, placebo-controlled studies.

  11. Mast Cell Tryptase Reduces Junctional Adhesion Molecule-A (JAM-A) Expression in Intestinal Epithelial Cells: Implications for the Mechanisms of Barrier Dysfunction in Irritable Bowel Syndrome.

    LENUS (Irish Health Repository)

    Wilcz-Villega, Ewa M

    2013-07-01

    The objective of this study was to investigate how mast cell tryptase may influence intestinal permeability and tight junction (TJ) proteins in vitro and explore translation to irritable bowel syndrome (IBS).

  12. Canadian Digestive Health Foundation Public Impact Series 3: irritable bowel syndrome in Canada. Incidence, prevalence, and direct and indirect economic impact.

    Science.gov (United States)

    Fedorak, Richard N; Vanner, Stephen J; Paterson, William G; Bridges, Ron J

    2012-05-01

    The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning irritable bowel syndrome.

  13. A Surgical Perspective of the Outcome of a Multidisciplinary Intestinal Rehabilitation Program for Children With Short Bowel Syndrome in the Netherlands

    NARCIS (Netherlands)

    Schurink, M.; Hulscher, J. B. F.; Nieuwenhuijs, V. B.; Heineman, E.; Rings, E. H. H. M.

    2014-01-01

    Aim. In 2001, a multidisciplinary intestinal rehabilitation program, prompted by a nationwide collaboration on intestinal failure (Dutch Registry for Intestinal Failure and Intestinal Transplantation), was started for children who have short bowel syndrome (SBS). This study evaluates this program,

  14. Anxiety in close relationships is higher and self-esteem lower in patients with irritable bowel syndrome compared to patients with inflammatory bowel disease.

    Science.gov (United States)

    Bengtsson, Mariette; Sjöberg, Klas; Candamio, Martina; Lerman, Annie; Ohlsson, Bodil

    2013-04-01

    Previous research has suggested an interaction between personality factors and inflammatory bowel disease (IBD) as well as irritable bowel syndrome (IBS). We therefore aimed to elucidate differences in psychological and coping functioning between patients with IBD and IBS, and to assess the relationship of disease activity with these functions. Seventy-four patients with IBD (mean age 43±17 years, range 18-82 years) and 81 patients with IBS (mean age 37±12 years, range 21-66 years) completed the questionnaires; Rosenberg Self-Esteem Scale, Toronto Alexithymia, Experiences in Close Relationships, and Sense of Coherence. Disease activity was evaluated either by the Harvey-Bradshaw index, the Simple Clinical Colitis Activity Index, or the Visual Analogue Scale for Irritable Bowel Syndrome. The study revealed that patients with IBS had higher degree of anxiety in close relationships than patients with IBD (p=0.003), and lower self-esteem (p=0.001). No other statistical differences between the whole groups IBS and IBD or between subgroups were seen. The fact that patients with IBS seem to have higher levels of anxiety in relationships and lower self-esteem could influence the way the patient deal with the disease and how the communication with health care professionals works out. A higher awareness of the importance of past negative life events should be taken into consideration. Whether the disease or the personal traits are the primary event should be addressed in future research. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  15. Effect of Gum Chewing on Bowel Motility in Patients with Colorectal Cancer after Open Colectomy: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Cherdsak Duangchan

    2016-05-01

    Full Text Available Background: Postoperative ileus (POI usually delays the postoperative recovery after open colectomy. Gum chewing may facilitate bowel motility through cephalic-vagal stimulation. Bowel sounds, the time to first postoperative flatus and defecation, the common nursing outcomes of bowel motility, has not been investigated in Thai patients. This study examines the effect of gum chewing on bowel motility in colorectal cancer patients after open colectomy. Methods: A single blind randomized controlled trial was conducted with 32 patients in experimental and 32 patients in control groups. The experimental group chewed a piece of sugar-free gum with a fruity flavor for 20 minutes each time, three times a day starting from the first postoperative day till the date of first oral liquid received, while the control group receive routine care. Results: The bowel sounds of the experimental group after chewing gum significantly increased more than those of the control group (p = 0.00. The time to the first postoperative flatus in the experimental group was significantly shorter than that in the control group; likewise the first postoperative defecation was also shorter (p = 0.04, p = 0.02, respectively. Conclusion: Gum chewing is helpful in stimulating bowel motility measured by an increase in bowel sounds and in reduced times to first postoperative flatus and defecation. This nursing intervention may be used for stimulating bowel motility in patients with colorectal cancer after an open colectomy.

  16. Annual Costs of Care for Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, and Functional Abdominal Pain Syndrome.

    Science.gov (United States)

    Hoekman, Daniël R; Rutten, Juliette M T M; Vlieger, Arine M; Benninga, Marc A; Dijkgraaf, Marcel G W

    2015-11-01

    To estimate annual medical and nonmedical costs of care for children diagnosed with irritable bowel syndrome (IBS) or functional abdominal pain (syndrome; FAP/FAPS). Baseline data from children with IBS or FAP/FAPS who were included in a multicenter trial (NTR2725) in The Netherlands were analyzed. Patients' parents completed a questionnaire concerning usage of healthcare resources, travel costs, out-of-pocket expenses, productivity loss of parents, and supportive measures at school. Use of abdominal pain related prescription medication was derived from case reports forms. Total annual costs per patient were calculated as the sum of direct and indirect medical and nonmedical costs. Costs of initial diagnostic investigations were not included. A total of 258 children, mean age 13.4 years (±5.5), were included, and 183 (70.9%) were female. Total annual costs per patient were estimated to be €2512.31. Inpatient and outpatient healthcare use were major cost drivers, accounting for 22.5% and 35.2% of total annual costs, respectively. Parental productivity loss accounted for 22.2% of total annual costs. No difference was found in total costs between children with IBS or FAP/FAPS. Pediatric abdominal pain related functional gastrointestinal disorders impose a large economic burden on patients' families and healthcare systems. More than one-half of total annual costs of IBS and FAP/FAPS consist of inpatient and outpatient healthcare use. Netherlands Trial Registry: NTR2725. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Disability and participation in breast and bowel cancer screening in England: a large prospective study

    OpenAIRE

    Floud, S; Barnes, I; Verfürden, M; Kuper, H; Gathani, T; Blanks, R G; Alison, R; Patnick, J; Beral, V; Green, J; Reeves, G K

    2017-01-01

    Background There is limited information about participation in organised population-wide screening programmes by people with disabilities. Methods Data from the National Health Service routine screening programmes in England were linked to information on disability reported by Million Women Study cohort participants. Results Of 473,185 women offered routine breast or bowel cancer screening, 23% reported some disability. Women with disabilities were less likely than oth...

  18. Low-FODMAP Diet for Irritable Bowel Syndrome: Is It Ready for Prime Time?

    Science.gov (United States)

    Khan, Muhammad Ali; Nusrat, Salman; Khan, Muhammad Imran; Nawras, Ali; Bielefeldt, Klaus

    2015-05-01

    Irritable bowel syndrome (IBS) is a chronic gastrointestinal disease, which adversely affects the quality of life. Its prevalence has been reported to be around 10-15 % in North America and constitutes the most common cause for gastroenterology referral. Unfortunately, the pathophysiology of IBS is not completely understood. Not surprisingly, the management strategies can leave the patients with inadequate symptom control, making IBS a debilitating gastrointestinal syndrome. Dietary interventions as a treatment strategy for IBS have been recently evaluated. One such intervention includes dietary restriction of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs). FODMAPs define a group of short-chain carbohydrates that are incompletely absorbed in small intestine and later fermented in the colon. Evidence in the form of randomized controlled trials and observational studies have evaluated the mechanism of action and efficacy of low-FODMAP diet. This dietary intervention has showed promising results in symptom reduction in IBS patients. However, latest trials have also shown that the low-FODMAP diet is associated with marked changes in gut microbiota specifically reduction in microbiota with prebiotic properties. Implications of such changes on gastrointestinal health need to be further evaluated in future trials.

  19. Rectal cancer and inflammatory bowel disease: natural history and implications for radiation therapy

    International Nuclear Information System (INIS)

    Green, Sheryl; Stock, Richard; Greenstein, Adrian

    1995-01-01

    PURPOSES/OBJECTIVE: There exists little information concerning the natural history of rectal cancer in patients with inflammatory bowel disease. In addition, the tolerance of pelvic irradiation in these patients is unknown. We analyzed the largest series of patients with inflammatory bowel disease and rectal cancer in order to determine the natural history of the disease as well as the effect and tolerance of pelvic irradiation. MATERIAL AND METHODS: A retrospective analysis of 47 patients with inflammatory bowel disease and rectal cancer treated over a 34 year period (1960-1994) was performed. Thirty five patients had Ulcerative Colitis and 12 patients had Crohn's Disease. There were 31 male patients and 16 female patients. The stage (AJC) distribution was as follows: stage 0 in 5 patients, stage I in 13 patients, stage II in 7 patients, stage III in 13 patients and stage IV in 9 patients. Surgical resection was performed in 44 patients. In 2 of these patients, preoperative pelvic irradiation was given followed by surgery. Twenty of these patients underwent post-operative adjuvant therapy (12 were treated with chemotherapy and pelvic irradiation and 8 with chemotherapy alone). Three patients were found to have unresectable disease and were treated with chemotherapy alone (2 patients) or chemotherapy and radiation therapy (1 patient). Radiation complications were graded using the RTOG acute and late effects scoring criteria. Follow up ranged from 4 to 250 months (median - 24 months). RESULTS: The 5 year actuarial results revealed an overall survival (OS) of 42%, a disease free survival (DFS) of 43%, a pelvic control rate (PC) of 67% and a freedom from distant failure (FFDF) of 47%. DFS decreased with increasing T stage with a 5 year rate of 86% for patients with Tis - T2 disease compared to 10% for patients with T3-T4 disease (p ) were noted in 3 patients (20%) receiving radiation therapy and these included two cases of grade 3 skin reactions and one case of grade

  20. The effect of obesity levels on irradiated small bowel volume in belly board with small bowel displacement device for rectal cancer radiotherapy

    International Nuclear Information System (INIS)

    Kim, Se Young; Kim, Joo Ho; Park, Hyo Kuk; Cho, Jeong Hee

    2013-01-01

    For radiotherapy in rectal cancer patients treated with small bowel displacement device (SBDD) and belly board, We will suggest new indication of using SBDD depending on obesity index by analyzing correlation between obesity and irradiated small bowel volume. In this study, We reviewed 29 rectal cancer patients who received pelvic radiation therapy with belly board and SBDD from January to April in 2012. We only analyzed those patients treated with three-field technique (PA and both LAT) on 45 Gy (1.8 Gy/fx). We measured patients' height, weight, body mass index (BMI), waist-hip ratio (WHR) and divided BMI into two groups.(≥23:BMI=group 1, <23:BMI=group 2) We performed a statistical analysis to evaluate correlation between total volume of bladder (TV bldder ), obesity index and high dose volume of small bowel (small bowel volume irradiated at 90% of prescribed dose, HDV sb ), low dose volume of small bowel (small bowel volume irradiated at 33% of prescribed dose, LDV sb ). The result shows, gender, WHR and status of pre operative or post operative do not greatly affect HDV sb and LDV sb . Statistical result shows, there are significant correlation between HDV sb and BMI (p<0.04), HDV sb and TV bladder (p<0.01), LDV sb and TV bladder (p<0.01). BMI seems to correlate with HDV sb but does not with LDV sb (p>0.05). There are negative correlation between HDV sb and BMI, TV bladder and HDV sb , TV bladder and LDV sb . Especially, BMI group1 has more effective and negative correlation with HDV sb (p=0.027) than in BMI group 2. In the case of BMI group 1, TV bladder has significant negative correlation with HDV sb and LDV sb (p<0.04). In conclusions, we confirmed that Using SBDD with belly board in BMI group 1 could more effectively reduce irradiated small bowel volume in radiation therapy for rectal cancer. Therefore, We suggest using belly board with SBDD in order to reduce the small bowel toxicity in rectal radiotherapy, if patients' BMI is above 23

  1. The effect of obesity levels on irradiated small bowel volume in belly board with small bowel displacement device for rectal cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Se Young; Kim, Joo Ho; Park, Hyo Kuk; Cho, Jeong Hee [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul (Korea, Republic of)

    2013-03-15

    For radiotherapy in rectal cancer patients treated with small bowel displacement device (SBDD) and belly board, We will suggest new indication of using SBDD depending on obesity index by analyzing correlation between obesity and irradiated small bowel volume. In this study, We reviewed 29 rectal cancer patients who received pelvic radiation therapy with belly board and SBDD from January to April in 2012. We only analyzed those patients treated with three-field technique (PA and both LAT) on 45 Gy (1.8 Gy/fx). We measured patients' height, weight, body mass index (BMI), waist-hip ratio (WHR) and divided BMI into two groups.(≥23:BMI=group 1, <23:BMI=group 2) We performed a statistical analysis to evaluate correlation between total volume of bladder (TV{sub bldder}), obesity index and high dose volume of small bowel (small bowel volume irradiated at 90% of prescribed dose, HDV{sub sb}), low dose volume of small bowel (small bowel volume irradiated at 33% of prescribed dose, LDV{sub sb}). The result shows, gender, WHR and status of pre operative or post operative do not greatly affect HDV{sub sb} and LDV{sub sb}. Statistical result shows, there are significant correlation between HDV{sub sb} and BMI (p<0.04), HDV{sub sb} and TV{sub bladder} (p<0.01), LDV{sub sb} and TV{sub bladder} (p<0.01). BMI seems to correlate with HDV{sub sb} but does not with LDV{sub sb} (p>0.05). There are negative correlation between HDV{sub sb} and BMI, TV{sub bladder} and HDV{sub sb}, TV{sub bladder} and LDV{sub sb} . Especially, BMI group1 has more effective and negative correlation with HDV{sub sb} (p=0.027) than in BMI group 2. In the case of BMI group 1, TV{sub bladder} has significant negative correlation with HDV{sub sb} and LDV{sub sb} (p<0.04). In conclusions, we confirmed that Using SBDD with belly board in BMI group 1 could more effectively reduce irradiated small bowel volume in radiation therapy for rectal cancer. Therefore, We suggest using belly board with SBDD in order

  2. The national bowel cancer audit project: the impact of organisational structure on outcome in operative bowel cancer within the United Kingdom.

    Science.gov (United States)

    Cornish, J A; Tekkis, P P; Tan, E; Tilney, H S; Thompson, M R; Smith, J J

    2011-06-01

    To investigate the relationship between organisational structure, process and surgical outcomes for bowel cancer surgery. An e-survey was sent to the members of the Association of Coloproctology of Great Britain and Ireland to determine the organisational structure of their Trusts. Responses were combined with the National Bowel Cancer Audit (NBOCAP) data. Items investigated included; number of consultants, nurse specialists, volume of cases and intensive care facilities. Main outcome measures included: 30-day risk-adjusted mortality, length of stay (LOS), lymph node yield and circumferential margin involvement (CRM). One hundred and seventeen Trusts responded (65.8%), matched to 7666 patient episodes (NBOCAP data) from 54 (62.8%)Trusts who submitted data to the audit. Trusts treating 0.001), 0.001), 0001) and 0001) were more likely to have a 30-day-risk-adjusted mortality twice that of the national mean. Sixty five percent (n = 1603) of Trusts treating ≥ 190 cases/annum harvested ≥ 12 lymph nodes vs. 58.3% (n = 1435) in Trusts organisational infrastructure of hospitals appears to have as great an impact on patient outcomes as the volume of cases performed by hospital Trusts. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  3. Could stool collection devices help increase uptake in bowel cancer screening programmes?

    Science.gov (United States)

    Morling, J R; Barke, A N; Chapman, C J; Logan, R F

    2018-01-01

    Objective To understand the usage and acceptability of a faecal collection device amongst participants in the National Health Service Bowel Cancer Screening Programme, with the aim of influencing future uptake. Setting Participants completing faecal occult blood test retests as part of the routine Bowel Cancer Screening Programme in Eastern England. Methods A faecal collection device and questionnaire were sent to all potential retest participants during a one-month period to collect information on prior stool collection methods and ease of use and usefulness of the enclosed faecal collection device. Results Out of 1087 participants invited, 679 (62.5%) returned their questionnaire. Of these, 429 (63.2%) trialled the faecal collection device at least once, 163 (38.4%) found the device made collecting their sample easier than previously, 189 (44.6%) found it made collection more difficult and 72 (17.0%) said it made no difference. Similar numbers reported finding that the faecal collection device made collecting the sample more pleasant (130, 31.5%), less pleasant (103, 25.0%) and no different (179, 43.4%) compared with previous collection without a faecal collection device. Conclusion Although a small proportion of participants found the faecal collection device helpful, a considerable majority did not or did not use it at all. Offering faecal collection devices is unlikely to produce a substantial increase in bowel cancer screening uptake.

  4. Advances in MRI for colorectal cancer and bowel motility

    NARCIS (Netherlands)

    van der Paardt, M.P.

    2015-01-01

    In the first part of this thesis certain aspects of MRI in the evaluation of colorectal cancer and its precursors, and restaging of rectal cancer were addressed. The current status of MR colonography regarding the different preparation techniques as well as the imaging sequences and colon distension

  5. Public appreciation of lifestyle risk factors for colorectal cancer and awareness of bowel cancer screening: A cross-sectional study.

    Science.gov (United States)

    Lynes, Kathryn; Kazmi, Sahar A; Robery, Jordan D; Wong, Simon; Gilbert, Deborah; Thaha, Mohamed A

    2016-12-01

    Prevention of colorectal cancer (CRC) via reduction of lifestyle risk factors, and participation in bowel screening are two ways in which public engagement could lower mortality from colorectal cancer. This study examined public awareness of lifestyle risk factors and bowel screening, with determination of the factors affecting this. A representative population sample (n = 1969) was surveyed using a study specific postal questionnaire to determine demographics, experience of bowel problems, awareness of lifestyle risk factors, knowledge about the incidence of CRC and potential benefits of screening, as well as personal experience of screening. The majority of respondents were aged over 50 (74%). 77% had either personal experience or a relative/friend with experience of a bowel problem. Knowledge of dietary advice was better than risks relating to weight and physical activity. Awareness of lifestyle risk factors was significantly worse in those less than 50 years old (p = 0.0004) and with a lower level of education (p = 0.0021). Awareness of bowel cancer diagnosis was significantly lower in those less than 50 years old (p=<0.0001). The most frequent reason for non-completion of a screening kit was that the process was dirty and unpleasant. Initiatives are required to improve awareness of younger people with regard to lifestyle risk factors for CRC, especially since this group stand to benefit most from risk reduction. Those with a lower educational level also had poor awareness but felt that the NHS should not prescribe exercise and lifestyle change; targeting this group would need to take this into account. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  6. The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments

    Science.gov (United States)

    Farzaei, Mohammad H; Bahramsoltani, Roodabeh; Abdollahi, Mohammad; Rahimi, Roja

    2016-01-01

    Irritable bowel syndrome (IBS) is the most common disorder referred to gastroenterologists and is characterized by altered bowel habits, abdominal pain, and bloating. Visceral hypersensitivity (VH) is a multifactorial process that may occur within the peripheral or central nervous systems and plays a principal role in the etiology of IBS symptoms. The pharmacological studies on selective drugs based on targeting specific ligands can provide novel therapies for modulation of persistent visceral hyperalgesia. The current paper reviews the cellular and molecular mechanisms underlying therapeutic targeting for providing future drugs to protect or treat visceroperception and pain sensitization in IBS patients. There are a wide range of mediators and receptors participating in visceral pain perception amongst which substances targeting afferent receptors are attractive sources of novel drugs. Novel therapeutic targets for the management of VH include compounds which alter gut-brain pathways and local neuroimmune pathways. Molecular mediators and receptors participating in pain perception and visceroperception include histamine-1 receptors, serotonin (5-hydrodytryptamine) receptors, transient receptor potential vanilloid type I, tachykinins ligands, opioid receptors, voltage-gated channels, tyrosine receptor kinase receptors, protease-activated receptors, adrenergic system ligands, cannabinoid receptors, sex hormones, and glutamate receptors which are discussed in the current review. Moreover, several plant-derived natural compounds with potential to alleviate VH in IBS have been highlighted. VH has an important role in the pathology and severity of complications in IBS. Therefore, managing VH can remarkably modulate the symptoms of IBS. More preclinical and clinical investigations are needed to provide efficacious and targeted medicines for the management of VH. PMID:27431236

  7. High risk of lower urinary tract symptoms in patients with irritable bowel syndrome.

    Science.gov (United States)

    Zingone, F; Iovino, P; Santonicola, A; Gallotta, S; Ciacci, C

    2017-06-01

    The aim of the present study was to investigate the prevalence of urinary tract infection (UTI) and the risk of lower urinary tract symptoms (LUTS) in women with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhea, and mixed) compared to women in the general population. Between January 2014 and December 2015, consecutive adult female patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy women with regular bowel habits were enrolled in the study. At baseline, we checked for UTI with a dipstick test and questioned patients about the presence of LUTS in the previous 24 h. We enrolled 141 IBS patients and 91 healthy controls in the study. There was no difference in the prevalence of UTI between IBS patients and healthy controls (4.9 vs 3.3%, p = 0.5). When we excluded patients with UTI, we found a 2.79 higher risk of increased urinary frequency [odds ratio (OR) 2.79, 95% confidence interval (CI) 1.37-5.68], a 2.68 higher risk of urinary urgency (OR 2.68, 95% CI 1.04-6.91), and more than three times the risk of having dysuria (OR 3.25, 95% CI 1.06-9.97) in IBS women compared to healthy controls. The risk of having at least one urinary symptom was independent of IBS subtype and IBS severity. Our study shows that IBS women have a similar risk of UTI compared to healthy women even if they complain more of LUTS, independently of IBS subtype and severity.

  8. Mindfulness for irritable bowel syndrome: protocol development for a controlled clinical trial

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    Garland Eric L

    2009-07-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS, a functional bowel disorder with symptoms of abdominal pain and disturbed defecation experienced by 10% of U.S. adults, results in significant disability, impaired quality of life, and health-care burden. Conventional medical care focusing on pharmacological approaches, diet, and lifestyle management has been partially effective in controlling symptoms. Behavioral treatments, such as cognitive-behavioral therapy and hypnosis, are promising. This paper describes an on-going feasibility study to assess the efficacy of mindfulness training, a behavioral treatment involving directing and sustaining attention to present-moment experience, for the treatment of IBS. Methods/Design The study design involves randomization of adult women with IBS according to Rome II criteria, to either an eight-week mindfulness training group (based on a Mindfulness-based Stress Reduction [MBSR] format or a previously validated IBS social-support group as an attention-control condition. The primary hypothesis is that, compared to Support Group participants, those in the Mindfulness Program will demonstrate significant improvement in IBS symptoms as measured by the IBS Symptom Severity Scale 1. Discussion 214 individuals have been screened for eligibility, of whom 148 were eligible for the study. Of those, 87 were enrolled, with 21 withdrawing after having given consent. 66 have completed or are in the process of completing the interventions. It is feasible to undertake a rigorous randomized clinical trial of mindfulness training for people with IBS, using a standardized MBSR protocol adapted for those experiencing IBS, compared to a control social-support group previously utilized in IBS studies. Trial Registration Clinical Trials.gov Identifier: NCT00680693

  9. Association of Psychological Disorders with Extra-intestinal Symptoms in Patients with Irritable Bowel Syndrome

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    Leila Mirbagher

    2015-03-01

    Full Text Available 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 (IBSSS, extraintestinal symptoms scale, Hospital Anxiety and Depression Scale, and Irritable Bowel SyndromeQuality 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.

  10. Disturbed Interhemispheric Functional Connectivity Rather than Structural Connectivity in Irritable Bowel Syndrome

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    Rongfeng Qi

    2016-12-01

    Full Text Available Neuroimaging studies have demonstrated that irritable bowel syndrome (IBS—a relapsing functional bowel disorder—presents with disrupted brain connections. However, little is known about the alterations of interhemispheric functional connectivity and underlying structural connectivity in IBS. This study combined resting-state functional magnetic resonance imaging (MRI and diffusion tensor imaging (DTI to investigate changes in interhemispheric coordination in IBS patients. Resting-state functional and structural magnetic resonance images were acquired from 65 IBS patients and 67 healthy controls (matched for age, sex and educational level. Interhemispheric voxel-mirrored homotopic connectivity (VMHC was calculated and compared between groups. Homotopic regions showing abnormal VMHC in patients were targeted as regions of interest for analysis of DTI tractography. The fractional anisotropy, fiber number, and fiber length were compared between groups. Statistical analysis was also performed by including anxiety and depression as covariates to evaluate their effect. A Pearson correlation analysis between abnormal interhemispheric connectivity and clinical indices of IBS patients was performed. Compared to healthy controls, IBS patients had higher interhemispheric functional connectivity between bilateral thalami, cuneus, posterior cingulate cortices, lingual gyri and inferior occipital/cerebellum lobes, as well as lower interhemispheric functional connectivity between bilateral ventral anterior cingulate cortices (vACC and inferior parietal lobules (IPL. The inclusion of anxiety and depression as covariates abolished VMHC difference in vACC. Microstructural features of white matter tracts connecting functionally abnormal regions did not reveal any differences between the groups. VMHC values in vACC negatively correlated with the quality of life scores of patients. In conclusion, this study provides preliminary evidence of the disrupted

  11. Do interactions between stress and immune responses lead to symptom exacerbations in irritable bowel syndrome?

    Science.gov (United States)

    O'Malley, Dervla; Quigley, Eamonn M M; Dinan, Timothy G; Cryan, John F

    2011-10-01

    Irritable bowel syndrome (IBS) is a common, debilitating gastrointestinal (GI) disorder, with a worldwide prevalence of between 10% and 20%. This functional gut disorder is characterized by episodic exacerbations of a cluster of symptoms including abdominal pain, bloating and altered bowel habit, including diarrhea and/or constipation. Risk factors for the development of IBS include a family history of the disorder, childhood trauma and prior gastrointestinal infection. It is generally accepted that brain-gut axis dysfunction is fundamental to the development of IBS; however the underlying pathophysiological mechanisms remain elusive. Additional considerations in comprehending the chronic relapsing pattern that typifies IBS symptoms are the effects of both psychosocial and infection-related stresses. Indeed, co-morbidity with mood disorders such as depression and anxiety is common in IBS. Accumulating evidence points to a role for a maladaptive stress response in the initiation, persistence and severity of IBS-associated symptom flare-ups. Moreover, mechanistically, the stress-induced secretion of corticotropin-releasing factor (CRF) is known to mediate changes in GI function. Activation of the immune system also appears to be important in the generation of IBS symptoms and increasing evidence now implicates low-grade inflammation or immune activation in IBS pathophysiology. There is a growing body of research focused on understanding at a molecular, cellular and in vivo level, the relationship between the dysregulated stress response and immune system alterations (either individually or in combination) in the etiology of IBS and to the occurrence of symptoms. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Using read codes to identify patients with irritable bowel syndrome in general practice: a database study.

    Science.gov (United States)

    Harkness, Elaine F; Grant, Laura; O'Brien, Sarah J; Chew-Graham, Carolyn A; Thompson, David G

    2013-12-02

    Estimates of the prevalence of irritable bowel syndrome (IBS) vary widely, and a large proportion of patients report having consulted their general practitioner (GP). In patients with new onset gastrointestinal symptoms in primary care it might be possible to predict those at risk of persistent symptoms. However, one of the difficulties is identifying patients within primary care. GPs use a variety of Read Codes to describe patients presenting with IBS. Furthermore, in a qualitative study, exploring GPs' attitudes and approaches to defining patients with IBS, GPs appeared reluctant to add the IBS Read Code to the patient record until more serious conditions were ruled out. Consequently, symptom codes such as 'abdominal pain', 'diarrhoea' or 'constipation' are used. The aim of the current study was to investigate the prevalence of recorded consultations for IBS and to explore the symptom profile of patients with IBS using data from the Salford Integrated Record (SIR). This was a database study using the SIR, a local patient sharing record system integrating primary, community and secondary care information. Records were obtained for a cohort of patients with gastrointestinal disorders from January 2002 to December 2011. Prevalence rates, symptom recording, medication prescribing and referral patterns were compared for three patient groups (IBS, abdominal pain (AP) and Inflammatory Bowel Disease (IBD)). The prevalence of IBS (age standardised rate: 616 per year per 100,000 population) was much lower than expected compared with that reported in the literature. The majority of patients (69%) had no gastrointestinal symptoms recorded in the year prior to their IBS. However a proportion of these (22%) were likely to have been prescribed NICE guideline recommended medications for IBS in that year. The findings for AP and IBD were similar. Using Read Codes to identify patients with IBS may lead to a large underestimate of the community prevalence. The IBS diagnostic Read

  13. Irritable bowel syndrome subtypes: clinical and psychological features, body mass index and comorbidities

    Directory of Open Access Journals (Sweden)

    Cristiane Kibune-Nagasako

    2016-02-01

    Full Text Available Background: Irritable bowel syndrome (IBS is classified into subtypes according to bowel habit. Objective: To investigate whether there are differences in clinical features, comorbidities, anxiety, depression and body mass index (BMI among IBS subtypes. Methods: The study group included 113 consecutive patients (mean age: 48 ± 11 years; females: 94 with the diagnosis of IBS. All of them answered a structured questionnaire for demographic and clinical data and underwent upper endoscopy. Anxiety and depression were assessed by the Hospital Anxiety and Depression scale (HAD. Results: The distribution of subtypes was: IBS-diarrhea (IBS-D, 46%; IBS-constipation (IBS-C, 32%, and mixed IBS (IBS-M, 22%. IBS overlap with gastroesophageal reflux disease (GERD, functional dyspepsia, chronic headache and fibromyalgia occurred in 65.5%, 48.7%, 40.7% and 22.1% of patients, respectively. Anxiety and/or depression were found in 81.5%. Comparisons among subgroups showed that bloating was significantly associated with IBS-M compared to IBS-D (odds ratio-OR-5.6. Straining was more likely to be reported by IBS-M (OR 15.3 and IBS-C (OR 12.0 compared to IBS-D patients, while urgency was associated with both IBS-M (OR 19.7 and IBS-D (OR 14.2 compared to IBS-C. In addition, IBS-M patients were more likely to present GERD than IBS-D (OR 6.7 and higher scores for anxiety than IBS-C patients (OR 1.2. BMI values did not differ between IBS-D and IBS-C. Conclusion: IBS-M is characterized by symptoms frequently reported by both IBS-C (straining and IBS-D (urgency, higher levels of anxiety, and high prevalence of comorbidities. These features should be considered in the clinical management of this subgroup.

  14. ASSESSING THE SLEEP QUALITY AND DEPRESSION-ANXIETY-STRESS IN IRRITABLE BOWEL SYNDROME PATIENTS

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    Nadieh BANIASADI

    2017-02-01

    Full Text Available ABSTRACT BACKGROUND Irritable bowel syndrome (IBS is one of the most common functional gastrointestinal disorders with chronic abdominal pain and altered bowel habit without any organic reason. Sleep disorders may be associated to IBS. OBJECTIVE We aimed to assess sleep disturbances and depression-anxiety-stress in IBS patients. METHODS In this analytical cross sectional study from November 2013 to May 2014, A total of 123 IBS patients were recruited by simple random sampling. IBS was diagnosed using ROME-III criteria. Demographic and basic data were driven from all patients then Pittsburg Sleep Quality Index questionnaire was utilized to estimate sleep quality and DASS (depression anxiety stress scale questionnaire was filled out for depression, anxiety and stress. RESULTS The mean age of patients was 29±9, where 48 cases (39% were male. Twelve cases (10% had a background disease. Types of IBS in patients were included 38% diarrhea, 42% constipation and 20% mixed. From all IBS patients 87 (71% cases had depression, 97 (79% patients stress, 94 (76% patients had anxiety. Seventy-six (62% cases of IBS patients had poor sleep quality. Simultaneously employing predictors demonstrate that gender, background disease, and type of IBS did not statistically significant. On the other hand, depression (P=0.034, OR=2.35, anxiety (P=0.011, OR=3.022, and stress (P=0.029, OR=2.77 were significantly effect on sleep quality in poor sleepers. CONCLUSION Many of IBS patients is suffering from poor sleep quality. It seems that sleep disorder should be considered and treated in this patients.

  15. Peculiarities of Intestine Motor-Evacuation Function in Patients with Various Forms of Irritable Bowel Syndrome

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    S.A. Nagieva

    2016-04-01

    Full Text Available To assess motor and evacuation function of gastrointestinal tract in irritable bowel syndrome (IBS several methods can be used. Our aim was to study colonic motility in patients with different variants of IBS using dynamic scintigraphy. Materials and methods. 107 patients with IBS by Rome III criteria (2006 were enrolled. All patients were divided into 4 groups: I group — IBS with constipation (36/107, 33.6 %, II group — IBS with diarrhea (35/107, 32.7 %, III group — unspecified IBS (22/107, 20.7 %, IV group — mixed IBS (14/107, 13.0 %. Dynamic scintigraphy was done using scintillation gamma-room OFECT‑1 and EBM. Medium activity of radiopharmaceutical was taken at a rate of 10 MBq/kg body weight of the patient. Results. The results showed that in case of the IBS with constipation the passage of radiopharmaceutical decreased (increased radioactivity in the abdomen (> 60 % and asymmetry of the right and left parts of the bowel is 2 5 %, p 0.05. Conclusion. Using dynamic scintigraphy we found expressed slowing of the passage of radiopharmaceutical in IBS patients with constipation (p < 0.05, while in case of IBS with diarrhea the speed of radiopharmaceutical evacuation was increased (p < 0.05. In a case of other variants of IBS no statistically significant changes were detected.

  16. VISUAL ASSESSMENT OF THE MUCOSA OF THE COLON IN IRRITABLE BOWEL SYNDROME IN THE DYNAMICS OF TREATMENT

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    A. E. Shklyaev

    2016-01-01

    Full Text Available Introduction. Irritable bowel syndrome (IBS is a common functional disorder of the gastrointestinal tract. The difficulty of its diagnosis related to the lack of specific markers of the disease. This article describes the visual changes of the mucosa of the colon in irritable bowel syndrome in the dynamics of medical and physiotherapy treatment. Materials and methods. Examined and treated 100 patients with endoscopically confirmed diagnosis of IBS. Of which 50 people were receiving pharmacotherapy and 50 –sinusoidal modulated currents — phoresis natural brine. Given the morphological evaluation of the mucosa of the intestine in the dynamics of treatment. Results. In IBS morpho-endoscopically detected dyskinetic disorders, minimal signs of nonspecific inflammation of the mucosa of the colon and primary degenerative manifestations. These changes are reversible and can be used to assess the quality of treatment. The high efficiency of SMC-phoresis natural brine in IBS.

  17. The risk of extra-colonic, extra-endometrial cancer in the Lynch syndrome

    DEFF Research Database (Denmark)

    Watson, Patrice; Vasen, Hans F A; Mecklin, Jukka-Pekka

    2008-01-01

    Persons with the Lynch syndrome (LS) are at high risk for cancer, including cancers of the small bowel, stomach, upper urologic tract (renal pelvis and ureter), ovary, biliary tract and brain tumors, in addition to the more commonly observed colorectal and endometrial cancers. Cancer prevention...... persons missing crucial information, cohort included 6,041 members of 261 families with LS-associated MLH1 or MSH2 mutations. All were either mutation carriers by test, probable mutation carriers (endometrial/colorectal cancer-affected), or first-degree relatives of these. Among mutation carriers...... strategies for these less common cancers require accurate, age-specific risk estimation. We pooled data from 4 LS research centers in a retrospective cohort study, to produce absolute incidence estimates for these cancer types, and to evaluate several potential risk modifiers. After elimination of 135...

  18. Oral Cancer and Oral Precancerous Lesions in Inflammatory Bowel Diseases: A Systematic Review.

    Science.gov (United States)

    Katsanos, Konstantinos H; Roda, Giulia; Brygo, Alexandre; Delaporte, Emmanuel; Colombel, Jean-Frédéric

    2015-11-01

    Oral cancer is historically linked to well-known behavioural risk factors such as tobacco smoking and alcohol consumption. Other risk factors include age over 40, male sex, several dietary factors, nutritional deficiencies, viruses, sexually transmitted infections, human papillomavirus, chronic irritation, and possibly genetic predisposition. Precancerous lesions in the oral cavity include leukoplakia, erythroplakia, and lichen planus. Histology of oral cancer varies widely but the great majority are squamous cell carcinomas.Epidemiological studies and cancer registries have shown a consistently increased risk of oral malignancies in kidney, bone marrow, heart, or liver transplantation, in graft vs host disease, and in patients with HIV infection. Because of the increasing use of immunosuppressive drugs in patients with inflammatory bowel disease, it is useful to more accurately delineate the consequences of chronic immunosuppression to the oral cavity. Oral cancer and precancerous oral lesions in patients with inflammatory bowel disease [IBD] have been scarcely reported and reviews on the topic are lacking.We conducted a literature search using the terms and variants of all cancerous and precancerous oral manifestations of inflammatory bowel diseases. By retrieving the existing literature, it is evident that patients with IBD belong to the high-risk group of developing these lesions, a phenomenon amplified by the increasing HPV prevalence. Education on modifiable risk behaviours in patients with oral cancer is the cornerstone of prevention.Oral screening should be performed for all IBD patients, especially those who are about to start an immunosuppressant or biological drug. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  19. Systematic identification of core transcription factors mediating dysregulated links bridging inflammatory bowel diseases and colorectal cancer.

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    Yun Xiao

    Full Text Available Accumulating evidence shows a tight link between inflammation and cancer. However, comprehensive identification of pivotal transcription factors (i.e., core TFs mediating the dysregulated links remains challenging, mainly due to a lack of samples that can effectively reflect the connections between inflammation and tumorigenesis. Here, we constructed a series of TF-mediated regulatory networks from a large compendium of expression profiling of normal colonic tissues, inflammatory bowel diseases (IBDs and colorectal cancer (CRC, which contains 1201 samples in total, and then proposed a network-based approach to characterize potential links bridging inflammation and cancer. For this purpose, we computed significantly dysregulated relationships between inflammation and their linked cancer networks, and then 24 core TFs with their dysregulated genes were identified. Collectively, our approach provides us with quite important insight into inflammation-associated tumorigenesis in colorectal cancer, which could also be applied to identify functionally dysregulated relationships mediating the links between other different disease phenotypes.

  20. Sexual Abuse in Irritable Bowel Syndrome: To Ask or Not to Ask – That Is the Question

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    Alexandra Ilnyckyj

    2002-01-01

    Full Text Available BACKGROUND: Irritable bowel syndrome (IBS is a common and costly disorder in Canada. The paucity of medical treatment underscores the importance of examining every element of the management approach. Data exist supporting an increased prevalence of abuse among individuals with IBS. Importantly, the pathophysiology underlying the link between abuse and IBS is increasingly understood. Treatment recommendations by opinion leaders support an abuse inquiry. However, many clinicians view abuse inquiry as an ethical dilemma.

  1. Screening of coeliac disease in undetected adults and patients diagnosed with irritable bowel syndrome in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Al-Ajlan, Abdulrahman S

    2016-07-01

    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.

  2. Effectiveness of group Mindfulness Based Stress Reduction consultation of severity of physical symptoms in women with irritable bowel syndrome

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    Hashemi Fatemeh

    2016-06-01

    Full Text Available Background and Objective: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders that affect both genders in different ages, but its prevalence is higher in women. Because of perceived stress are very important factors in development of symptoms, the current study aimed to determine the effectiveness of group mindfulness based stress reduction consultation on severity of physical symptoms in women with irritable bowel syndrome. Materials and Method: This semi-experimental study was conducted on 30 women with irritable bowel syndrome referred to one of the educational hospitals in Zahedan in 2015. 30 patients were selected conveniently and then were randomly allocated into two intervention and control groups. The intervention group was received the 8 sessions (each session 90-minutes educational program. Data were collected through the IBS Symptom Severity Scale before and one week after the intervention. Data analysis was done through using SPSS 20, chi-square, independent T-test, paired T-test and ANCOVA. Results: The mean of physical symptoms severity before the intervention in intervention and control groups was 309.46±32.19 and 304.01±34.01 respectively that after the intervention were changed to 228.6±13.56 in intervention (p=0.001 and 299.8±15.72 in control group (p=0.8 The result of ANCOVA test showed that there was significant differences between the two groups after the intervention (p=0.001 Conclusion: Group mindfulness based stress reduction method can be used to reduce severity of physical symptoms in women with irritable bowel syndrome. The application of this method in order to improve the symptoms of stress in other diseases is recommended

  3. Effectiveness of group Mindfulness Based Stress Reduction consultation of severity of physical symptoms in women with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Fatemeh Hashemi

    2016-02-01

    Full Text Available Background: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders that affect both genders in different ages, but its prevalence is higher in women. Because of perceived stress are very important factors in development of symptoms, the current study aimed to determine the effectiveness of group mindfulness based stress reduction consultation on severity of physical symptoms in women with irritable bowel syndrome. Methods: This semi-experimental study was conducted on 30 women with irritable bowel syndrome referred to one of the educational hospitals in Zahedan in 2015. 30 patients were selected conveniently and then were randomly allocated into two intervention and control groups. The intervention group was received the 8 sessions (each session 90-minutes educational program. Data were collected through the IBS Symptom Severity Scale before and one week after the intervention. Data analysis was done through using SPSS 20, chi-square, independent T-test, paired T-test and ANCOVA. Results: The mean of physical symptoms severity before the intervention in intervention and control groups was 309.46 ± 32.19 and 304.01 ± 34.01 respectively that after the intervention were changed to 228.60 ± 13.56 in intervention (p = 0.001 and 299.80 ± 15.72 in control group (p = 0.8 The result of ANCOVA test showed that there was significant differences between the two groups after the intervention (p = 0.001. Conclusion: Group mindfulness based stress reduction method can be used to reduce severity of physical symptoms in women with irritable bowel syndrome. The application of this method in order to improve the symptoms of stress in other diseases is recommended.

  4. Screening of coeliac disease in undetected adults and patients diagnosed with irritable bowel syndrome in Riyadh, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulrahman S. Al-Ajlan

    2016-07-01

    Full Text Available 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.

  5. Prevalence and predictors of irritable bowel syndrome among medical students and interns in King Abdulaziz University, Jeddah

    OpenAIRE

    Ibrahim, Nahla Khamis Ragab; Battarjee, Wijdan Fahad; Almehmadi, Samia Ahmed

    2013-01-01

    Background: Irritable bowel syndrome (IBS) is a frequent, costly, and potentially disabling gastrointestinal disorder. Medical education is among the most challenging and the most stressful education, and this may predispose to high rates of IBS.Objective: To determine the prevalence and predictors of IBS among medical students and interns in King Abdulaziz University, Jeddah, Saudi Arabia.Methods: A cross-sectional study was conducted among 597 medical students and interns selected by multis...

  6. Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women

    OpenAIRE

    Mykletun, Arnstein; Jacka, Felice; Williams, Lana; Pasco, Julie; Henry, Margaret; Nicholson, Geoffrey C.; Kotowicz, Mark A.; Berk, Michael

    2010-01-01

    Abstract Background Irritable bowel syndrome (IBS) is commonly regarded as a functional disorder, and is hypothesized to be associated with anxiety and depression. This evidence mainly rests on population-based studies utilising self-report screening instruments for psychopathology. Other studies applying structured clinical interviews are generally based on small clinical samples, which are vulnerable to biases. The extant evidence base for an association between IBS and psychopathology is h...

  7. Effect of a corticotropin releasing hormone receptor antagonist on colonic sensory and motor function in patients with irritable bowel syndrome

    OpenAIRE

    Sagami, Y; Shimada, Y; Tayama, J; Nomura, T; Satake, M; Endo, Y; Shoji, T; Karahashi, K; Hongo, M; Fukudo, S

    2004-01-01

    Background and aims: Corticotropin releasing hormone (CRH) is a major mediator of the stress response in the brain-gut axis. Irritable bowel syndrome (IBS) is presumed to be a disorder of the brain-gut link associated with an exaggerated response to stress. We hypothesised that peripheral administration of α-helical CRH (αhCRH), a non-selective CRH receptor antagonist, would improve gastrointestinal motility, visceral perception, and negative mood in response to gut stimulation in IBS patient...

  8. Gastrointestinal Endometriosis Causing Subacute Intestinal Obstruction with Gradual Development of Weight Loss and Misdiagnosed as Irritable Bowel Syndrome

    OpenAIRE

    Amir Soumekh; Jerry Nagler

    2014-01-01

    Both endometriosis and irritable bowel syndrome (IBS) are commonly found in young women and the diagnosis of either is challenging. Alarm symptoms can exclude the diagnosis of IBS, but their onset may be insidious and often no evidence of organic disease may be found. We present a patient with a 4-year history of presumed IBS, absent gynecological symptoms, negative gastrointestinal as well as gynecological testing who developed the only alarm symptom of weight loss and was eventually found t...

  9. Increased chromogranin A cell density in the large intestine of patients with irritable bowel syndrome after receiving dietary guidance

    OpenAIRE

    Mazzawi, Tarek; Gundersen, Doris Irene; Hausken, Trygve; El-Salhy, Magdy

    2015-01-01

    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...

  10. Surgical management of malignant bowel obstruction in recurrent pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Hyung Sun Kim

    2017-01-01

    Discussion and conclusion: Palliative surgery improves quality of life in recurrent pancreatic cancer patients and can continue patient’s palliative management. In selected patients, palliative surgery may effective management for progress of survival and quality of life.

  11. [Malignant small bowel ileus due to recurrent colorectal cancer with peritoneal metastasis].

    Science.gov (United States)

    Tomita, Ryouichi; Fujisaki, Shigeru; Sakurai, Kenichi; Park, Eichi; Inoue, Mikiya; Sugito, Kiminobu; Ikeda, Taro; Koshinaga, Tsugumichi

    2014-11-01

    To investigate the clinical findings of patients who underwent surgery for small bowel obstruction following a previous operation for colorectal cancer. We assessed consecutive patients operated on for peritoneal metastasis with small bowel ileus. We evaluated the clinical characteristics of 7 consecutive patients with malignant small bowel ileus due to recurrent colorectal cancer with peritoneal metastasis. 1) Primary cancer location: descending colon, 2 cases (28.6%); sigmoid colon, 1 case (14.3%); and rectum, 4 cases (57.1%). 2) Peritoneal dissemination grade: P2, 1 case (14.3%); and P3, 6 cases (85.7%). 3) Liver metastasis grade: H1, 1 case (14.3%); H2, 5 cases (71.4%); and H3, 1 case (14.3%). 4) Lymph node metastasis grade: N2, 1 case (14.3%); and N3, 6 cases (85.7%). 5) Extra-abdominal metastasis: multiple lung metastases were detected in 3 cases (42.9%). 6) Pathological type: moderately differentiated tubular adenocarcinoma (tub2), 3 cases (42.3%); poorly differentiated adenocarcinoma (por), 1 case (14.3%); and mucinous adenocarcinoma (muc), 3 cases (42.3%). The differentiated type (tub2) was more common than the undifferentiated types(por and muc). 7) Malignant small bowel stenosis and/or obstruction: there were 3 or more cases with stenosis and/or obstruction in jejunum and ileum. 8) OPERATIVE PROCEDURE: gastrostomy was performed in 2 cases (28.6%); nephrostomy was performed in 1 case (14.3%); gastrostomy with nephrostomy was performed in 1 case (14.3%); and probe laparotomy was performed in 3 cases (42.9%). 9) Survival time of patients with recurrent colorectal cancer, from readmission to death: 0.5-1 month, 3 cases (42.9%); 1-1.5 months, 3 cases (42.9%); and 1.5-3 months, 1 case (14.3%). All patients died in less than 3 months. The prognosis of the malignant small bowel ileus due to recurrent colorectal cancer with peritoneal metastasis is very bad.

  12. The effects of an acute serotonergic challenge on brain-gut responses in irritable bowel syndrome patients and controls.

    Science.gov (United States)

    Kilkens, T O C; Honig, A; Fekkes, D; Brummer, R-J M

    2005-11-01

    Serotonin, a key denominator of the brain-gut axis is involved in the regulation of gastrointestinal function as well as cognition, mood and hypothalamic-pituitary-adrenal axis-mediated neuroendocrine responses. To assess the effects of an acutely increased serotonergic activity, using a 20 mg intravenous citalopram challenge test on visceral perception, affective memory performance, mood and neuroendocrine responses, respectively, in diarrhoea-predominant irritable bowel syndrome patients and controls. In a randomized, double-blind crossover design, 14 diarrhoea-predominant irritable bowel syndrome patients and 14 matched controls were studied under citalopram and placebo conditions, respectively. Visceral perception was scored in response to rectal distensions. Affective memory performance, mood, levels of adrenocorticotropic hormone, cortisol, prolactin and biochemical parameters of serotonergic metabolism were simultaneously assessed. Visceral perception did not significantly differ between the citalopram and placebo condition. Citalopram administration enhanced affective memory performance because of a bias towards positive material but no significant changes in mood. Citalopram significantly increased plasma serotonin, adrenocorticotropic hormone and cortisol levels compared with placebo. Citalopram did not differentially affect the patient or control group. We have provided evidence that acutely increased serotonergic activity influences neuroendocrine responses and cognition in diarrhoea-predominant irritable bowel syndrome and controls without a significant effect on visceral perception.

  13. Abnormal breath tests to lactose, fructose and sorbitol in irritable bowel syndrome may be explained by small intestinal bacterial overgrowth.

    Science.gov (United States)

    Nucera, G; Gabrielli, M; Lupascu, A; Lauritano, E C; Santoliquido, A; Cremonini, F; Cammarota, G; Tondi, P; Pola, P; Gasbarrini, G; Gasbarrini, A

    2005-06-01

    Small intestinal bacterial overgrowth and sugar malabsorption (lactose, fructose, sorbitol) may play a role in irritable bowel syndrome. The lactulose breath test is a reliable and non-invasive test for the diagnosis of small intestinal bacterial overgrowth. The lactose, fructose and sorbitol hydrogen breath tests are widely used to detect specific sugar malabsorption. To assess the extent to which small intestinal bacterial overgrowth may influence the results of hydrogen sugar breath tests in irritable bowel syndrome patients. We enrolled 98 consecutive irritable bowel syndrome patients. All subjects underwent hydrogen lactulose, lactose, fructose and sorbitol hydrogen breath tests. Small intestinal bacterial overgrowth patients were treated with 1-week course of antibiotics. All tests were repeated 1 month after the end of therapy. A positive lactulose breath test was found in 64 of 98 (65%) subjects; these small intestinal bacterial overgrowth patients showed a significantly higher prevalence of positivity to the lactose breath test (P fructose breath test (P fructose and sorbitol breath tests positivity (17% vs. 100%, 3% vs. 62%, and 10% vs. 71% respectively: P malabsorption misdiagnosis.

  14. Diagnosis and treatment of irritable bowel syndrome with predominant constipation in the primary-care setting: focus on linaclotide

    Directory of Open Access Journals (Sweden)

    Chandar AK

    2017-10-01

    Full Text Available Apoorva Krishna Chandar1,2 1Department of Gastroenterology and Liver Disease, Case Western Reserve University, 2Digestive Health Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA Abstract: Irritable bowel syndrome (IBS is a complex functional gastrointestinal disorder that is exceedingly common in clinical practice. IBS with predominant constipation (IBS-C is a subtype of IBS that accounts for more than a third of the IBS diagnosed. Diagnosis of IBS requires a careful personalized approach, a comprehensive clinical history, limited but relevant investigations, and continued follow-up. Major IBS societies and guidelines recommend offering a positive diagnosis of IBS based on presenting symptomatology. Abdominal pain that may or may not be relieved by defecation is the cardinal symptom of IBS; distension and bloating are other common symptoms. Careful attention should be paid to alarm symptoms before a diagnosis of IBS is made. Pharmacotherapy with linaclotide is recommended for moderate–severe IBS-C, based on high-quality evidence from randomized controlled trials. Diarrhea is the major side effect of linaclotide, and limited cost-effectiveness data currently exist. Keywords: irritable bowel syndrome, irritable bowel syndrome with predominant constipation, primary care, Rome IV, linaclotide, systematic review 

  15. Expression and role of 5-HT7 receptor in brain and intestine in rats with irritable bowel syndrome.

    Science.gov (United States)

    Zou, Bai-cang; Dong, Lei; Wang, Yan; Wang, Sheng-hao; Cao, Ming-bo

    2007-12-05

    The 5-hydroxytryptamine7 receptor (5-HT(7) receptor, 5-HT(7)R) plays an important role in the regulation of smooth muscle relaxation and visceral sensation and might be involved in the pathogenesis of the gastrointestinal dyskinesia, abdominal pain and visceral paresthesia in irritable bowel syndrome (IBS). The aim of this study was to investigate the role of the 5-HT(7) receptor in the pathogenesis of IBS. A rat model of irritable bowel syndrome with diarrhea (IBS-D) was established by colonic instillation of acetic acid and restraint stress. A rat model with irritable bowel syndrome with constipation (IBS-C) was established by stomach irrigated with 0 - 4 degrees C cool water daily for 14 days. The content and distribution of 5-HT in the brain and gut were examined by immunohistochemistry and the mRNA expression of the 5-HT(7) receptor was determined by fluorescent quantitative reverse transcription polymerase chain reaction. The accumulation of cyclic adenosine monophosphate (cAMP) in all the same tissues was measured by radioimmunity. The models of IBS were reliable by identification. The immunohistochemistry results showed that there were significantly more 5-HT positive cells in the IBS-D group than in the control group in the hippocampus, hypothalamus, jejunum, ileum, proximate colon and distal colon (P intestine is related to the IBS pathogenesis. The up-regulated expression of the 5-HT(7) receptor in the brain and colon might play an important role in the pathogenesis of IBS-C.

  16. Impact of the diagnosis and treatment of cancer on the course of inflammatory bowel disease.

    Science.gov (United States)

    Rajca, S; Seksik, P; Bourrier, A; Sokol, H; Nion-Larmurier, I; Beaugerie, L; Cosnes, J

    2014-08-01

    The effects of extra-intestinal cancer on the course of inflammatory bowel disease (IBD) are poorly understood. To evaluate the impact of cancer and its management on IBD outcomes. A total 80 IBD patients (51 Crohn's disease, 29 ulcerative colitis; 33 men, median age at cancer diagnosis 48yrs) diagnosed with extra-intestinal cancer were selected from a prospective database. IBD activity and therapeutic requirements (assessed year-by-year) were compared before and after cancer diagnosis, with a control group of patients without cancer matched for gender, birth date, date of IBD diagnosis and IBD phenotype. Paired comparisons of the consecutive periods before and after cancer diagnosis did not show significant changes in median (IQR) percentages of years with active disease (27% [0-50] vs. 19% [0-53]), while the proportion of patient-years on any immunosuppressant remained stable (26% vs. 28%). Chemotherapy had no significant effect on IBD activity. Compared to controls, patients with cancer had a similar IBD activity and use of anti-TNF, but less use of immunomodulators (19% vs. 25%, pcancer diagnosis were not significantly different in patients with cancer and their matched controls. Occurrence of extra-intestinal cancer impacts IBD therapeutic management, with a trend towards less use of immunomodulators and more surgery. In the long-term, cancer diagnoses and treatments do not modify IBD outcomes. Copyright © 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  17. The association of catastrophizing with quality-of-life outcomes in patients with irritable bowel syndrome.

    Science.gov (United States)

    Sherwin, LeeAnne B; Leary, Emily; Henderson, Wendy A

    2017-08-01

    Catastrophizing is a cognitive process characterized by a propensity to concentrate on and magnify the value of an actual or anticipated painful stimulus and negatively assesses one's ability to cope. Catastrophizing is an important predictor of pain-related outcomes. A cornerstone symptom of irritable bowel syndrome (IBS) is abdominal pain or discomfort. Also individuals with IBS have been reported to have a tendency to catastrophize. In a sample of individuals who suffer from IBS, we hypothesized that those individuals who catastrophize (catastrophizers) would have worse outcomes as compared to those who do not catastrophize (non-catastrophizers). One hundred and one adults with IBS (79% female, mean age 42 years, 97% Caucasian) were recruited from outpatient clinics and data were collected through self-report measures. Catastrophizing was measured with the catastrophizing subscale of the Coping Strategies Questionnaire, illness representations were measured with The Revised Illness Perception Questionnaire (IPQ-R), psychological distress was measured with the Brief Symptom Inventory 18 (BSI-18), and health-related quality of life was measured using the Irritable Bowel Syndrome-Quality of Life (IBS-QOL) measure. Descriptive statistics, correlations, and multiple linear regression analyses were completed to describe participants, the associations of the variables of interest, and the unique relationship between psychosocial variables and HRQOL. Overall, participants reported poor HRQOL (M = 63.32, range 0-100). Catastrophizers differed significantly on IBS-QOL from non-catastrophizers (M = 48.98 vs. non-catastrophizers M = 78.53; p IPQ-R, specifically the consequences (M = 21.75 vs. non-catastrophizers M = 17.20; p < 0.001) and emotional representations (M = 20.90 vs. non-catastrophizers M = 15.43; p < 0.001). Catastrophizing was positively correlated with the consequences (r = .54; p < 0.01) and emotional

  18. Increase in Mexican and Latin American scientific articles on irritable bowel syndrome.

    Science.gov (United States)

    Porras, R; López-Colombo, A; Schmulson, M

    2015-01-01

    There is an implied perception that little scientific information on irritable bowel syndrome (IBS) comes out of Mexico and Latin America in the international medical literature, but the number and tendencies of articles from the region on IBS are not known. To determine the number and type of Mexican and Latin American articles on IBS published between 1990-2015. A systematic search of Medline was carried out employing the terms « Irritable Bowel Syndrome » or its abbreviation (IBS). Mexico and every other Latin American country were added to specify the search. The articles were selected if they were published in Mexico and/or the rest of Latin America, if they were international papers on IBS in the region, or if they were written by Mexican and/or Latin American authors. In addition, the articles were classified into the following categories: Reviews/Editorials/Letters to the Editor (REV/ED), Epidemiology/Quality of Life/Psychosocial Factors (EPI/QOL), Diagnostic (DX), Treatment (TX), and Translational/Pathophysiologic (TRANS) studies. A total of 66 articles from Mexico and 47 from Latin America were identified, but only 87.7 and 48.9%, respectively, fit the selection criteria. Category distribution was: EPI/QOL: 36.2%, REV/ED: 27.5%, TRANS: 18.8, TX: 10%, and DX: 7.5% and was similar between Mexico and Latin America (p=0.33). The year 2005 saw an increase in the number of articles in Mexico, with a peak in 2010. The figures for Latin American articles remained stable over the years, with a peak in 2012. A noticeable increase has been observed over the last decade in the research conducted on IBS in Mexico and Latin America. Even though the EPI/QOL studies predominate, the sophistication of research is reflected in the TRANS studies that are in third place of frequency. The information referred to herein demonstrates maturity in the field, making it possible to carry out consensuses based on local data. Copyright © 2015 Asociación Mexicana de

  19. The small intestine and irritable bowel syndrome (IBS): a batch process model.

    Science.gov (United States)

    Dobson, Brian C

    2008-11-01

    Faults in a batch process model of the small intestine create the symptoms of all types of irritable bowel syndrome. The model has three sequential processing sections corresponding to the natural divisions of the intestine. It is governed by a brain controller that is divided into four sub-controllers, each with a unique neurotransmitter. Each section has a sub-controller to manage transport. Sensors in the walls of the intestine provide input and output goes to the muscles lining the walls of the intestine. The output controls the speed of the food soup, moves it in both directions, mixes it, controls absorption, and transfers it to the next section at the correct speed (slow). The fourth sub-controller manages the addition of chemicals. It obtains input from the first section of the process via the signalling hormone Cholecystokinin and sends output to the muscles that empty the gall bladder and pancreas. The correct amounts of bile salts and enzymes are then added to the first section. The sub-controllers produce output only when input is received. When output is missing the enteric nervous system applies a default condition. This default condition normally happens when no food is in the intestine. If food is in the intestine and a transport sub-controller fails to provide output then the default condition moves the food soup to the end of that section. The movement is in one direction only (forward), at a speed dependent on the amount and type of fibre present. Cereal, bean and vegetable fibre causes high speeds. This default high speed transport causes irritable bowel syndrome. A barrier is created when a section moving fast at the default speed, precedes a section controlled by a transport sub-controller. Then the sub-controller constricts the intestine to stop the fast flow. The barrier causes constipation, cramping, and bloating. Diarrhoea results when the section terminating the process moves at the fast default speed. Two problems can occur to prevent

  20. Use of azathioprine and the risk of cancer in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Pasternak, Björn; Svanström, Henrik; Schmiegelow, Kjeld

    2013-01-01

    interval: 0.83, 1.25) or increasing cumulative received doses (increase in rate ratio per 365 additional defined daily doses = 1.06, 95% confidence interval: 0.89, 1.27) were not. In subgroup analyses, azathioprine use was associated with increased risk of lymphoid tissue cancer (rate ratio = 2.40, 95......Increased risks of lymphoma and skin cancer associated with thiopurine use among patients with inflammatory bowel disease have been shown, but data on the overall cancer risk are limited. We conducted a historical cohort study of 45,986 patients with inflammatory bowel disease (of whom, 5,197 (11.......9 (interquartile range: 3.5-12.0) person-years of follow-up, 2,596 incident cases of cancer were detected. Azathioprine use was associated with an increased risk of overall cancer (rate ratio = 1.41, 95% confidence interval: 1.15, 1.74), whereas former use of azathioprine (rate ratio = 1.02, 95% confidence...