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Sample records for bowel syndrome ibs

  1. Development and psychometric testing of the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS).

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    Ohlsson Bodil; Bengtsson Mariette; Ulander Kerstin

    2007-01-01

    Abstract Background The aim of this study was to develop and psychometrically test a short, patient-reported questionnaire to be used in clinical practice for patients with Irritable Bowel Syndrome (IBS). The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) questionnaire was designed to measure the treatment response of symptoms and well-being in patients suffering from IBS. Methods The VAS-IBS was psychometrically tested for content and criterion validity, scale acceptability, it...

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

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    Anita D. Stuart; Debbie Bloch; 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...

  3. Tegaserod in the treatment of irritable bowel syndrome (IBS) with constipation as the prime symptom

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    Layer, Peter; Keller, Jutta; Loeffler, Helena; Kreiss, Andreas

    2007-01-01

    Irritable bowel syndrome with constipation (IBS-C) as the predominant bowel symptom is a prevalent disorder, characterized by recurring abdominal pain/discomfort, bloating, and constipation, and imposes a significant socio-economic burden. Traditional treatments generally address just one of the multiple IBS symptoms. The efficacy and safety profile of tegaserod, a serotonin 5-HT4 receptor agonist, has been demonstrated in several randomized, placebo-controlled, and open-label trials. This re...

  4. Development and psychometric testing of the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS

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    Ohlsson Bodil

    2007-05-01

    Full Text Available Abstract Background The aim of this study was to develop and psychometrically test a short, patient-reported questionnaire to be used in clinical practice for patients with Irritable Bowel Syndrome (IBS. The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS questionnaire was designed to measure the treatment response of symptoms and well-being in patients suffering from IBS. Methods The VAS-IBS was psychometrically tested for content and criterion validity, scale acceptability, item-reduction, internal reliability consistency, simplicity, and speed. Two samples were used. One expert panel (five physicians and four registered nurses, who gave their opinion on the content validity, and one of 71 patients with IBS (mean age 38 years SD +13, range 19–65, who completed the VAS-IBS, as well as the Gastrointestinal Symptom Rating Scale and the Psychological General Well-Being Index for criterion validity. Results The items in the VAS-IBS capture the main physical concerns women with IBS might present and the psychometric testing confirmed that the VAS-IBS is an acceptable homogeneous patient-reported questionnaire indicated by Cronbach's alpha internal consistency reliability coefficient, with a value of 0.85. All correlations to test the criterion validity performed by using Pearson's correlation test, were statistically significant (p Conclusion The VAS-IBS appears to be reliable and user-friendly, for patients as well as for health professionals. The final version of the VAS-IBS including nine items needs to be further tested in clinical practice cross-culturally in women as well as in men.

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

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    Anita D Stuart

    1999-01-01

    Full Text Available 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 determine if there is a significant difference between women with and wi!5out IBS with regard to the following subscales on the Eating Disorder Inventory-2: "Body Dissatisfaction", "Drive for Thinness", "Bulimia" and the "lntroceptive Awareness" subscale. The results show a statistical significant difference between the groups, as well as a statistical significant difference on the "Bulimia" subscale. A statistical significant difference between the groups was also shown with regard to the "introceptive Awareness" subscale. No differences were found with regard to the "Drive for Thinness" and the "Body Dissatisfaction" subscales. The results also did not show a statistical significant difference between the groups with regard to serotonin levels.

    Opsomming
    Die studie het vrouens met Prikkelbare Dermsindroom (PDS en vrouens daarsonder vergelyk ten opsigte van kenmerke van die ingestie versteurings, soos gemeet deur die "Eating Disorder Inventory-2. 'n Vergelyking tussen die groepe ten opsigte van bloed-serotonien vlakke is ook getref. 'n Steekproei (N = 30 van vrouens wat aan PDS ly en 'n kontrolegroep (N = 28 het die "lrritable bowel syndrome Client Questionnaire" en die "Eating Disorder Inventory-2 voltooi. 'n Deel van die studie het gepoog om te bepaai of daar 'n beduidende verskil is tussen vrouens met en sonder PDS ten opsigte van die volgende subskale op die "Eating Disorder Inventory-2: "Body Dissatisfaction", "Drive for Thinness", "Bulimia" en die

  6. Burden of constipation-predominant irritable bowel syndrome (IBS-C) in France, Italy, and the United Kingdom

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    DiBonaventura MD; Prior M; Prieto P.; Fortea J

    2012-01-01

    Marco daCosta DiBonaventura,1 Mercedes Prior,2 Pablo Prieto,2 Josep Fortea21Health Outcomes Practice, Kantar Health, New York, NY, USA; 2Global Market Access, Marketing and Medical Affairs, Almirall, Barcelona, SpainBackground: Several studies have examined the effect of irritable bowel syndrome (IBS) on health outcomes in Western Europe, but less research has focused on the constipation subtype (IBS-C). The current study addresses this gap by comparing patients with IBS-C and matched control...

  7. A prospective study of the psychobehavioral factors responsible for a change from non-patient irritable bowel syndrome to IBS patient status

    OpenAIRE

    Nomura Shinobu; Fujii Yasushi

    2008-01-01

    Abstract Background To investigate non-patient irritable bowel syndrome (IBS) change to IBS and to determine factors predictive of the onset of IBS, individual biological factors, psychological factors, behavioral factors, and environmental factors were examined. Methods The subjects were 105 non-patient IBS (male = 59, female = 46, average age:21.49 ± 2.37), including 68 of the diarrhea-predominant type and 37 of the constipation-predominant type selected from 1,409 university and technical ...

  8. Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS. An epidemiological population based study of women

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    Mykletun Arnstein

    2010-08-01

    Full Text Available 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 hence not conclusive. The aim of this study was therefore to re-examine the hypothesis using population-based data and psychiatric morbidity established with a structured clinical interview. Methods Data were derived from a population-based epidemiological study (n = 1077. Anxiety and mood disorders were established using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP and the General Health Questionnaire (GHQ-12. Current and lifetime IBS was self-reported. Hypertension and diabetes were employed as comparison groups as they are expected to be unrelated to mental health. Results Current IBS (n = 69, 6.4% was associated with an increased likelihood of current mood and/or anxiety disorders (OR = 2.62, 95%CI 1.49 - 4.60. Half the population reporting a lifetime IBS diagnosis also had a lifetime mood or anxiety disorder. Exploratory analyses demonstrated an increased prevalence of IBS across most common anxiety and mood disorders, the exception being bipolar disorder. The association with IBS and symptoms load (GHQ-12 followed a curved dose response pattern. In contrast, hypertension and diabetes were consistently unrelated to psychiatric morbidity. Conclusions IBS is significantly associated with anxiety and mood disorders. This study provides indicative evidence for IBS as a disorder with a psychosomatic aspect.

  9. Genetic epidemiology of irritable bowel syndrome

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    Makker, Jasbir; Chilimuri, Sridhar; Bella, Jonathan N

    2015-01-01

    Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder characterized by presence of abdominal pain or discomfort associated with altered bowel habits. It has three main subtypes - constipation predominant IBS (C-IBS), diarrhea predominant IBS (D-IBS) and IBS with mixed features of both diarrhea as well as constipation (M-IBS). Its pathophysiology and underlying mechanisms remain elusive. It is traditionally believed that IBS is a result of multiple factors incl...

  10. Burden of constipation-predominant irritable bowel syndrome (IBS-C in France, Italy, and the United Kingdom

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    DiBonaventura MD

    2012-11-01

    Full Text Available Marco daCosta DiBonaventura,1 Mercedes Prior,2 Pablo Prieto,2 Josep Fortea21Health Outcomes Practice, Kantar Health, New York, NY, USA; 2Global Market Access, Marketing and Medical Affairs, Almirall, Barcelona, SpainBackground: Several studies have examined the effect of irritable bowel syndrome (IBS on health outcomes in Western Europe, but less research has focused on the constipation subtype (IBS-C. The current study addresses this gap by comparing patients with IBS-C and matched controls for health status, work productivity, and resource utilization.Methods: Data were obtained from the 2010 5EU National Health and Wellness Survey (NHWS, which includes respondents from France, Germany, Italy, Spain, and the UK. Only participants from France (n = 15,051, Italy (n = 7580, and the UK (n = 15,065 were included in the analyses. Respondents who reported a physician diagnosis of IBS and reported only constipation symptoms were compared with respondents who did not report being diagnosed with IBS using a propensity score-matching methodology (matching on sociodemographics, health behaviors, and comorbidities. Differences between patients with IBS-C and matched controls were examined on health status (Short Form Survey Instrument version 2, work productivity (Work Productivity and Activity Impairment questionnaire, and health care resource use in the past 6 months.Results: A total of 83 (0.55%, 109 (1.44%, and 204 (1.35% respondents reported a diagnosis of IBS with only constipation symptoms in France, Italy, and the UK, respectively. Within each country, patients with IBS-C reported significantly worse health status compared with matched controls (all P < 0.05 and significantly more physician visits (all P < 0.05. More hospitalizations were also observed in the UK (P < 0.05. Among those who were employed, patients with IBS-C in France and the UK also reported significantly more presenteeism than matched controls (all P < 0.05.Conclusion: These

  11. Translation and validation of a Japanese version of the irritable bowel syndrome-quality of life measure (IBS-QOL-J

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    Hongo Michio

    2007-03-01

    Full Text Available Abstract Aims To compare quality of life (QOL for patients with irritable bowel syndrome (IBS between the U.S. and Japan, it is indispensable to develop common instruments. The IBS-QOL, which is widely used in Western countries, was translated into Japanese as there has been a lack of Japanese disease-specific QOL measures for IBS. Methods The original 34 items of the IBS-QOL were translated from English into Japanese through two independent forward translations, resolution, back translation, and resolution of differences. Forty nine patients who had GI symptoms but did not have any organic diseases (including 30 IBS patients diagnosed by Rome II criteria were recruited from Tohoku University Hospital in Sendai, Japan and completed a Japanese version of the IBS-QOL (IBS-QOL-J concomitant with a Japanese version of the IBS severity index (IBSSI-J twice within 7–14 days. Results The IBS-QOL-J demonstrated high internal consistency (Cronbach's alpha; 0.96 and high reproducibility (intraclass correlation coefficient; 0.92, p Conclusion The IBS-QOL-J is a reliable instrument to assess the disease-specific QOL for IBS. Considering cross-cultural comparison, this measure is likely to be a valuable tool to investigate the QOL in Japanese patients with IBS.

  12. Validity, reliability, and factor analysis of Persian version of quality of life questionnaire for irritable bowel syndrome (IBS-QOL-34

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    Nasrine Masaeli

    2013-01-01

    Full Text Available Background: Quality of life (QOL improvement is the main objective of treating patients with irritable bowel syndrome (IBS. This study aimed to assess the validity, reliability, and factor analysis of IBS-QOL-34 questionnaire as a common transcultural instrument for Iranian IBS patients. Materials and Methods: Two hundred and forty patients with IBS (based on gastroenterologists′ diagnosis according to ROM III criteria were referred to Digestive Health Clinic in Psychosomatic Research Center have been selected in this study. Aside with IBS-QOL-34, MOS 36-item short-form health survey (SF-36 and IBS severity index (IBSSI questionnaires were completed by the cases for determination of correlation coefficients; the data were analyzed using descriptive statistics, factor analysis, Cronbach′s alpha, Pearson correlation coefficient by Statistical Package for Social Sciences (SPSS software, version 18. Results: Total reliability of the questionnaire was reported by using Cronbach′s alpha as 0.95, ranging from 0.65 to 0.90. Correlation coefficients of concurrent implementation of IBS-QOL with SF-36 and IBSSI resulted in −0.61 and 0.64, respectively. Exploratory factor analysis using varimax rotation identified eight principle components, which will determine QOL at 67% variance. Conclusion: According to the results, IBS-QOL-34 questionnaire has good psychometric properties in the research community and can be safely used as a valid tool to assess QOL of patients with IBS for healthcare and therapeutic purposes.

  13. Blastocystis sp. in Irritable Bowel Syndrome (IBS)--Detection in Stool Aspirates during Colonoscopy.

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    Ragavan, Nanthiney Devi; Kumar, Suresh; Chye, Tan Tian; Mahadeva, Sanjiv; Shiaw-Hooi, Ho

    2015-01-01

    Blastocystis is one of the most common gut parasites found in the intestinal tract of humans and animals. Its' association with IBS is controversial, possibly as a result of irregular shedding of parasites in stool and variation in stool detection. We aimed to screen for Blastocystis in colonic stool aspirate samples in adult patients with and without IBS undergoing colonoscopy for various indications and measure the interleukin levels (IL-8, IL-3 and IL-5). In addition to standard stool culture techniques, polymerase chain reaction (PCR) techniques were employed to detect and subtype Blastocystis. All the serum samples collected were subjected for ELISA studies to measure the interleukin levels (IL-8, IL-3 and IL-5). Among 109 (IBS n = 35 and non-IBS n = 74) adults, direct stool examination and culture of colonic aspirates were initially negative for Blastocystis. However, PCR analysis detected Blastocystis in 6 (17%) IBS and 4 (5.5%) non-IBS patients. In the six positive IBS patients by PCR method, subtype 3 was shown to be the most predominant (3/6: 50%) followed by subtype 4 (2/6; 33.3%) and subtype 5 (1/6; 16.6%). IL-8 levels were significantly elevated in the IBS Blasto group and IBS group (pBlastocystis-infected stools. Patients with IBS infected with parasite showed an increase in the interleukin levels demonstrate that Blastocystis does have an effect in the immune system. PMID:26375823

  14. A prospective study of the psychobehavioral factors responsible for a change from non-patient irritable bowel syndrome to IBS patient status

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    Nomura Shinobu

    2008-09-01

    Full Text Available Abstract Background To investigate non-patient irritable bowel syndrome (IBS change to IBS and to determine factors predictive of the onset of IBS, individual biological factors, psychological factors, behavioral factors, and environmental factors were examined. Methods The subjects were 105 non-patient IBS (male = 59, female = 46, average age:21.49 ± 2.37, including 68 of the diarrhea-predominant type and 37 of the constipation-predominant type selected from 1,409 university and technical college students by use of a questionnaire based on the Rome II diagnostic criteria. The subjects were followed for three years, and various characteristics and IBS symptoms were serially observed (12 times. The IBS incidence rate was calculated. Results During the three years, 37 non-patient IBS (35.24% changed to IBS: 28 diarrhea-predominant type and 9 constipation-predominant type. All IBS symptoms disappeared in 26 non-patient IBS subjects (24.76%. According to quantification method II (discriminant analysis, seven factors (stressor, two kinds of stress coping styles, cognitive appraisal, eating habits, sleeping time, and psychologically abuse were adopted as a predictive model for IBS incidence and were confirmed as predictive of IBS. Conclusion The results of this research show that non-patient IBS is a changeable state that can change into IBS or persons without symptoms. Most of the non-patient IBS subjects who became asymptomatic had had symptoms for six months or less. Furthermore, the longer a non-patient IBS subject had symptoms, the higher the risk of a change to IBS became. The findings suggest the usefulness of identifying and approaching non-patient IBS as early as possible to prevent the onset of IBS. It must be noted that the persons surveyed in the present study had only the diarrhea-predominant and constipation-predominant types. Therefore, the findings of the present study are limited only these two types. Further study including the

  15. Sex-Related Differences in Prepulse Inhibition of Startle in Irritable Bowel Syndrome (IBS)

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    Kilpatrick, L. A.; Ornitz, E.; Ibrahimovic, H.; Treanor, M.; Craske, M.; Nazarian, M.; Labus, J; Mayer, E. A.; Naliboff, B. D.

    2010-01-01

    Alterations in central networks involved in regulation of arousal, attention, and cognition may be critical for IBS symptom maintenance and exacerbation. Differential sensitivities in these networks may underlie sex differences noted in IBS. The current study examined prepulse inhibition (PPI), a measure of sensorimotor gating, in male and female IBS patients. Relationships between PPI and symptom severity were examined, as well as potential menstrual status effects. Compared to healthy contr...

  16. Diet in irritable bowel syndrome

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    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...

  17. Irritable Bowel Syndrome in Children

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    ... KB)​​​​​ Alternate Language URL Irritable Bowel Syndrome in Children Page Content On this page: What is irritable ... GI tract [ Top ] How common is IBS in children? Limited information is available about the number of ...

  18. Sleep and Irritable Bowel Syndrome

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    ... Bruce D. Naliboff, PhD, Clinical Professor of Medical Psychology in the Dept. of Psychiatry and Biobehavioral Sciences, ... Gynecological Aspects of Irritable Bowel Syndrome Symptom Diary Testing in IBS Changes You Should Not Ignore if ...

  19. Medications (for IBS)

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    Full Text Available ... with Diarrhea Nausea and IBS Bloating in IBS Sleep and Irritable Bowel Syndrome Gynecological Aspects of Irritable ... with Diarrhea Nausea and IBS Bloating in IBS Sleep and Irritable Bowel Syndrome Gynecological Aspects of Irritable ...

  20. Efficacy and mode of action of mesalazine in the treatment of diarrhoea-predominant irritable bowel syndrome (IBS-D: study protocol for a randomised controlled trial

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    Leighton Matthew P

    2013-01-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS is reported by one in ten of the population accounting for up to 40% of new referrals to gastroenterology outpatients. Patients characteristically have abdominal discomfort and disturbed bowel habit. Diarrhoea-predominant IBS is characterised by frequent loose stools with associated urgency and abdominal cramps. Current symptomatic treatments can reduce bowel frequency but often fail to reduce discomfort. Mesalazine is an anti-inflammatory drug used to treat patients with inflammatory bowel disease. There is one pilot study suggesting it may be beneficial to patients who have diarrhoea-predominant IBS but these findings need to be confirmed in a larger trial. The current study aims to test the effectiveness of mesalazine to reduce symptoms in diarrhoea-predominant IBS patients. The study will also investigate the mode of action of the drug, especially its impact on mast cell activation. Methods/design This is a multicentre randomised, double-blind, placebo-controlled trial using a parallel group design. At least 108 participants with diarrhoea-predominant IBS will be recruited through at least six hospitals. The intervention is a 12-week course of 2g mesalazine granules taken up to twice a day. The comparator is a blinded placebo granule formulation. Outcome measures include stool diaries, symptom questionnaires, stool and blood samples together with rectal mucosal biopsies. The daily stool diary will record stool frequency and form, urgency, bloating, abdominal pain and a global satisfaction with control of IBS scored each week. The questionnaires will assess bowel symptoms, while the samples and biopsies will be used to analyse underlying mechanisms of any response. Primary outcome will be the average stool frequency during weeks 11 and 12 of the treatment period and will be compared between treatment arms using an analysis of covariance in the form of a general linear model incorporating

  1. 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

  2. The Immune System in Irritable Bowel Syndrome

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    Barbara, Giovanni; 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...

  3. IBS and IBD: Two Very Different Disorders

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    ... IBS. Different intestinal disorders can produce similar symptoms. Irritable bowel syndrome (IBS) is a condition that produces some symptoms ... of IBS and how it differs from IBD. Irritable bowel syndrome (IBS) is classified as a functional gastrointestinal disorder, ...

  4. Quality of Life in Patients with Irritable Bowel Syndrome (IBS), Assessed Using the IBS–Quality of Life (IBS-QOL) Measure After 4 and 8 Weeks of Treatment with Mebeverine Hydrochloride or Pinaverium Bromide: Results of an International Prospective Observational Cohort Study in Poland, Egypt, Mexico and China

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    Hou, Xiaohua; Chen, Shengliang; Zhang,Yali; Sha, Weihong; Yu, Xiaofeng; Elsawah, Hesham; Afifi, Afifi Fahmy; El-Khayat, Hisham Raafat; Nouh, Alaa; Hassan, Mohamed Fathalla; Fatah, Ayman Abdel; Rucker Joerg, Isabel; Sánchez Núñez, Juan Manuel; Osthoff Rueda, Rodolfo; Jurkowska, Grazyna

    2014-01-01

    Background and Objective Irritable Bowel Syndrome (IBS) has a substantial impact on health-related quality of life (HR-QoL) but high-quality data pre- and post-treatment using the IBS–Quality of Life (IBS-QOL) measure are limited. The objective of this study was to evaluate the changes from baseline of the IBS-QOL scores, symptom scores and health economic data in IBS patients, after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide. Methods This was a prospective...

  5. Genetics of irritable bowel syndrome.

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    Henström, Maria; D'Amato, Mauro

    2016-12-01

    Irritable bowel syndrome (IBS) is a common condition with a complex and largely unknown etiology. There is no cure, and treatment options are mainly directed to the amelioration of symptoms. IBS causes reduced quality of life and poses considerable repercussions on health and socioeconomic systems. There is a heritable component in IBS, and genetic research is a valuable tool for the identification of causative pathways, which will provide important insight into the pathophysiology. However, although some gene-hunting efforts have been conducted and a few risk genes proposed, IBS genetic research is lagging behind compared to other complex diseases. In this mini-review, we briefly summarize existing genetic studies, discuss the main challenges in IBS genetic research, and propose strategies to overcome these challenges for IBS gene discovery. PMID:26873717

  6. Serotonin, visceral sensation in irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    QIAN Jia-ming

    2007-01-01

    @@ Irritable bowel syndrome(IBS) is highly prevalent and can affect up to 20% of the population.1 It is a common gastrointestinal(GI) disorder associated with alterations in motility,secretion and visceral sensation.

  7. 18B. Integrative Solutions for the Irritable Bowel Syndrome

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    Mullin, Gerard; Lee, Linda

    2013-01-01

    Focus Areas: Integrative Approaches to Care, Pediatrics The irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and altered bowel movements. The diagnosis of IBS is established by the Rome III criteria. IBS afflicts 10% to 15% of the US population (30 million Americans) and is the most common digestive disorder seen in the primary care setting. Patients with IBS have an impaired quality of life and high rate of absenteeism from work with diminished pr...

  8. Narcotic Bowel Syndrome

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    ... Intolerance Malabsorption Narcotic Bowel Syndrome Radiation Therapy Injury Short Bowel Syndrome Symptoms & Causes Treatments Nutrition and Diet Managing Secondary Effects Medications Surgery Daily Living with SBS Resources SMA Syndrome Volvulus ...

  9. 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 hav

  10. 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 co

  11. Irritable bowel syndrome: Relations with functional, mental, and somatoform disorders

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    Hausteiner-Wiehle, Constanze; Henningsen, Peter

    2014-01-01

    This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is l...

  12. No difference in small bowel microbiota between patients with irritable bowel syndrome and healthy controls

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    Aldona Dlugosz; Björn Winckler; Elin Lundin; Katherina Zakikhany; Gunnar Sandström; Weimin Ye; Lars Engstrand; Greger Lindberg

    2015-01-01

    Several studies have indicated that colonic microbiota may exhibit important differences between patients with irritable bowel syndrome (IBS) and healthy controls. Less is known about the microbiota of the small bowel. We used massive parallel sequencing to explore the composition of small bowel mucosa-associated microbiota in patients with IBS and healthy controls. We analysed capsule biopsies from the jejunum of 35 patients (26 females) with IBS aged 18-(36)-57 years and 16 healthy voluntee...

  13. Diet in irritable bowel syndrome.

    Science.gov (United States)

    El-Salhy, Magdy; Gundersen, Doris

    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-coeliac gluten sensitivity (NCGS). The component in wheat that triggers symptoms in NCGS appears to be the carbohydrates. Patients with NCGS appear to be IBS patients who are self-diagnosed and self-treated with a gluten-free diet. IBS symptoms are triggered by the consumption of the poorly absorbed fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) and insoluble fibre. On reaching the distal small intestine and colon, FODMAPS and insoluble fibre increase the osmotic pressure in the large-intestine lumen and provide a substrate for bacterial fermentation, with consequent gas production, abdominal distension and abdominal pain or discomfort. Poor FODMAPS and insoluble fibres diet reduces the symptom and improve the quality of life in IBS patients. Moreover, it changes favourably the intestinal microbiota and restores the abnormalities in the gastrointestinal endocrine cells. Five gastrointestinal endocrine cell types that produce hormones regulating appetite and food intake are abnormal in IBS patients. Based on these hormonal abnormalities, one would expect that IBS patients to have increased food intake and body weight gain. However, the link between obesity and IBS is not fully studied. Individual dietary guidance for intake of poor FODMAPs and insoluble fibres diet in combination with probiotics intake and regular exercise is to be recommended for IBS patients. PMID:25880820

  14. 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.

  15. Berberine Improves Intestinal Motility and Visceral Pain in the Mouse Models Mimicking Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D) Symptoms in an Opioid-Receptor Dependent Manner

    OpenAIRE

    Chunqiu Chen; Meiling Lu; Qiuhui Pan; Jakub Fichna; Lijun Zheng; Kesheng Wang; Zhen Yu; Yongyu Li; Kun Li; Aihong Song; Zhongchen Liu; Zhenshun Song; Martin Kreis

    2015-01-01

    Background and Aims Berberine and its derivatives display potent analgesic, anti-inflammatory and anticancer activity. Here we aimed at characterizing the mechanism of action of berberine in the gastrointestinal (GI) tract and cortical neurons using animal models and in vitro tests. Methods The effect of berberine was characterized in murine models mimicking diarrhea-predominant irritable bowel syndrome (IBS-D) symptoms. Then the opioidantagonists were used to identify the receptors involved....

  16. [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. PMID:27598274

  17. [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.

  18. 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...

  19. Short Bowel Syndrome

    Science.gov (United States)

    ... may include nutritional support medications surgery intestinal transplant Nutritional Support The main treatment for short bowel syndrome is nutritional support, which may include the following: Oral rehydration. Adults ...

  20. 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.

  1. Asian Motility Studies in Irritable Bowel Syndrome

    OpenAIRE

    Lee, Oh Young

    2010-01-01

    Altered motility remains one of the important pathophysiologic factors in patients with irritable bowel syndrome (IBS) who commonly complain of abdominal pain and stool changes such as diarrhea and constipation. The prevalence of IBS has increased among Asian populations these days. Gastrointestinal (GI) physiology may vary between Asian and Western populations because of differences in diets, socio-cultural backgrounds, and genetic factors. The characteristics and differences of GI dysmotili...

  2. Irritable bowel syndrome: Diagnosis and pathogenesis

    Institute of Scientific and Technical Information of China (English)

    Magdy El-Salhy

    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.

  3. Dysmotility of the small intestine in irritable bowel syndrome.

    OpenAIRE

    Kellow, J E; Phillips, S F; Miller, L J; Zinsmeister, A R

    1988-01-01

    Though the pathophysiology of the irritable bowel syndrome (IBS) is commonly attributed to dysfunction of the large intestine, evidence exists to incriminate the small bowel. In order to further explore the role of the small bowel in IBS several stimuli were applied, in an attempt to unmask the dysmotility of the jejunum and ileum. These included infusions of cholecystokinin-octapeptide (CCK-OP), a high fat meal, neostigmine and balloon distension of the ileum. Three groups (n = 8) each of ag...

  4. Post-infectious irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Marroon Thabane; John K Marshall

    2009-01-01

    Post-infectious irritable bowel syndrome (PI-IBS) is a common disorder wherein symptoms of IBS begin after an episode of acute gastroenteritis. Published studies have reported incidence of PI-IBS to range between 5% and 32%. The mechanisms underlying the development of PI-IBS are not fully understood, but are believed to include persistent sub-clinical inflammation, changes in intestinal permeability and alteration of gut flora. Individual studies have suggested that risk factors for PI-IBS include patients' demographics, psychological disorders and the severity of enteric illness. However, PI-IBS remains a diagnosis of exclusion with no specific disease markers and, to date, no definitive therapy exists. The prognosis of PIIBS appears favorable with spontaneous and gradual resolution of symptoms in most patients.

  5. Berberine Improves Intestinal Motility and Visceral Pain in the Mouse Models Mimicking Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D Symptoms in an Opioid-Receptor Dependent Manner.

    Directory of Open Access Journals (Sweden)

    Chunqiu Chen

    Full Text Available Berberine and its derivatives display potent analgesic, anti-inflammatory and anticancer activity. Here we aimed at characterizing the mechanism of action of berberine in the gastrointestinal (GI tract and cortical neurons using animal models and in vitro tests.The effect of berberine was characterized in murine models mimicking diarrhea-predominant irritable bowel syndrome (IBS-D symptoms. Then the opioid antagonists were used to identify the receptors involved. Furthermore, the effect of berberineon opioid receptors expression was established in the mouse intestine and rat fetal cortical neurons.In mouse models, berberine prolonged GI transit and time to diarrhea in a dose-dependent manner, and significantly reduced visceral pain. In physiological conditions the effects of berberine were mediated by mu- (MOR and delta- (DOR opioid receptors; hypermotility, excessive secretion and nociception were reversed by berberine through MOR and DOR-dependent action. We also found that berberine increased the expression of MOR and DOR in the mouse bowel and rat fetal cortical neurons.Berberine significantly improved IBS-D symptoms in animal models, possibly through mu- and delta- opioid receptors. Berberine may become a new drug candidate for the successful treatment of IBS-D in clinical conditions.

  6. Quality of Life in Irritable Bowel Syndrome: A Narrative Overview

    OpenAIRE

    Liang,; Tien

    2016-01-01

    Context Health-related quality of life (HRQoL) is increasingly important in the assessment of chronic conditions, especially for irritable bowel syndrome (IBS), which has no associated mortality, but is prevalent and significantly impacts patient’s lives. Disease-specific instruments such as the irritable bowel syndrome quality of life instrument (IBS-QOL), in addition to generic instruments such as the short form (SF)-36, are useful in measuring health-related quality of life, a...

  7. Meditation over medication for irritable bowel syndrome? On exercise and alternative treatments for irritable bowel syndrome.

    Science.gov (United States)

    Asare, Fredrick; Störsrud, Stine; Simrén, Magnus

    2012-08-01

    Complimentary alternative treatment regimens are widely used in irritable bowel syndrome (IBS), but the evidence supporting their use varies. For psychological treatment options, such as cognitive behavioral therapy, mindfulness, gut-directed hypnotherapy, and psychodynamic therapy, the evidence supporting their use in IBS patients is strong, but the availability limits their use in clinical practice. Dietary interventions are commonly included in the management of IBS patients, but these are primarily based on studies assessing physiological function in relation to dietary components, and to a lesser degree upon research examining the role of dietary components in the therapeutic management of IBS. Several probiotic products improve a range of symptoms in IBS patients. Physical activity is of benefit for health in general and recent data implicates its usefulness also for IBS patients. Acupuncture does not seem to have an effect beyond placebo in IBS. A beneficial effect of some herbal treatments has been reported. PMID:22661301

  8. Short bowel syndrome

    International Nuclear Information System (INIS)

    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.)

  9. Intestinal secretory mechanisms in irritable bowel syndrome-diarrhea.

    Science.gov (United States)

    Camilleri, Michael

    2015-06-01

    Although diarrhea is the predominant bowel dysfunction in as many as one-third of patients with irritable bowel syndrome (IBS), it is unclear whether there is a specific disorder of intestinal fluid or electrolyte secretion in IBS. Diarrhea is generally considered a result of accelerated colonic transit in patients with IBS. Although a primary secretory diathesis has not been well-documented in patients with IBS with diarrhea (IBS-D), several mechanisms that could potentially contribute to intestinal secretion have been reported. Some of these mechanisms also influence motor and secretory dysfunctions that contribute to the pathophysiology of IBS-D. We review the evidence supporting secretion in IBS-D caused by peptides and amines produced by enteroendocrine cells or submucosal neurons, enterocyte secretory processes, and intraluminal factors (bile acids and short-chain fatty acids). Understanding these mechanisms and developing clinical methods for their identification could improve management of patients with IBS-D. PMID:25041862

  10. 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.

  11. Irritable bowel syndrome.

    OpenAIRE

    Beck, E.; Hurwitz, B

    1992-01-01

    1. Irritable bowel syndrome is a functional disorder of the lower intestinal tract affecting approximately 10% of the population and causing a wide range of symptoms. 2. Most cases of irritable bowel syndrome can be diagnosed in general practice on the basis of the presenting history and clinical examination but some patients may need to be referred to a gastro-enterologist for further assessment including sigmoidoscopy and barium enema. 3. The clinical picture may include symptoms of abdomin...

  12. Irritable bowel syndrome: Relations with functional, mental, and somatoform disorders

    Science.gov (United States)

    Hausteiner-Wiehle, Constanze; Henningsen, Peter

    2014-01-01

    This review describes the conceptual and clinical relations between irritable bowel syndrome (IBS), other functional, somatoform, and mental disorders, and points to appropriate future conceptualizations. IBS is considered to be a functional somatic syndrome (FSS) with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome. IBS patients show an increased prevalence of psychiatric symptoms and disorders, especially depression and anxiety. IBS is largely congruent with the concepts of somatoform and somatic symptom disorders. Roughly 50% of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity. IBS concepts, treatment approaches, as well as health care structures should acknowledge its variability and multidimensionality by: (1) awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS; (2) general and collaborative care rather than specialist and separated care; and (3) implementation of “interface disorders” to abandon the dualistic classification of purely organic or purely mental disorders. PMID:24876725

  13. Testing a biobehavioral model of irritable bowel syndrome

    NARCIS (Netherlands)

    Veek, P.P.J. van der; Dusseldorp, E.; Rood, Y.R. van; Masclee, A.A.M.

    2010-01-01

    Objective: The pathogenesis of irritable bowel syndrome (IBS) is probably multifactorial with dysfunction at different levels of the brain-gut axis. The aim of this study was to evaluate an existing biobehavioral model of IBS symptom generation in a large group of patients. Material and Methods: In

  14. Irritable bowel syndrome : an integrated explanatory model for clinical practice

    NARCIS (Netherlands)

    Hungin, A. P. S.; Becher, A.; Cayley, B.; Heidelbaugh, J. J.; Muris, J. W. M.; Rubin, G.; Seifert, B.; Russell, A.; De Wit, N. J.

    2015-01-01

    BACKGROUND: Although irritable bowel syndrome (IBS) is a symptom-based diagnosis, clinicians' management of and communication about the disorder is often hampered by an unclear conceptual understanding of the nature of the problem. We aimed to elucidate an integrated explanatory model (EM) for IBS f

  15. Short-term stability of subtypes in the irritable bowel syndrome

    DEFF Research Database (Denmark)

    Engsbro, A L; Simren, M; Bytzer, P

    2012-01-01

    In irritable bowel syndrome (IBS) subtyping is used in research and clinical practice. Knowledge of subtype stability is needed for proper design of trials and treatment strategies.......In irritable bowel syndrome (IBS) subtyping is used in research and clinical practice. Knowledge of subtype stability is needed for proper design of trials and treatment strategies....

  16. 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...

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

    OpenAIRE

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

    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....

  18. 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...

  19. Gut Microbiota as Potential Orchestrators of Irritable Bowel Syndrome

    OpenAIRE

    Bennet, Sean M.P.; Öhman, Lena; Simrén, Magnus

    2015-01-01

    Irritable bowel syndrome (IBS) is a multifactorial functional disorder with no clearly defined etiology or pathophysiology. Modern culture-independent techniques have improved the understanding of the gut microbiota’s composition and demonstrated that an altered gut microbiota profile might be found in at least some subgroups of IBS patients. Research on IBS from a microbial perspective is gaining momentum and advancing. This review will therefore highlight potential links between the gut mic...

  20. Recent developments in the pathophysiology of irritable bowel syndrome

    OpenAIRE

    El-Salhy, Magdy

    2015-01-01

    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 predispos...

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

    OpenAIRE

    Stefano Evangelista

    2012-01-01

    It is known that irritable bowel syndrome (IBS) is a chronic disease of cyclic nature characterized by recurrent symptoms. IBS patients should receive, as initial therapeutic approach a short course of treatment which, if effective, has the additional value of confirming the diagnosis. Long-term treatment should be reserved to diagnosed IBS patients with recurrent symptoms. Clinical trials with stabilized therapies and new active treatments showed an improvement of the symptoms over placebo t...

  2. Cognitive Functions and Depression in Patients with Irritable Bowel Syndrome

    OpenAIRE

    Farup, Per G; Knut Hestad

    2015-01-01

    Background. Irritable bowel syndrome (IBS) is associated with depression and depression with impaired cognitive functions. The primary aim was to study associations between depression and cognitive functions in patients with IBS. Methods. IBS (according to the Rome III criteria), cognitive functions (evaluated with a set of neuropsychological tests), and depression (measured with Beck Depression Inventory II and Montgomery-Åsberg Depression Scale) were analysed in patients with idiopathic dep...

  3. Underlying molecular and cellular mechanisms in childhood irritable bowel syndrome.

    Science.gov (United States)

    Chumpitazi, Bruno P; Shulman, Robert J

    2016-12-01

    Irritable bowel syndrome (IBS) affects a large number of children throughout the world. The symptom expression of IBS is heterogeneous, and several factors which may be interrelated within the IBS biopsychosocial model play a role. These factors include visceral hyperalgesia, intestinal permeability, gut microbiota, psychosocial distress, gut inflammation, bile acids, food intolerance, colonic bacterial fermentation, and genetics. The molecular and cellular mechanisms of these factors are being actively investigated. In this mini-review, we present updates of these mechanisms and, where possible, relate the findings to childhood IBS. Mechanistic elucidation may lead to the identification of biomarkers as well as personalized childhood IBS therapies. PMID:26883355

  4. Visceral hypersensitivity in Irritable Bowel Syndrome:pathophysiological mechanisms

    OpenAIRE

    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 composition, intestinal mucosal barrier, serine protease and serotonergic signalling components which may play a role in the visceral hypersensitivity. We showed alterations in microbiota composition...

  5. Nucleotide supplementation: a randomised double-blind placebo controlled trial of IntestAidIB in people with Irritable Bowel Syndrome [ISRCTN67764449

    Directory of Open Access Journals (Sweden)

    Attree EA

    2006-06-01

    Full Text Available Abstract Background Dietary nucleotide supplementation has been shown to have important effects on the growth and development of cells which have a rapid turnover such as those in the immune system and the gastrointestinal tract. Work with infants has shown that the incidence and duration of diarrhoea is lower when nucleotide supplementation is given, and animal work shows that villi height and crypt depth in the intestine is increased as a result of dietary nucleotides. Dietary nucleotides may be semi-essential under conditions of ill-health, poor diet or stress. Since people with Irritable Bowel Syndrome tend to fulfil these conditions, we tested the hypothesis that symptoms would be improved with dietary nucleotide supplementation. Methods Thirty-seven people with a diagnosis of Irritable Bowel gave daily symptom severity ratings for abdominal pain, diarrhoea, urgency to have a bowel movement, incomplete feeling of evacuation after a bowel movement, bloating, flatulence and constipation for 28 days (baseline. They were then assigned to either placebo (56 days followed by experimental (56 days or the reverse. There was a four week washout period before crossover. During the placebo and experimental conditions participants took one 500 mg capsule three times a day; in the experimental condition the capsule contained the nutroceutical substances. Symptom severity ratings and psychological measures (anxiety, depression, illness intrusiveness and general health were obtained and analysed by repeated measures ANOVAs. Results Symptom severity for all symptoms (except constipation were in the expected direction of baseline>placebo>experimental condition. Symptom improvement was in the range 4 – 6%. A feeling of incomplete evacuation and abdominal pain showed the most improvement. The differences between conditions for diarrhoea, bloating and flatulence were not significant at the p Conclusion Dietary nucleotide supplementation improves some of the

  6. [Contemporary dietotherapy of the irritable bowel syndrome].

    Science.gov (United States)

    Pilipenko, V I; Burliaeva, E A; Isakov, V A

    2013-01-01

    Irritable bowel syndrome (IBS) is the most prevalent functional disease of the gastrointestinal tract. This highly prevalent condition is best diagnosed by assessing the constellation of symptoms with which patients present to their physicians. Because some critics have previously questioned whether irritable bowel syndrome and other functional gastrointestinal disorders truly exist because they do not have defining structural features, the Rome Foundation fostered the use of symptom-based criteria for universal use. In most cases treatment is reduced to symptomatic therapy because a lot of unknown in pathogenesis by irritable bowel syndrome. Irritable bowel syndrome leads to decrease of quality of life of the patients and could be one of the reasons of patients' disability. Food is believed by patients promotes symptoms and the diet or avoiding specific food can reduce symptoms. Possible role of different food and microbiota in the pathophysiology of irritable bowel syndrome, as well as the data from randomized, controlled clinical trials dedicated to the effects of diet in irritable bowel syndrome are summarized and discussed in this review. The efficacy of the diet, enriched by fiber, prebiotics, probiotics, peppermint oil, curcumin and vitamin B6 in irritable bowel syndrome patients was shown in numerous studies. In some studies restriction in consumption of fermented carbohydrates, coffee and alcohol, as well as diet with elimination IgG-sensed food was also shown to be effective in irritable bowel syndrome. Food intolerances, defined as non-toxic non-immune adverse reactions to food, include reactions to bioactive chemicals in foods and metabolic reactions to poorly absorbed dietary carbohydrates. New dietary approaches like polyunsaturated fatty acids intake correction and the low tryptophan intake are discussed. PMID:23808281

  7. Irritable bowel syndrome: Physicians' awareness and patients' experience

    Institute of Scientific and Technical Information of China (English)

    Linda Bjork Olafsdottir; Hallgrímur Gudjonsson; Heidur Hrund Jonsdottir; Jon Steinar Jonsson; Einar Bjornsson; Bjarni Thjodleifsson

    2012-01-01

    AIM:TO study if and how physicians use the irritable bowel syndrome (IBS) diagnostic criteria and to assess treatment strategies in IBS patients.METHODS:A questionnaire was sent to 191 physicians regarding IBS criteria,diagnostic methods and treatment.Furthermore,94 patients who were diagnosed with IBS underwent telephone interview.RESULTS:A total of 80/191 (41.9%) physicians responded to the survey.Overall,13 patients were diagnosed monthly with IBS by specialists in gastroenterology (SGs) and 2.5 patients by general practitioners (GPs).All the SGs knew of the criteria to diagnose IBS,as did 46/70 (65.7%) GPs.Seventy-nine percent used the patient's history,38% used a physical examination,and 38% exclusion of other diseases to diagnose IBS.Only 18/80 (22.5%) physicians used specific IBS criteria.Of the patients interviewed,5g/94 (62.8%) knew they had experienced IBS.Two out of five patients knew IBS and had seen a physician because of IBS symptoms.Half of those received a diagnosis of IBS.A total of 13% were satisfied with treatment.IBS affected daily activities in 43% of cases.CONCLUSION:Half of the patients with IBS who consuited a physician received a diagnosis.Awareness and knowledge of diagnostic criteria for IBS differ between SGs and GPs.

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

    OpenAIRE

    Lee, Kang Nyeong; Lee, Oh Young

    2014-01-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder without any structural or metabolic abnormalities that sufficiently explain the symptoms, which include abdominal pain and discomfort, and bowel habit changes such as diarrhea and constipation. Its pathogenesis is multifactorial: visceral hypersensitivity, dysmotility, psychosocial factors, genetic or environmental factors, dysregulation of the brain-gut axis, and altered intestinal microbiota have all been proposed as possible cau...

  9. Genetic determination of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Cristina Hotoleanu; Radu Popp; Adrian Pavel Trifa; Laurentiu Nedelcu; Dan L Dumitrascu

    2008-01-01

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder.According to the Rome Ⅲ criteria,IBS is defined as recurrent abdominal pain or discomfort for at least 3 d per month during the previous 3 mo associated with two or more of the following symptoms:improvement with defecation,onset associated with a change in the frequency of stool and/or onset associated with a change in form or appearance of stool.There is growing evidence regarding the genetic contribution in IBS,however the precise etiology of IBS is still unknown.The evaluation of the genetic influence is based on twin studies,familial aggregation and genetic epidemiological investigations.Most studies showed a concordance for IBS significantly greater in monozygotic than in dizygotic twins.The majority of the studies have shown that familial aggregation may represent exposures to a similar environment,as well as the influence of genetic factors.Whereas no specific gene has been identified in association with IBS,recent studies have noticed the importance of polymorphisms in the promoter region of the serotonin reuptake transporter gene,G-protein beta 3 subunit gene (C825T),cholecystokinin receptor (CCKAR gene 779T>C),and high-producer tumornecrosis factor genotype.Further studies are necessary to determine how genetic factors influence the clinical manifestations and therapeutical response in IBS patients.

  10. The Intestinal Microbiota and Irritable Bowel Syndrome.

    Science.gov (United States)

    Ringel, Yehuda; Ringel-Kulka, Tamar

    2015-01-01

    Irritable bowel syndrome (IBS) is the most prevalent and the best studied functional gastrointestinal disorder. The etiology and the pathogenesis of IBS are still not clear; however, recent studies have implicated a role for alterations in the intestinal microbiota (dysbiosis) in the pathophysiology of the disorder. Epidemiological observations have demonstrated that the development of IBS symptoms is often preceded by a disruption of the individual's normal intestinal microbiota, and microbiological studies have demonstrated compositional differences in the intestinal microbiota between patients with IBS patients and healthy controls. In addition, animal studies and a few recent human clinical studies have demonstrated that compositional changes in the intestinal microbiota in IBS are associated with relevant abnormal gastrointestinal and brain-gut axis functions that are often observed in patients with IBS. This article discusses points of interest from the current research on the microbiota-gut-brain interactions in IBS and highlights the relevance of the emerging data to our understanding of the disorder and the clinical implications for patients' care. PMID:26447966

  11. Maladjustment to Academic Life and Employment Anxiety in University Students with Irritable Bowel Syndrome

    OpenAIRE

    Jun Tayama; Naoki Nakaya; Toyohiro Hamaguchi; Tatsuo Saigo; Atsushi Takeoka; Toshimasa Sone; Shin Fukudo; Susumu Shirabe

    2015-01-01

    The present study tested our hypothesis that university students with irritable bowel syndrome (IBS) may experience less satisfactory academic lives than those of students without IBS. We also verified the hypothesis that university students with IBS might have higher employment anxiety than students without IBS might. We conducted a cross-sectional study of 1,686 university students. Presence or absence of IBS was assessed via the Rome III Questionnaire. Two original items were used to evalu...

  12. Maladjustment to Academic Life and Employment Anxiety in University Students with Irritable Bowel Syndrome

    OpenAIRE

    Tayama, Jun; NAKAYA, NAOKI; Hamaguchi, Toyohiro; Saigo, Tatsuo; Takeoka, Atsushi; Sone, Toshimasa; Fukudo, Shin; Shirabe, Susumu

    2015-01-01

    The present study tested our hypothesis that university students with irritable bowel syndrome (IBS) may experience less satisfactory academic lives than those of students without IBS. We also verified the hypothesis that university students with IBS might have higher employment anxiety than students without IBS might.We conducted a cross-sectional study of 1, 686 university students. Presence or absence of IBS was assessed via the Rome III Questionnaire. Two original items were used to evalu...

  13. Estimating the Burden of Irritable Bowel Syndrome: Analysis of a Nationwide Korean Database

    OpenAIRE

    Jung, Hye-Kyung; Kim, Youn Hee; Park, Joo Yeon; Jang, Bo Hyoung; Park, Sun-Young; Nam, Mi-Hee; Choi, Myung-Gyu

    2014-01-01

    Background/Aims Management of irritable bowel syndrome (IBS) imposes a heavy economic burden. This study was to estimate the epidemiologic features of IBS and to report the IBS burden for the first time in the Korean population. Methods A cross-sectional study was conducted using the National Health Insurance (NHI) system database, which covers the entire population of Korea. IBS was defined as diagnostic code −10 in adults with any outpatient clinic visits or hospitalization related to IBS. ...

  14. Risk of inflammatory bowel disease following a diagnosis of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Porter Chad K

    2012-05-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS and inflammatory bowel disease (IBD symptoms often overlap. In some IBS cases there are subtle inflammatory changes similar to the immune-mediated pathophysiology of IBD, and the risk of both increases after infectious gastroenteritis (IGE. Methods To evaluate the effect of IBS and IGE on IBD risk utilizing US Department of Defense medical encounter data, active duty personnel with IBS were matched to subjects without IBS. Medical encounter history was analyzed to assess for incident IBD. IGE was identified from documented medical encounters and by self-report. Relative risks were calculated using Poisson regression models. Results We identified 9,341 incident IBS cases and 18,678 matched non-IBS subjects and found an 8.6-fold higher incidence (p p  Conclusions These data reflect a complex interaction between illness presentation and diagnosis of IBS and IBD and suggest intercurrent IGE may increase IBD risk in IBS patients. Additional studies are needed to determine whether IBS lies on the causal pathway for IBD or whether the two are on a pathophysiological spectrum of the same clinical illness. These data suggest consideration of risk reduction interventions for IGE among IBS patients at high disease risk.

  15. Remarkable prevalence of coeliac disease in patients with irritable bowel syndrome plus fibromyalgia in comparison with those with isolated irritable bowel syndrome: a case-finding study

    OpenAIRE

    Rodrigo Sáez, Luis Ricardo; Blanco, Ignacio; Bobes, Julio; de Serres, Frederick J

    2013-01-01

    Introduction Irritable bowel syndrome (IBS) and fibromyalgia syndrome (FMS) are two common central sensitization disorders frequently associated in the same patient, and some of these patients with IBS plus FMS (IBS/FMS) could actually be undiagnosed of coeliac disease (CD). The present study was an active case finding for CD in two IBS cohorts, one constituted by IBS/FMS subjects and the other by people with isolated IBS. Methods A total of 104 patients (89.4% females) fulfilling the 1990 AC...

  16. Irritable Bowel Syndrome: A Clinical Review.

    Science.gov (United States)

    Cashman, Michael D; Martin, Daniel K; Dhillon, Sonu; Puli, Srinivas R

    2016-01-01

    Symptoms of irritable bowel syndrome (IBS) are common in population studies including chronic abdominal pain associated with altered bowel habits. Patients often have associated gastrointestinal and somatic symptoms suggesting a possible common contributing mechanism, but the heterogeneous symptom patterns of individual patients make generalizations difficult. The pathophysiology of IBS is incompletely understood but includes disturbances of the brain-gut axis. Central mechanisms are: the psychosocial history and environment, dysfunctional brain processing of peripheral signals attributed to the intestine including the enteric nervous system, the microbiome and the innate and adaptive immune system. As a result there is visceral hypersensitivity and disturbed intestinal secretory and motor activity. Some mechanisms of visceral pain hypersensitivity may overlap with other pain syndromes including fibromyalgia (FMS). Central Sensitization (CS) would offer a way to conceptualize an integration of life experience and psychologic response into a biopsychosocial framework of pathophysiology, diagnosis and treatment of IBS. Corticotropin-releasing factor, a principle regulator in the stress and pain response may contribute to a neuroendocrine mechanism for the brain-gut interaction. The positive diagnostic approach to IBS symptoms to avoid excess testing and enhance the patient-provider therapeutic relationship requires the recognition of the "cluster" of IBS symptoms while identifying "alarm" symptoms requiring specific attention. The severity of the symptoms and other individual psychosocial factors characterize patients who seek medical care. The presence of significant psychosocial comorbidities adds to the complexity of management which often requires a multidisciplinary approach. Several treatment options exist but no single method is effective for all the symptoms of IBS. The therapeutic benefit of the well-executed physician-patient relationship is considered

  17. Irritable bowel syndrome consulters in Zhejiang province:The symptoms pattern,predominant bowel habit subgroups and quality of life

    Institute of Scientific and Technical Information of China (English)

    Jian-Min Si; Liang-Jing Wang; Shu-Jie Chen; Lei-Min Sun; Ning Dai

    2004-01-01

    AIM: To investigate the pattern of symptoms, predominant bowel habits and quality of life (QOL) by the Chinese version of the SF-36 in irritable bowel syndrome (IBS) consulters in Zhejiang province.METHODS: From January 2001 to January 2002, 662 Roma Ⅱ criteria-positive IBS patients were enrolled by gastroenterologists in 10 hospitals from Digestive Disease Center of Zhejiang (DDCZ). Patients were classified into constipation predominant IBS (IBS-C), diarrhea predominant IBS (IBS-D) and alternating constipation and diarrhea IBS (IBS-A) according to the predominant bowel habits. All patients were evaluated for the demographic checklists, IBS bowel symptoms, extra-colonic symptoms, and QOL by Chinese version of the SF-36 questionnaire.RESULTS: (1) Besides abdominal pain, the predominant colonic symptoms were in order of altered stool form,abnormalities of stool passage, abdominal distension and passage of mucus in IBS patients. Also, IBS subjects reported generalized body discomfort and psychosocial problems including dyspeptic symptoms, poor appetite, heartburn,headache, back pain, difficulty with urination, fatigue, anxiety and depression. (2) IBS-C and IBS-A are more common among female patients, whereas male patients experiencedmore cases of IBS-D. In regards to the IBS symptoms, there were significant differences among IBS subgroups.Abdominal pain (frequency ≥2 days per week and duration ≥ 1 hour per day) was frequent in IBS-A patients (P=0.010and 0.027, respectively), IBS-D patients more frequently experienced the passage of mucus, dyspeptic symptoms and anxiety (P=0.000, 0.014 and 0.015, respectively). (3)IBS patients experienced significant impairment in QOL,decrements in QOL were most pronounced in vitality, general health, mental health, and bodily pain. Compared with the general population (adjusted for gender and age), IBS patientsscored significantly lower on all SF-scales (P<0.001), except for physical function scale (P=0.149). (4) QOL was

  18. Nutritional therapy of irritable bowel syndrome.

    Science.gov (United States)

    Friedman, G

    1989-09-01

    Nutritional factors relative to IBS include diagnostic and therapeutic considerations. Etiologically, foods do not cause IBS. A small percentage of patients with childhood allergic diatheses, usually in association with atopic dermatitis and asthma, may be intolerant to one or more of wheat, corn, dairy products, coffee, tea, or citrus fruits. Diagnostically, many patients labeled as IBS subjects are in fact intolerant to the ingestion of lactose-containing foods, sorbitol, fructose, or combinations of fructose and sorbitol. A precise dietary history will characterize this group. Taken in its broadest context, IBS involves the entire hollow tract inclusive of esophagus, stomach, small bowel, and colon. The symptomatic presentation relative to the hollow organ involved allows the selection of dietary manipulations that may help to reduce symptoms. Gastroesophageal reflux, a consequence of low LES pressure in some IBS patients, may be treated with the elimination of fatty foods, alcohol, chocolate, and peppermint. Delayed gastric emptying may be helped by the elimination of fatty foods and reduction of soluble fiber. Aberrant small bowel motor function may be ameliorated by reduction of lactose, sorbitol, and fructose and the addition of soluble fiber. Gas syndromes may be improved by reduced intake of beans, cabbage, lentils, legumes, apples, grapes, and raisins. Colonic motor dysfunction may be overcome by the gradual addition of combinations of soluble and insoluble fiber-containing foods and supplements. The selective use of activated charcoal and simethicone may be helpful. PMID:2553606

  19. Irritable Bowel Syndrome.

    Science.gov (United States)

    Wald

    1999-02-01

    I believe there are four essential elements in the management of patients with irritable bowel syndrome (IBS): to establish a good physician-patient relationship; to educate patients about their condition; to emphasize the excellent prognosis and benign nature of the illness; and to employ therapeutic interventions centering on dietary modifications, pharmacotherapy, and behavioral strategies tailored to the individual. Initially, I establish the diagnosis, exclude organic causes, educate patients about the disease, establish realistic expectations and consistent limits, and involve patients in disease management. I find it critical to determine why the patient is seeking assistance (eg, cancer phobia, disability, interpersonal distress, or exacerbation of symptoms). Most patients can be treated by their primary care physician. However, specialty consultations may be needed to reinforce management strategies, perform additional diagnostic tests, or institute specialized treatment. Psychological co-morbidities do not cause symptoms but do affect how patients respond to them and influence health care-seeking behavior. I find that these issues are best explored over a series of visits when the physician-patient relationship has been established. It can be helpful to have patients fill out a self-administered test to identify psychological co-morbidities. I often use these tests as a basis for extended inquiries into this area, resulting in the initiation of appropriate therapies. I encourage patients to keep a 2-week diary of food intake and gastrointestinal symptoms. In this way, patients become actively involved in management of their disease, and I may be able to obtain information from the diary that will be valuable in making treatment decisions. I do not believe that diagnostic studies for food intolerances are cost-effective or particularly helpful; however, exclusion diets may be beneficial. I introduce fiber supplements gradually and monitor them for

  20. Blastocystis is associated with decrease of fecal microbiota protective bacteria: Comparative analysis between patients with irritable bowel syndrome and control subjects

    OpenAIRE

    Céline Nourrisson; Julien Scanzi; Bruno Pereira; Christina NkoudMongo; Ivan Wawrzyniak; Amandine Cian; Eric Viscogliosi; Valérie Livrelli; Frédéric Delbac; Michel Dapoigny; Philippe Poirier

    2014-01-01

    Blastocystis is a protistan parasite living in the digestive tract of many animals, including humans. This highly prevalent intestinal parasite is suspected to be linked to Irritable Bowel Syndrome (IBS), a chronic functional bowel disorder. Here, we first compared the prevalence of Blastocystis among 56 IBS patients (40 IBS with constipation (IBS-C), 9 IBS with diarrhea (IBS-D), 4 mixed IBS (IBS-M) and 3 unsubtyped IBS (IBS-U) according to the Rome III criteria) and 56 control (i.e. without ...

  1. Diagnosis and treatment of irritable bowel syndrome.

    Science.gov (United States)

    Dalton, C B; Drossman, D A

    1998-07-01

    Irritable bowel syndrome (IBS) is a common medical disorder characterized by symptoms of abdominal pain and bowel dysfunction. It is associated with significant disability and health care costs. A practical approach to diagnosis is the symptom-based Rome criteria. Management of patients has been helped by recent findings relating to the epidemiology, pathophysiology and psychosocial contributions of the disorder. Dysregulation of intestinal motor, sensory and central nervous system function is currently believed to be the basis for IBS symptoms. Symptoms are due to both abnormal intestinal motility and enhanced visceral sensitivity. Psychosocial factors are not a cause but can affect the illness experience and clinical outcome. Finally, treatment involves an effective physician-patient relationship and an integrated pharmacologic and behavioral approach that is determined by the needs of the patient, the type and severity of the symptoms and the degree of disability. PMID:14988758

  2. When to reconsider the diagnosis of irritable bowel syndrome.

    Science.gov (United States)

    Hammerle, Christopher W; Crowe, Sheila E

    2011-06-01

    Irritable bowel syndrome (IBS) is a highly prevalent disorder characterized by nonspecific symptoms that can mimic other common medical conditions. A careful history and physical examination may reveal clues that suggest a coexisting or alternative diagnosis, such as small intestinal bacterial overgrowth or celiac disease (CD). Testing for bacterial overgrowth has limitations, but emerging data suggest that antibiotics may be of some benefit in patients with IBS with diarrhea and bloating. CD seems to have a higher prevalence in patients with IBS. Some patients with IBS may have symptomatic improvement on gluten-restricted diets, without histologic or serologic evidence of CD. PMID:21601781

  3. [Current Status of Translational Research on Irritable Bowel Syndrome].

    Science.gov (United States)

    Kwon, Yong Hwan; Kim, Hyun Jin

    2016-09-25

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. The pathophysiology of IBS is not completely understood. Genetic, immune, environmental, inflammatory, neurological and psychological factors contribute to the risk of this condition. Traditional research explored gastrointestinal motor abnormalities, central neural dysregulation, abnormal psychological features, and visceral hypersensitivity. More recent investigations consider bacterial overgrowth, abnormal serotonin pathways, altered gut flora, immune activation and mucosal inflammation. The purpose of this article is to review recent translational research concerning the pathophysiology, biomarker and genetic factors of IBS and to encourage IBS research in Korea. PMID:27646582

  4. PREVALENCE OF IRRITABLE BOWEL SYNDROME IN COLLEGE STUDENTS AND ASSOCIATION WITH ANXIETY, DEPRESSION AND FODMAP DIET

    OpenAIRE

    Gopi K.; Shanthi; Sridhar

    2015-01-01

    BACKGROUND: I rritable bowel syndrome ( IBS ) is the most common functional gastro - intestinal disorder. The data regarding the prevalence of IBS in young adults is limited along with its association with anxiety and depression in a community setting in India . MATERIALS AND METHODS: the prevalence of IBS and its subtypes based on Rome iii criteria were assessed in 2078 college students ...

  5. Recent advances in the diagnosis of irritable bowel syndrome.

    Science.gov (United States)

    El-Salhy, Magdy

    2015-01-01

    The symptom-based diagnosis of irritable bowel syndrome (IBS) has not been established in everyday clinical practice, and the diagnosis of this disorder remains one of exclusion. It has been demonstrated that the densities of duodenal chromogranin A, rectal peptide YY and somatostatin cells are good biomarkers for the diagnosis of sporadic IBS, and low-grade mucosal inflammation is a promising biomarker for the diagnosis of postinfectious IBS. Genetic markers are not useful as biomarkers for IBS since the potential risk genes have yet to be validated, and the intestinal microbiota cannot be used because of the lack of an association between a specific bacterial species and IBS. Furthermore, gastrointestinal dysmotility and visceral hypersensitivity tests produce results that are too nonconsistent and noncharacteristic to be used in the diagnosis of IBS. A combination of symptom-based assessment, exclusion of overlapping gastrointestinal diseases and positive biomarkers appears to be the best way to diagnose IBS. PMID:26162959

  6. psychosocial impact of irritable bowel syndrome: A brief review

    Institute of Scientific and Technical Information of China (English)

    Sarah; Ballou; Alyse; Bedell; Laurie; Keefer

    2015-01-01

    Irritable bowel syndrome(IBS) is a common disorder of the gastrointestinal tract with unclear etiology and no reliable biomarker. Like other chronic and functional disorders, medical treatments for IBS are suboptimal and the overall illness burden is high. Patients with IBS report high rates of psychopathology, low quality of life, and increased suicidal ideation. These patients also miss more days of work, are less productive at work, and use many healthcare resources. However, little is known about the burden of IBS on daily functioning. The primary aim of this paper is to review the current literature on the burden of IBS and to highlight the need for further research to evaluate the impact of IBS on daily activities. This research would contribute to our existing understanding of the impact of IBS on overall quality of life and well-being.

  7. [Irritable Bowel Syndrome treatment: a multidisciplinary approach].

    Science.gov (United States)

    Shani-Zur, Dana; Wolkomir, Keren

    2015-01-01

    Irritable Bowel Syndrome affects 9-23% of the general population. This diagnosis contributes to more frequent doctor visits and multiple consultations by patients. The current approach to treating IBS is symptomatic and consists of a regimen of first line pharmacological treatment options; the use of anti-depressant drugs is also common. The efficiency of complementary medicine in the treatment of IBS has been studied in the last few years. Qualitative multidisciplinary approach studies, using personalized medicines with complementary therapies are needed. We present the case of a 39-year-old woman with a diagnosis of IBS since 2009, who complained about gastrointestinal symptoms since the age of 13 and severe episodes of spasmodic stomach aches in the last year self-ranked as 10, on a 0-10 scale; 3-4 episodes a month, which last for 5 days, accompanied by severe flatulence and bloating. In addition, she has constipation (one bowel movement every 10 days), alternating with multiple diarrheic bowel movements (6 times a day). Using a multidisciplinary approach, including medicinal care, Chinese medicine, reflexology and naturopathy resulted in significant improvement in symptoms and quality of life, as well as gradual reduction of drugs, approved by her physician. Stomach ache self-ranked now as 1, on a 0-10 scale; and flatulence and bloating self-ranked as mild. Bowel movement frequency increased and is now every other day. She no longer has diarrheic and/or multiple bowel movements. This case report emphasizes the importance of integrative treatment in IBS and its benefit in improving patients' quality of life.

  8. Changing face of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Eamonn MM Quigley

    2006-01-01

    Recent years have witnessed tremendous progress in our understanding of irritable bowel syndrome (IBS). It is evident that this is a truly global disease associated with significant symptoms and impairments in personal and social functioning for afflicted individuals. Advances in our understanding of gut flora-mucosal interactions, the enteric nervous system and the brain-gut axis have led to substantial progress in the pathogenesis of symptoms in IBS and have provided some hints towards the basic etiology of this disorder, in some subpopulations, at the very least. We look forward to a time when therapy will be addressed to pathophysiology and perhaps, even to primary etiology. In the meantime, a model based on a primary role for intestinal inflammation serves to integrate the various strands, which contribute to the presentation of IBS

  9. Updates on treatment of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Christopher W Hammerle; Christina M Surawicz

    2008-01-01

    Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits.It is estimated to affect 10%-15% of the Western population,and has a large impact on quality of life and (in)direct healthcare costs.IBS is a multifactorial disorder involving dysregulation within the brain-gut axis,and it is frequently associated with gastrointestinal motor and sensory dysfunction,enteric and central nervous system irregularities,neuroimmune dysregulation,and postinfectious inflammation.As with other functional medical disorders,the treatment for IBS can be challenging.Conventional therapy for those with moderate to severe symptoms is largely unsatisfactory,and the development of new and effective drugs is made difficult by the complex pathogenesis,variety of symptoms,and lack of objective clinical findings that are the hallmark of this disorder.Fortunately,research advances over the past several decades have provided insight into potential mechanisms responsible for the pathogenesis of IBS,and have led to the development of several promising pharmaceutical agents.In recent years there has been much publicity over several of these new IBS medications (alosetron and tegaserod) because of their reported association with ischemic colitis and cardiovascular disease.While these agents remain available for use under restricted prescribing programs,this highlights the need for continued development of safe and effective medication for IBS.This article provides a physiologicallybased overview of recently developed and frequently employed pharmaceutical agents used to treat IBS,and discusses some non-pharmaceutical options that may be beneficial in this disorder.

  10. 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.

  11. [Irritable Bowel Syndrome, Emotion Regulation, and Gut Microbiota].

    Science.gov (United States)

    Fukudo, Shin

    2016-06-01

    Irritable bowel syndrome (IBS) is defined as a representative functional gastrointestinal disorder which is characterized by chronic or recurrent abdominal pain and/or abdominal discomfort associated with abnormal bowel movement. Gut microbiota are related to the pathophysiology of IBS. In the field of IBS, post-infectious etiology, stress-induced alteration of microbiota, increased mucosal permeability, bacterial overgrowth, disease-specific microbiota, microbial products, and brain-gut interactions are being investigated. In some individuals, IBS develops after recovery from acute gastroenteritis known as post-infectious IBS. Gut microbiota in IBS patients differ from those in healthy individuals, and the profiles of gut microbiota in IBS patients also vary among IBS patients with constipation, diarrhea, and mixed subtypes. In Japan, gut microbiota in IBS patients also differ from those observed in healthy individuals, and organic acid by-products observed in the patients correlated with symptoms, quality of life, and alexithymia. Further research on gut microbiota in IBS patients is warranted. PMID:27279158

  12. A randomised controlled trial of a probiotic 'functional food' in the management of irritable bowel syndrome.

    OpenAIRE

    Roberts, LM; McCahon, D; Holder, R; Wilson, S; Hobbs, FD

    2013-01-01

    BACKGROUND: Irritable Bowel Syndrome (IBS) is a common condition characterised by pain, distension and altered bowel habit. Evidence suggests functional foods containing probiotics improve gastrointestinal transit, however, data are limited by short follow-up periods and evaluation in selected populations. METHODS: A multi-centre, randomized, double blind, controlled trial to evaluate the effect of a probiotic vs non-probiotic dairy product on symptoms in IBS with a constipation element (IBS-...

  13. Sleep and gastric function in irritable bowel syndrome: derailing the brain-gut axis

    OpenAIRE

    Orr, W; Crowell, M; Lin, B.; Harnish, M; J. Chen

    1997-01-01

    Background—Recently, several studies have shown an alteration in bowel function during sleep in patients with irritable bowel syndrome (IBS), and a recent study also suggests a remarkable increase in rapid eye movement (REM) sleep. These studies have suggested that an alteration in CNS function may play an important role in the pathogenesis of IBS. 
Aims—To confirm the presence of an alteration in REM sleep in patients with IBS and to assess the relation between sleep and a non...

  14. Need for a comprehensive medical approach to the neuro-immuno-gastroenterology of irritable bowel syndrome

    OpenAIRE

    2011-01-01

    Irritable bowel syndrome (IBS) is defined by the Rome III criteria as symptoms of recurrent abdominal pain or discomfort with the onset of a marked change in bowel habits with no evidence of an inflammatory, anatomic, metabolic, or neoplastic process. As such, many clinicians regard IBS as a central nervous system problem of altered pain perception. Here, we review the recent literature and discuss the evidence that supports an organic based model, which views IBS as a complex, heterogeneous,...

  15. Acupuncture-moxibustion in treating irritable bowel syndrome: How does it work?

    OpenAIRE

    Ma, Xiao-peng; Hong, Jue; An, Cai-Ping; Zhang, Dan; Huang, Yan; Wu, Huan-Gan; Zhang, Cui-Hong; Meeuwsen, Sian

    2014-01-01

    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 mod...

  16. Treatment of irritable bowel syndrome with probiotics: An etiopathogenic approach at last?

    OpenAIRE

    M. Bixquert Jiménez

    2009-01-01

    Irritable bowel syndrome (IBS) is the most common functional digestive disorder, and may affect 11-20% of the adult population in industrialized countries. In accordance with Rome III criteria (2006) IBS involves abdominal pain and bowel habit disturbance, which are not explained by structural or biochemical abnormalities. Several hypotheses attempt to account for the pathophysiology of IBS, but the etiology still remains uncertain or obscure, perhaps multifactorial. Abnormalities in colonic ...

  17. 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.

  18. 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.

  19. Psychosocial determinants of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Teodora Surdea-Blaga; Adriana Bǎban; Dan L Dumitrascu

    2012-01-01

    From a pure motor disorder of the bowel,in the past few years,irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity,alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system,alteration of the gut microflora,an increased intestinal permeability and minimum intestinal inflammation.Psychological and social factors can interfere with the communication between the central and enteric nervous systems,and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome.There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders.In order to explain clustering of IBS in families,genetic factors and social learning mechanisms have been proposed.The psychological features,such as anxiety,depression as well as the comorbid psychiatric disorders,health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.

  20. Irritable bowel syndrome and its associated factors in adolescents

    Directory of Open Access Journals (Sweden)

    Lara Fillekes

    2014-11-01

    Full Text Available Background Irritable bowel syndrome (IBS is a common functional gastrointestinal disorder. Increasing prevalences have been reported in Asian adolescent populations, however, there have been few reports on Indonesian adolescents. Objective To investigate the prevalence of IBS and associated factors among adolescents in Jakarta. Methods This cross-sectional study included senior high school students in a district of Jakarta. Students were asked to fill questionnaires based on the Rome III criteria for IBS. They were then divided into groups: those with IBS and those without IBS, for the purposes of comparison. Results Out of 232 adolescents (145 females and 87 males with mean age of 16.06 (SD 0.91 years, 14 (6.0% had IBS. Eleven out of 14 adolescents with IBS reported upper abdominal pain as well as periumbilical/lower abdominal pain. Irritable bowel syndrome was not associated with socioeconomic status, food and drink habits, the use of antibiotics, or scolding as a parental form of discipline. However, a significant higher proportion in the use of corporal punishment was found in IBS adolescents compared to the non-IBS (P=0.034. In addition, stress related to scolding, as a parental form of discipline was more likely to be found in the IBS group than in the non-IBS group (P=0.019. Conclusion The prevalence of IBS among adolescents in Jakarta is 6%, which is lower compared to those of other Asian countries. Corporal punishment at home and stress related to scolding at home are found to be associated with IBS. [Paediatr Indones. 2014;54:344-50.].

  1. Treatment of irritable bowel syndrome in China: A review

    OpenAIRE

    Li, Chun-Yan; Li, Shu-Chuen

    2015-01-01

    Irritable bowel syndrome (IBS) is a common, chronic, functional gastrointestinal disorder with a high incidence rate in the general population, and it is common among the Chinese population. The pathophysiology, etiology and pathogenesis of IBS are poorly understood, with no evidence of inflammatory, anatomic, metabolic, or neoplastic factors to explain the symptoms. Treatment approaches are mainly focused on symptom management to maintain everyday functioning and to improve quality of life f...

  2. Mind/Body Psychological Treatments for Irritable Bowel Syndrome

    OpenAIRE

    Naliboff, Bruce D.; Fresé, Michael P.; Lobsang Rapgay

    2008-01-01

    Currently, the goal of treatment for those with irritable bowel syndrome (IBS) is to improve the quality of life through a reduction in symptoms. While the majority of treatment approaches involve the use of traditional medicine, more and more patients seek out a non-drug approach to managing their symptoms. Current forms of non-drug psychologic or mind/body treatment for IBS include hypnotherapy, cognitive behavioral therapy and brief psychodynamic psychotherapy, all of which have been prove...

  3. Psychopharmacological Treatment and Psychological Interventions in Irritable Bowel Syndrome

    OpenAIRE

    Emanuele Sinagra; Claudia Romano; Mario Cottone

    2012-01-01

    Irritable bowel syndrome (IBS) accounts for 25% of gastroenterology output practice, making it one of the most common disorders in this practice. Psychological and social factors may affect the development of this chronic disorder. Furthermore, psychiatric symptoms and psychiatric diseases are highly prevalent in this condition, but the approach to treating these is not always straightforward. As emphasized in the biopsychosocial model of IBS, with regard to the modulatory role of stress-rela...

  4. Irritable bowel syndrome and its associated factors in adolescents

    OpenAIRE

    Lara Fillekes; Ari Prayogo; Fatima Safira Alatas; Badriul Hegar

    2014-01-01

    Background Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Increasing prevalences have been reported in Asian adolescent populations, however, there have been few reports on Indonesian adolescents. Objective To investigate the prevalence of IBS and associated factors among adolescents in Jakarta. Methods This cross-sectional study included senior high school students in a district of Jakarta. Students were asked to fill questionnaires based on the Rome...

  5. Functional findings in irritable bowel syndrome

    OpenAIRE

    Posserud, Iris; Ersryd, Amanda; Simrén, Magnus

    2006-01-01

    The pathophysiology of IBS is complex and still incompletely known. Both central and peripheral factors, including psychosocial factors, abnormal GI motility and secretion, and visceral hypersensitivity, are thought to contribute to the symptoms of IBS. Several studies have demonstrated altered GI motor function in IBS patients and the pattern differs between IBS subgroups based on the predominant bowel pattern. Few studies have so far addressed GI secretion in IBS, but there are some evidenc...

  6. Eluxadoline for Irritable Bowel Syndrome with Diarrhea.

    Science.gov (United States)

    Lembo, Anthony J; Lacy, Brian E; Zuckerman, Marc J; Schey, Ron; Dove, Leonard S; Andrae, David A; Davenport, J Michael; McIntyre, Gail; Lopez, Rocio; Turner, Lisa; Covington, Paul S

    2016-01-21

    Background Effective and safe treatments are needed for patients who have irritable bowel syndrome (IBS) with diarrhea. We conducted two phase 3 trials to assess the efficacy and safety of eluxadoline, a new oral agent with mixed opioid effects (μ- and κ-opioid receptor agonist and δ-opioid receptor antagonist), in patients with IBS with diarrhea. Methods We randomly assigned 2427 adults who had IBS with diarrhea to eluxadoline (at a dose of 75 mg or 100 mg) or placebo twice daily for 26 weeks (IBS-3002 trial) or 52 weeks (IBS-3001 trial). The primary end point was the proportion of patients who had a composite response of decrease in abdominal pain and improvement in stool consistency on the same day for at least 50% of the days from weeks 1 through 12 and from weeks 1 through 26. Results For weeks 1 through 12, more patients in the eluxadoline groups (75 mg and 100 mg) than in the placebo group reached the primary end point (IBS-3001 trial, 23.9% with the 75-mg dose and 25.1% with the 100-mg dose vs. 17.1% with placebo; P=0.01 and P=0.004, respectively; IBS-3002 trial, 28.9% and 29.6%, respectively, vs. 16.2%; P<0.001 for both comparisons). For weeks 1 through 26, the corresponding rates in IBS-3001 were 23.4% and 29.3% versus 19.0% (P=0.11 and P<0.001, respectively), and the corresponding rates in IBS-3002 were 30.4% and 32.7% versus 20.2% (P=0.001 and P<0.001, respectively). The most common adverse events associated with 75 mg of eluxadoline and 100 mg of eluxadoline, as compared with placebo, were nausea (8.1% and 7.5% vs. 5.1%), constipation (7.4% and 8.6% vs. 2.5%), and abdominal pain (5.8% and 7.2% vs. 4.1%). Pancreatitis developed in 5 (2 in the 75-mg group and 3 in the 100-mg group) of the 1666 patients in the safety population (0.3%). Conclusions Eluxadoline is a new therapeutic agent that reduced symptoms of IBS with diarrhea in men and women, with sustained efficacy over 6 months in patients who received the 100-mg dose twice daily. (Funded by

  7. Diagnosis of Irritable Bowel Syndrome

    Science.gov (United States)

    ... your anus. The doctor will fill your large intestine with barium . You may be asked to change positions several times during the test. ​​​​​ ​February 23, 2015​​​​ Previous: Symptoms and Causes of Irritable Bowel Syndrome Next: Treatment for Irritable Bowel Syndrome Digestive Disease ...

  8. Pharmacologic and Complementary and Alternative Medicine Therapies for Irritable Bowel Syndrome

    OpenAIRE

    Chey, William D; Maneerattaporn, Monthira; Saad, Richard

    2011-01-01

    Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by episodic abdominal pain or discomfort in association with altered bowel habits (diarrhea and/or constipation). Other gastrointestinal symptoms, such as bloating and flatulence, are also common. A variety of factors are believed to play a role in the development of IBS symptoms, including altered bowel motility, visceral hypersensitivity, psychosocial stressors, altered brain-gut interactions, imm...

  9. Comparing administrative and survey data for ascertaining cases of irritable bowel syndrome: a population-based investigation

    OpenAIRE

    Targownick Laura E; Shaw Souradet Y; Yogendran Marina S; Lix Lisa M; Jones Jennifer; Bataineh Osama

    2010-01-01

    Abstract Background Administrative and survey data are two key data sources for population-based research about chronic disease. The objectives of this methodological paper are to: (1) estimate agreement between the two data sources for irritable bowel syndrome (IBS) and compare the results to those for inflammatory bowel disease (IBD); (2) compare the frequency of IBS-related diagnoses in administrative data for survey respondents with and without self-reported IBS, and (3) estimate IBS prev...

  10. The Role of Diet in Irritable Bowel Syndrome with special reference to Gut Neuroendocrine System

    OpenAIRE

    Mazzawi, Tarek

    2015-01-01

    Background: The majority of the patients with irritable bowel syndrome (IBS) believe that diet triggers their symptoms, which affect the quality of their lives. The pathophysiology of IBS is not exactly known, however, the endocrine cells of the gut, which are known to regulate most of the functions of the gastrointestinal tract, are believed to play an important role in the IBS pathophysiology. These cells have been found abnormal in the patients with IBS. These endocrine cell...

  11. Practical Evaluation and Handling of Patients with Irritable Bowel Syndrome

    OpenAIRE

    Bodil Ohlsson

    2012-01-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder by unknown aetiology. Several reviews are written about pharmacological and psychological treatment of the disease. Nevertheless, healthcare professionals consider these patients difficult to handle in daily practice. There is an uncertainty about how to measure symptoms and to evaluate the effect of any given treatment. In the absence of objective markers, professionals feel unsure of how to manage the condition and the patients d...

  12. Role of antispasmodics in the treatment of irritable bowel syndrome

    OpenAIRE

    Annaházi, Anita; Róka, Richárd; Rosztóczy, András; Wittmann, Tibor

    2014-01-01

    Irritable bowel syndrome (IBS) is a long-lasting, relapsing disorder characterized by abdominal pain/discomfort and altered bowel habits. Intestinal motility impairment and visceral hypersensitivity are the key factors among its multifactorial pathogenesis, both of which require effective treatment. Voltage-gated calcium channels mediate smooth muscle contraction and endocrine secretion and play important roles in neuronal transmission. Antispasmodics are a group of drugs that have been used ...

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

    Science.gov (United States)

    El-Salhy, Magdy

    2015-07-01

    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. PMID:26167065

  14. Open-Label Treatment With Citalopram in Patients With Irritable Bowel Syndrome: A Pilot Study

    OpenAIRE

    Masand, Prakash S.; Gupta, Sanjay; Schwartz, Thomas L; Virk, Subhdeep; Hameed, Ahmad; Kaplan, David S.

    2005-01-01

    Background: This open-label pilot study investigated whether the selective serotonin reuptake inhibitor (SSRI) citalopram improves symptoms of irritable bowel syndrome (IBS), a functional gastrointestinal disorder with frequent psychiatric comorbidity.

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

    OpenAIRE

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

    2015-01-01

    Purpose 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). Materials and Methods This was a retrospective, cross-sectiona...

  16. Managing irritable bowel syndrome: The low-FODMAP diet.

    Science.gov (United States)

    Dugum, Mohannad; Barco, Kathy; Garg, Samita

    2016-09-01

    A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been found to significantly reduce symptoms of irritable bowel syndrome (IBS). The diet is best implemented in two phases: initial strict elimination of foods high in FODMAPs, then gradual reintroduction based on symptoms. Further study of this diet's effect on intestinal microbiota is needed. PMID:27618353

  17. Non-pharmacological treatments in the irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    A Leahy; O Epstein

    2001-01-01

    @@INTRODUCTION The irritable bowel syndrome (IBS) is a gastrointestinal disorder characteried by chronic lower abdominal pain and disordered defaecation associated with bloating ,tenesmus and extra-intestinal symptoms including and functional upper gastrointestinal symptoms .Currently there is nounifying hypothesis which adepuately explains the pathogenesis of the disorder although a number of physiological and psychological abmormalites have been described.

  18. Irritable Bowel Syndrome

    Science.gov (United States)

    ... IBS-C due to the effect on colon transit, although this theory has not been confirmed in ... often found in people with IBS include • chronic fatigue syndrome—a disorder that causes extreme fatigue, which ...

  19. Association and symptom characteristics of irritable bowel syndrome among bronchial asthma patients in Kuwait

    OpenAIRE

    Panicker Radhakrishna; Arifhodzic Nermina; Al Ahmad Mona; Ali Seham

    2010-01-01

    Context : Excess prevalence of irritable bowel syndrome in asthma has been reported, suggesting a link between these two conditions. Aims: To investigate the association between irritable bowel syndrome (IBS) and asthma, and explore the symptoms of IBS among asthma patients in Kuwait. Settings and Design: Case control study. Methods: In a tertiary center, for allergy and asthma, 138 patients aged 20-65 years, with asthma, diagnosed clinically and by spirometry,were compared with 145 hea...

  20. The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations

    OpenAIRE

    Fadgyas-Stanculete, Mihaela; Buga, Ana-Maria; Popa-Wagner, Aurel; Dumitrascu, Dan L

    2014-01-01

    Irritable bowel syndrome (IBS) is a functional syndrome characterized by chronic abdominal pain accompanied by altered bowel habits. Although generally considered a functional disorder, there is now substantial evidence that IBS is associated with a poor quality of life and significant negative impact on work and social domains. Neuroimaging studies documented changes in the prefrontal cortex, ventro-lateral and posterior parietal cortex and thalami, and implicate alteration of brain circuits...

  1. Prevalence of restless legs syndrome in patients with irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Patrick Basu; N James Shah; Nithya Krishnaswamy; Tommy Pacana

    2011-01-01

    AIM: To determine the prevalence of restless legs syndrome (RLS) in patients with irritable bowel syndrome (IBS).METHODS: Patients with diarrhea-predominant IBS (n = 30), constipation-predominant IBS (n = 30), or mixed-symptom IBS (n = 30) were recruited from the community between March 2008 and February 2009. Rifaximin 200 mg three times daily was administered empirically to alleviate small intestinal bowel overgrowth in all patients. The presence of RLS was assessed via an RLS questionnaire and polysomnography. RESULTS: Twenty-six patients with IBS (29%) were diagnosed with RLS using the RLS questionnaire. Twenty-four of the 26 patients (92%) underwent polysomnog Pacanaraphy, and all had confirmation of RLS. A greater percentage of patients with RLS had diarrhea-predominant IBS (62%) compared with patients with constipation-predominant IBS (4%) or mixed-symptom IBS (33%). CONCLUSION: Restless legs syndrome is prevalent in patients with IBS, especially those with diarrheal symptoms. Assessment of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.

  2. The role of infection in irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Hani Abu Zeid* Magdi Abdel Karim* Mahmoud M. Bazid*

    2005-03-01

    Full Text Available A clinically distinct subset of Irritable Bowel syndrome (IBS could be induced or exaggerated by bowel infection that is called post-infective IBS (PI-IBS which is characterized by diarrhea predominant symptoms with less psychiatric illness. The purpose of this work was to study whether some bowel infections contribute to the pathogenesis of IBS and whether the treatment of such infections reduces IBS symptoms. 100 patients with symptoms suggestive of IBS according to Rome II Criteria were chosen from Internal Medicine outpatient clinic-Al Hussein university hospital. They were 64 females and 36 males, aged 18-52 years old with mean age 38,2 3,6 years. They were submitted to: full clinical examination and frequent stool examinations (direct smear and culture before, soon after and six months after administration of drug therapies for common stool-positive associated bowel infections (diloxanide for E. histolytica, metronidazole for Giardia lamblia, Ketoconazole for Candida, ciprofloxacin for Salmonella and neomycin for Pseudomonas. Results obtained showed that 24% of patients had diarrhea predominant symptoms, 13 patients (54% out of them had history suggestive of acute gastroenteritis. 80 patients had initial positive stool examination and continued the post treatment six months follow up study. Out of them, 13 patients had stool positive for Salmonella typhi mixed with E. histolytica; ten of them (76.9% showed a statistically significant persistent clinical and laboratory improvement after ciprofloxacin therapy (P 0.05. This finding makes the correlation between E. histolytica infection and IBS is unlikely. 20 patients had isolated Candida overgrowth on stool examination; eight of them (40% showed a statistically significant clinical and laboratory improvement after Ketoconazole therapy (P < 0.05. Therefore Candida overgrowth may induce or exaggerate IBS symptoms. Finally, no growth was noticed for shigella sp. or E. coli, this may exclude the

  3. 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. PMID:25339801

  4. Irritable bowel syndrome and psychological stress

    Directory of Open Access Journals (Sweden)

    Anita D Stuart

    1999-01-01

    Full Text Available The purpose of this study was twofold. The first aim was to clarify the relationship between psychological stress and lrritable Bowel Syndrome (IBS by establishing whether individuals suffering from IBS experience minor stress differently from healthy individuals in terms of its frequency or intensity. The second aim was more general and concerns theory building in a field filled with ambiguity and confusion. Two groups, one comprising IBS sufferers and the other healthy controls, completed the Daily Stress lnventory and the Occupational Stress lnventory - questionnaires designed to measure minor daily and occupational stress respectively. The findings indicate that IBS sufferers do not experience more stress than healthy individuals, but they experience the stressors with greater intensity.

    Opsomming
    Die doel van die studie was tweeledig. Eerstens is daar gepoog om duidelikheid te kry oor die verband tussen sielkundige stres en Prikkelbare Dermsindroom (PDS, deur te bepaal of individue wat aan PDS ly geringe stres anders ervaar as gesonde individue in terme van gereeldheid of intensiteit. Die tweede doelwit was meer algemeen en spreek die kwessie van teorie ontwikkeling aan in 'n veld gevul met dubbelsinningheid en verwarring. Twee groepe, een bestaande uit PDS lyers en die ander 'n gesonde kontrolegroep, het die "Daily Stress Inventory'' en die "Occupational Stress Inventory" voltooi. Die vraelyste is ontwerp om onderskeidelik daaglikse stres en werkstres te meet. Die resultate dui daarop dat PDS lyers nie meer stres ervaar as die gesonde individue nie, maar dat hulle wel die stressors ervaar met groter intensiteit.

  5. Practical Evaluation and Handling of Patients with Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Bodil Ohlsson

    2012-12-01

    Full Text Available Irritable bowel syndrome (IBS is a functional bowel disorder by unknown aetiology. Several reviews are written about pharmacological and psychological treatment of the disease. Nevertheless, healthcare professionals consider these patients difficult to handle in daily practice. There is an uncertainty about how to measure symptoms and to evaluate the effect of any given treatment. In the absence of objective markers, professionals feel unsure of how to manage the condition and the patients do not feel that they are taken seriously. The development of the short, self-reported questionnaire, Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS, offers a practical guide to objective measurement of symptoms and effect of given treatments into numerical values in the daily practice.

  6. 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.

  7. 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

  8. 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. PMID:24627584

  9. Constructive thinking, rational intelligence and irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Enrique Rey; Marta Moreno Ortega; Monica Olga Garcia Alonso; Manuel Diaz-Rubio

    2009-01-01

    AIM: To evaluate rational and experiential intelligence in irritable bowel syndrome (IBS) sufferers.METHODS: We recruited 100 subjects with IBS as per Rome n criteria (50 consulters and 50 non-consulters) and 100 healthy controls, matched by age, sex and educational level. Cases and controls completed a clinical questionnaire (including symptom characteristics and medical consultation) and the following tests: rational-intelligence (Wechsler Adult Intelligence Scale, 3rd edition); experiential-intelligence (Constructive Thinking Inventory); personality (NEO personality inventory); psychopathology (MMPI-2), anxiety (state-trait anxiety inventory) and life events (social readjustment rating scale). Analysis of variance was used to compare the test results of IBS-sufferers and controls, and a logistic regression model was then constructed and adjusted for age, sex and educational level to evaluate any possible association with IBS.RESULTS: No differences were found between IBS cases and controls in terms of IQ (102.0 ± 10.8 vs 102.8 ± 12.6), but IBS sufferers scored significantly lower in global constructive thinking (43.7 ± 9.4 vs 49.6 ± 9.7). In the logistic regression model, global constructive thinking score was independently linkedto suffering from IBS [OR 0.92 (0.87-0.97)], without significant OR for total IQ.CONCLUSION: IBS subjects do not show lower rational intelligence than controls, but lower experiential intelligence is nevertheless associated with IBS.

  10. Small intestinal bacterial overgrowth and lactose intolerance contribute to irritable bowel syndrome symptomatology in Pakistan

    OpenAIRE

    Javed Yakoob; Zaigham Abbas; Rustam Khan; Saeed Hamid; Safia Awan; Wasim Jafri

    2011-01-01

    Background /Aim: The symptoms of irritable bowel syndrome resemble those of small intestinal bacterial overgrowth (SIBO). The aim of this study was to determine the frequency of SIBO and lactose intolerance (LI) occurrence in patients with diarrhea-predominant irritable bowel syndrome (IBS-D) according to Rome III criteria. Patients and Methods: In this retrospective case-control study, patients over 18 years of age with altered bowel habit, bloating, and patients who had lactose Hydrogen bre...

  11. Intervening on cognitions and behavior in irritable bowel syndrome: a feasibility trial using PDAs.

    NARCIS (Netherlands)

    Oerlemans, S.; Cranenburgh, O. van; Herremans, P.J.; Spreeuwenberg, P.; Dulmen, S. van

    2011-01-01

    Objective: Irritable bowel syndrome (IBS) is a common, chronic, and often disabling disorder. Cognitive–behavioral therapy (CBT) has been shown to be effective in alleviating IBS symptoms. The aim of this study was to establish the feasibility and the efficacy of a cognitive-behavioral e-interventio

  12. 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.

  13. 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

    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...

  14. Quality of life of patients with irritable bowel syndrome before and after education

    Directory of Open Access Journals (Sweden)

    Ewa B. Joć

    2015-08-01

    1. Quality of life of patients with irritable bowel syndrome is substantially reduced in all the examined spheres. 2. Education of patients with IBS resulted in enhanced quality of life and reduced disease-related complaints. 3. Education of patients with IBS plays a significant role in the entire therapeutic process.

  15. Associations among gut permeability, inflammatory markers, and symptoms in patients with irritable bowel syndrome

    Science.gov (United States)

    Alterations in gastrointestinal (GI) permeability and immune measures are present in some patients with irritable bowel syndrome (IBS) but the relationship to symptoms is poorly defined. In adults with IBS, we compared permeability, unstimulated peripheral blood monocyte (PBMC) interleukin-10 (IL-10...

  16. 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 an

  17. Irritable bowel syndrome: the role of gut neuroendocrine peptides.

    Science.gov (United States)

    El-Salhy, Magdy; Seim, Inge; Chopin, Lisa; Gundersen, Doris; Hatlebakk, Jan Gunnar; Hausken, Trygve

    2012-01-01

    Irritable bowel syndrome (IBS) is a common chronic disorder with a prevalence ranging from 5 to 10 percent of the world's population. This condition is characterised by abdominal discomfort or pain, altered bowel habits, and often bloating and abdominal distension. IBS reduces quality of life in the same degree of impairment as major chronic diseases such as congestive heart failure and diabetes and the economic burden on the health care system and society is high. Abnormalities have been reported in the neuroendocrine peptides/amines of the stomach, small- and large intestine in patients with IBS. These abnormalities would cause disturbances in digestion, gastrointestinal motility and visceral hypersensitivity, which have been reported in patients with IBS. These abnormalities seem to contribute to the symptom development and appear to play a central role in the pathogenesis of IBS. Neuroendocrine peptides/amines are potential tools in the treatment and diagnosis of IBS. In particular, the cell density of duodenal chromogranin A expressing cells appears to be a good histopathological marker for the diagnosis of IBS with high sensitivity and specificity. PMID:22652678

  18. Need for a comprehensive medical approach to the neuroimmuno-gastroenterology of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Pejman Katiraei; Gilberto Bultron

    2011-01-01

    Irritable bowel syndrome (IBS) is defined by the Rome Ⅲ criteria as symptoms of recurrent abdominal pain or discomfort with the onset of a marked change in bowel habits with no evidence of an inflammatory, anatomic,metabolic, or neoplastic process. As such, many clinicians regard IBS as a central nervous system problem of altered pain perception. Here, we review the recent literature and discuss the evidence that supports an organic based model, which views IBS as a complex,heterogeneous, inter-dependent, and multi-variable inflammatory process along the neuronal-gut axis. We delineate the organic pathophysiology of IBS, demonstrate the role of inflammation in IBS, review the possible differences between adult and pediatric IBS, discuss the merits of a comprehensive treatment model as taught by the Institute of Functional Medicine, and describe the potential for future research for this syndrome.

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

    OpenAIRE

    BrentMyers; BeverleyGreenwood-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...

  20. No difference in small bowel microbiota between patients with irritable bowel syndrome and healthy controls.

    Science.gov (United States)

    Dlugosz, Aldona; Winckler, Björn; Lundin, Elin; Zakikhany, Katherina; Sandström, Gunnar; Ye, Weimin; Engstrand, Lars; Lindberg, Greger

    2015-01-01

    Several studies have indicated that colonic microbiota may exhibit important differences between patients with irritable bowel syndrome (IBS) and healthy controls. Less is known about the microbiota of the small bowel. We used massive parallel sequencing to explore the composition of small bowel mucosa-associated microbiota in patients with IBS and healthy controls. We analysed capsule biopsies from the jejunum of 35 patients (26 females) with IBS aged 18-(36)-57 years and 16 healthy volunteers (11 females) aged 20-(32)-48 years. Sequences were analysed based on taxonomic classification. The phyla with the highest total abundance across all samples were: Firmicutes (43%), Proteobacteria (23%), Bacteroidetes (15%), Actinobacteria (9.3%) and Fusobacteria (7.0%). The most abundant genera were: Streptococcus (19%), Veillonella (13%), Prevotella (12%), Rothia (6.4%), Haemophilus (5.7%), Actinobacillus (5.5%), Escherichia (4.6%) and Fusobacterium (4.3%). We found no difference among major phyla or genera between patients with IBS and controls. We identified a cluster of samples in the small bowel microbiota dominated by Prevotella, which may represent a common enterotype of the upper small intestine. The remaining samples formed a gradient, dominated by Streptococcus at one end and Escherichia at the other. PMID:25687743

  1. Nerve growth factor and diarrhea-predominant irritable bowel syndrome (IBS-D):a potential therapeutic target?%神经生长因子与腹泻型肠易激综合征:具有前景的治疗靶点?

    Institute of Scientific and Technical Information of China (English)

    Xiao-juan XU; Liang LIU; Shu-kun YAO

    2016-01-01

    Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by recurrent abdominal pain or discomfort associated with abnormal bowel habits. Diarrhea-predominant IBS (IBS-D) is a major subtype of IBS, the predominant manifestations of which are abdominal pain and diarrhea. The pathogenesis of IBS-D remained unknown until recently. The effects of psychosocial stress, central hypervigilance, neuroendocrine abnor-mality, disturbed gastrointestinal motility, mucosal immune activation, intestinal barrier dysfunction, visceral hyper-sensitivity (VH), altered gut flora, and genetic susceptibility may be involved in its development. Recently, increased attention has been placed on the neural-immune-endocrine network mechanism in IBS-D, especially the role of var-ious neuroendocrine mediators. As a member of the neurotrophin family, nerve growth factor (NGF) has diverse bio-logical effects, and participates in the pathogenesis of many diseases. Basic studies have demonstrated that NGF is associated with inflammatory- and stress-related VH, as well as stress-related intestinal barrier dysfunction. The aim of this study is to summarize recent literature and discuss the role of NGF in the pathophysiology of IBS-D, especially in VH and intestinal barrier dysfunction, as wel as its potential as a therapeutic target in IBS-D.%目的:回顾国内外研究进展,针对神经生长因子(NGF)在腹泻型肠易激综合征(IBS-D)病理生理学,尤其在内脏高敏感和肠屏障功能受损中的作用作一综述。  创新点:总结了国内外有关 NGF参与 IBS-D病理生理学的基础及临床研究证据,提出了NGF介导IBS-D内脏高敏感和肠屏障功能受损的可能机制,并首次构建了NGF-肥大细胞-神经纤维三者在IBS-D发病中的作用网络。  方法:在PubMed、EMBASE、Web of Science、CNKI、维普和万方等数据库检索有关 NGF 参与 IBS-D病理生理学的中英文文献

  2. A randomised controlled trial of a probiotic ‘functional food’ in the management of irritable bowel syndrome

    OpenAIRE

    Roberts, Lesley M; McCahon, Deborah; Holder, Roger; Wilson, Sue; Hobbs, FD Richard

    2013-01-01

    Background Irritable Bowel Syndrome (IBS) is a common condition characterised by pain, distension and altered bowel habit. Evidence suggests functional foods containing probiotics improve gastrointestinal transit, however, data are limited by short follow-up periods and evaluation in selected populations. Methods A multi-centre, randomized, double blind, controlled trial to evaluate the effect of a probiotic vs non-probiotic dairy product on symptoms in IBS with a constipation element (IBS – ...

  3. Irritable Bowel Syndrome

    Science.gov (United States)

    ... be excluded from or reduced in the diet. Dietary fiber may improve constipation symptoms in people with IBS, ... may be recommended to relieve constipation when increasing dietary fiber is ineffective. • Laxatives may help constipation. Laxatives work ...

  4. Prediction of symptomatic improvement after exposure-based treatment for irritable bowel syndrome

    OpenAIRE

    Ljotsson, Brjann; Andersson, Erik; Lindfors, Perjohan; Lackner, Jeffrey M; Gronberg, Karin; Molin, Katarina; Noren, Johanna; Romberg, Karin; Andersson, Evelyn; Hursti, Timo; Hesser, Hugo; Hedman, Erik

    2013-01-01

    Background: Several studies show that psychological treatments relieve symptoms for patients suffering from irritable bowel syndrome (IBS). However, there are no consistent findings that show what patient characteristics make a psychological treatment more or less likely to result in improvement. We have previously conducted a study of a newly developed internet-delivered cognitive behavioral therapy (ICBT) that emphasized exposure to IBS symptoms and IBS-related situations and reduced sympto...

  5. Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome

    OpenAIRE

    Acosta, Andrés; Camilleri, Michael; Shin, Andrea; Linker Nord, Sara; O'Neill, Jessica; Gray, Amber V; Lueke, Alan J; Donato, Leslie J; Burton, Duane D.; Szarka, Lawrence A.; Zinsmeister, Alan R.; Golden, Pamela L.; Fodor, Anthony

    2016-01-01

    Objectives: Rifaximin relieves irritable bowel syndrome (IBS) symptoms, bloating, abdominal pain, and loose or watery stools. Our objective was to investigate digestive functions in rifaximin-treated IBS patients. Methods: In a randomized, double-blind, placebo-controlled, parallel-group study, we compared the effects of rifaximin, 550 mg t.i.d., and placebo for 14 days in nonconstipated IBS and no evidence of small intestinal bacterial overgrowth (SIBO). All subjects completed baseline and o...

  6. Burden of Illness in Irritable Bowel Syndrome Comparing Rome I and Rome II Criteria

    OpenAIRE

    Xavier Badia; Fermin Mearin; Agustin Balboa; Eva Baro; Ellen Caldwell; Mercedes Cucala; Manuel Diaz-Rubio; Arturo Fueyo; Julio Ponce; Mentse Roset; Talley, Nicholas J

    2002-01-01

    Objectives: To evaluate the burden of illness in irritable bowel syndrome (IBS), in terms of resource utilisation (direct and indirect) and health-related quality of life (HR-QOL), in individuals with IBS who meet Rome I and Rome II criteria. Methods: A cross-sectional study, carried out by personal interview, on a representative sample (n = 2000) of the Spanish population. Individuals with suspected IBS were identified via a screening question and subsequently given an epidemiological questi...

  7. Linaclotide: A Novel Therapy for Chronic Constipation and Constipation-Predominant Irritable Bowel Syndrome

    OpenAIRE

    Lacy, Brian E.; Levenick, John M.; Crowell, Michael D.

    2012-01-01

    Chronic constipation and irritable bowel syndrome (IBS) are functional gastrointestinal disorders that significantly affect patients’ quality of life. Chronic constipation and IBS are prevalent—1 2% of the US population meet the diagnostic criteria for IBS, and 1 5% meet the criteria for chronic constipation— and these conditions negatively impact the healthcare system from an economic perspective. Despite attempts at dietary modification, exercise, or use of over-the-counter medications, man...

  8. Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome

    OpenAIRE

    Ringel, Yehuda; Maharshak, Nitsan

    2013-01-01

    The pathophysiology of irritable bowel syndrome (IBS) is believed to involve alterations in the brain-gut axis; however, the etiological triggers and mechanisms by which these changes lead to symptoms of IBS remain poorly understood. Although IBS is often considered a condition without an identified “organic” etiology, emerging evidence suggests that alterations in the gastrointestinal microbiota and altered immune function may play a role in the pathogenesis of the disorder. These recent dat...

  9. A candidate probiotic with unfavourable effects in subjects with irritable bowel syndrome: a randomised controlled trial

    OpenAIRE

    Axelsson Lars; Naterstad Kristine; Ligaarden Solveig C; Lydersen Stian; Farup Per G

    2010-01-01

    Abstract Background Some probiotics have shown efficacy for patients with irritable bowel syndrome (IBS). Lactobacillus (L.) plantarum MF1298 was found to have the best in vitro probiotic properties of 22 strains of lactobacilli. The aim of this study was to investigate the symptomatic effect of L. plantarum MF1298 in subjects with IBS. Primary outcome was treatment preference and secondary outcomes were number of weeks with satisfactory relief of symptoms and IBS sum score. Methods The desig...

  10. Small intestinal bacterial overgrowth in irritable bowel syndrome: are there any predictors?

    OpenAIRE

    McCallum Richard W; Sostarich Sandra; Reddymasu Savio C

    2010-01-01

    Abstract Background Small intestinal bacterial overgrowth (SIBO) is a condition in which excessive levels of bacteria, mainly the colonic-type species are present in the small intestine. Recent data suggest that SIBO may contribute to the pathophysiology of Irritable bowel syndrome (IBS). The purpose of this study was to identify potential predictors of SIBO in patients with IBS. Methods Adults with IBS based on Rome II criteria who had predominance of bloating and flatulence underwent a gluc...

  11. A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome

    OpenAIRE

    Tack, Jan; Broekaert, Dorine; Fischler, Benjamin; Oudenhove, Lukas Van; Gevers, Anne-Marie; Janssens, Jozef

    2006-01-01

    INTRODUCTION: Selective serotonin reuptake inhibitors (SSRIs) are frequently used in the treatment of irritable bowel syndrome (IBS) although evidence of their efficacy is scarce. AIM: Twenty three non-depressed IBS patients were recruited from a tertiary care centre and included in a crossover trial comparing six weeks of treatment with the SSRI citalopram (20 mg for three weeks, 40 mg for three weeks) with placebo. IBS symptom severity was the primary outcome measure, and depression and anx...

  12. Association between Diet and Lifestyle Habits and Irritable Bowel Syndrome: A Case-Control Study

    OpenAIRE

    Guo, Yu-Bin; Zhuang, Kang-Min; Kuang, Lei; Zhan, Qiang; Wang, Xian-fei; Liu, Si-De

    2014-01-01

    Background/Aims Recent papers have highlighted the role of diet and lifestyle habits in irritable bowel syndrome (IBS), but very few population-based studies have evaluated this association in developing countries. The aim of this study was to evaluate the association between diet and lifestyle habits and IBS. Methods A food frequency and lifestyle habits questionnaire was used to record the diet and lifestyle habits of 78 IBS subjects and 79 healthy subjects. Cross-tabulation analysis and lo...

  13. Effect of prolonged stress on the adrenal hormones of individuals with irritable bowel syndrome

    OpenAIRE

    Sugaya, Nagisa; Izawa, Shuhei; Saito, Keisuke; Shirotsuki, Kentaro; Nomura, Shinobu; Shimada, Hironori

    2015-01-01

    Background The purpose of this study was to investigate the effect of prolonged stress on the salivary adrenal hormones (cortisol, dehydroepiandrosterone [DHEA], DHEA-sulfate [DHEA-S]) of individuals with irritable bowel syndrome (IBS). Methods The participants were female college students, including 10 with IBS and 16 without IBS (control group), who were scheduled for a 2-week teaching practice at a kindergarten. Participants were asked to collect saliva for determining adrenal hormones imm...

  14. Prevalence of irritable bowel syndrome in Chinese college and university students assessed using Rome Ⅲ criteria

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To estimate the prevalence of irritable bowel syndrome(IBS)in college and university students of North China and certain related factors for IBS.METHODS:A total of 2500 students from Shandong University in North China were asked in February-March 2009 to complete questionnaires,including the Rome Ⅲquestionnaire,hospital anxiety and depression scale,and IBS-quality of life questionnaire(IBS-QOL).RESULTS:Among the 2126 students with complete data,the prevalence of IBS was 7.85%according to the RomeⅢcriter...

  15. Endocrine cells in the oxyntic mucosa of the stomach in patients with irritable bowel syndrome

    OpenAIRE

    El-Salhy, Magdy; Gilja, Odd Helge; Gundersen, Doris Irene; Hausken,Trygve

    2014-01-01

    AIM: To study the different endocrine cell types in the oxyntic mucosa of patients with irritable bowel syndrome (IBS). METHODS: Seventy-six patients with IBS were included in the study (62 females and 14 males; mean age 32 years, range 18-55 years), of which 40 also fulfilled the Rome III criteria for functional dyspepsia (FDP). Of the entire IBS cohort, 26 had diarrhea as the predominant symptom (IBS-D), 21 had a mixture of diarrhea and constipation (IBS-M), and 29 had constipation as th...

  16. The relation of Cx43 and NMDA to visceral sensitization in rats with irritable bowel syndrome

    OpenAIRE

    Zhang, Jing-Yu; Huang, Yu-Xin; Ming QIN; Hui-jun GAO; Wei-jia DOU; Jing-jie WANG

    2016-01-01

    Objective  To study the relationship between connexin 43 (Cx43) and N-methyl-D-aspartate (NMDA) receptors and visceral sensitization in the rats with irritable bowel syndrome (IBS). Methods  Thirty rats were gavaged with Triehinella spiralis to reproduce the IBS model. These rats were randomly divided into IBS group, IBS+colon distension group, and IBS+STI-571+colon distension group, and other groups of normal rats were randomized into normal group and normal+colon distension group, with 10 r...

  17. Irritable bowel syndrome and intestinal parasites: a view from South America.

    Science.gov (United States)

    Vasquez-Rios, George; Machicado, Jorge D; Terashima, Angelica; Marcos, Luis A

    2016-01-01

    Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder of uncertain etiology. Several studies have proposed the possible role of intestinal parasites in the pathogenesis of IBS. We aimed to summarize the epidemiological studies that describe a possible link between intestinal parasites and IBS, with special interest in endemic areas for intestinal parasitism such as South America. A comprehensive review of the literature was conducted by using the keywords: irritable bowel syndrome, intestinal parasites, protozoan infection, soil-transmitted helminths and South America. Giardia lamblia may cause IBS symptoms that can persist several years after effective treatment. Dientamoeba fragilis can cause IBS-like symptoms, but low sensitive parasitological techniques may fail to detect it. Entamoeba histolytica can cause a chronic non-dysenteric colitis, but several studies have failed to find an association with IBS. The role of Blastocystis hominis in IBS remains controversial. In addition, epidemiological studies evaluating the effect of soil-transmitted helminths in IBS are scant. Symptoms elicited by intestinal parasites may resemble to those in IBS, especially in endemic areas such as South America, where both the prevalence of IBS and intestinal parasitism are high. Whether these organisms are the cause or contributing factors in IBS remains a subject of study. Routine parasitologicalexamination of stools in individuals who full-fit the criteria for IBS should be included upon initial assessment in endemic countries. PMID:27409092

  18. Medications (for IBS)

    Medline Plus

    Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome ( ... take for a therapeutic effect counts as a medicine. It can be readily available over-the-counter, ...

  19. Medications (for IBS)

    Medline Plus

    Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome ( ... limited by prescription only. It might be a drug or a supplement; manufactured or "natural." It might ...

  20. Long-term efficacy and safety of otilonium bromide in the management of irritable bowel syndrome: a literature review

    OpenAIRE

    Triantafillidis JK; Malgarinos G

    2014-01-01

    John K Triantafillidis, George Malgarinos Inflammatory Bowel Disease Unit, IASO General Hospital, Athens, Greece Abstract: Irritable bowel syndrome (IBS) is a very common functional gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits. The disease affects a large part of the world population. The clinical course is mostly characterized by a cyclic recurrence of symptoms. Therefore, IBS patients should receive, as an initial therapeutic approach, a ...

  1. Lubiprostone: evaluation of the newest medication for the treatment of adult women with constipation-predominant irritable bowel syndrome

    OpenAIRE

    Lunsford, Tisha N; Harris, Lucinda A

    2010-01-01

    Tisha N Lunsford, Lucinda A HarrisDepartment of Gastroenterology and Hepatology, Mayo Clinic – School of Medicine, Scottsdale, Arizona, USAAbstract: Irritable bowel syndrome (IBS) is a chronic disorder that affects primarily female patients and is thought also to afflict approximately 7%–10% of the population of the Western World. Although bowel habits may change over the course of years, patients with IBS are characterized according to their predominant bowel habit, const...

  2. 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.

  3. Genetic polymorphism in pathogenesis of irritable bowel syndrome.

    Science.gov (United States)

    Cheung, Cynthia K Y; Wu, Justin C Y

    2014-12-21

    Irritable bowel syndrome (IBS) is a complex symptom-based disorder without established biomarkers or putative pathophysiology. IBS is a common functional gastrointestinal disorder which is defined as recurrent abdominal pain or discomfort that has at least two of the following symptoms for 3 d per month in the past 3 mo according to ROME III: relief by defecation, onset associated with a change in stool frequency or onset with change in appearance or form of stool. Recent discoveries revealed genetic polymorphisms in specific cytokines and neuropeptides may possibly influence the frequencies and severity of symptoms, as well as the therapeutic responses in treating IBS patients. This review gives new insights on how genetic determinations influence in clinical manifestations, treatment responses and potential biomarkers of IBS.

  4. 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. PMID:24627586

  5. Irritable Bowel Syndrome

    Science.gov (United States)

    ... foods are linked to other digestive conditions like lactose intolerance or celiac disease , though, so it's important to ... MORE ON THIS TOPIC Gastroesophageal Reflux Disease (GERD) Lactose Intolerance Inflammatory Bowel Disease Ulcers Digestive System Eating Well ...

  6. A randomised, controlled study of small intestinal motility in patients treated with sacral nerve stimulation for irritable bowel syndrome

    OpenAIRE

    Fassov, Janne; Lundby, Lilli; Worsøe, Jonas; Buntzen, Steen; Laurberg, Søren; Krogh, Klaus

    2014-01-01

    Background Irritable bowel syndrome (IBS) is among the most common gastrointestinal disorders worldwide. In selected patients with severe diarrhoea-predominant or mixed IBS subtypes sacral nerve stimulation (SNS) alleviates IBS-specific symptoms and improves quality of life. The mode of action, however, remains unknown. The present study aimed to evaluate the effect of SNS on small intestinal motility in IBS patients. Methods Twenty patients treated with SNS for severe diarrhoea-predominant o...

  7. Endogenous Inhibition of Somatic Pain is Impaired in Girls with Irritable Bowel Syndrome Compared with Healthy Girls

    OpenAIRE

    Williams, Amy E; Heitkemper, Margaret; Self, Mariella M.; Czyzewski, Danita I.; Shulman, Robert J.

    2013-01-01

    Endogenous pain-inhibition is often deficient in adults with chronic pain conditions including irritable bowel syndrome (IBS). It is unclear whether deficiencies in pain-inhibition are present in young children with IBS. The present study compared endogenous pain-inhibition, somatic pain threshold, and psychosocial distress in young girls with IBS versus controls. Girls with IBS did not show significant endogenous pain-inhibition of heat pain-threshold during a cold-pressor task in contrast t...

  8. Effects of Demographic Factors, Body Mass Index, Alcohol Drinking and Smoking Habits on Irritable Bowel Syndrome: A Case Control Study

    OpenAIRE

    N. Farzaneh; Ghobaklou, M; Moghimi-Dehkordi, B; Naderi, N; Fadai, F

    2013-01-01

    Background: Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder. Aims: To identify demographic factors in patients with IBS. Subjects and Methods: One-hundred and fifty three IBS patients seen at Taleghani Hospital Gastroenterology Clinic and met the Rome III criteria and 163 peoples who did not meet IBS criteria were consecutively enrolled. Both groups were asked to complete a self-rating questionnaire containing information, which included questions about age, se...

  9. Gastric sarcoidosis mimicking irritable bowel syndrome-Cause not association?

    Institute of Scientific and Technical Information of China (English)

    John Samuel Leeds; Mark Edward McAlindon; Eleanor Lorenz; Asha Kumari Dube; David Surendran Sanders

    2006-01-01

    Sarcoidosis is a systemic disease of unknown aetiology that may affect any organ in the body. The gastrointestinal tract however is only rarely affected outside the liver. Symptoms may be non-specific.Irritable bowel syndrome (IBS) is a common diagnosis.The recognition of TBS is aided by the use of the Rome Ⅱ criteria - in the absence of organic disease. We describe the first case of a patient with gastric sarcoidosis who presented with IBS symptoms but subsequently responded to immunosuppressive therapy.

  10. Psychopharmacological Treatment and Psychological Interventions in Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Emanuele Sinagra

    2012-01-01

    Full Text Available Irritable bowel syndrome (IBS accounts for 25% of gastroenterology output practice, making it one of the most common disorders in this practice. Psychological and social factors may affect the development of this chronic disorder. Furthermore, psychiatric symptoms and psychiatric diseases are highly prevalent in this condition, but the approach to treating these is not always straightforward. As emphasized in the biopsychosocial model of IBS, with regard to the modulatory role of stress-related brain-gut interactions and association of the disease with psychological factors and emotional state, it proves useful to encourage psychopharmacological treatments and psychosocial therapies, both aiming at reducing stress perception. The aim of this paper is to analyze the effectiveness of psychopharmacological treatment and psychological interventions on irritable bowel syndrome.

  11. [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. PMID:25252862

  12. 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. PMID:25083056

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

    OpenAIRE

    Quigley, Eamonn M. M.; Ng, Siew C.; Ujjala Ghoshal; Kok-Ann Gwee; Ghoshal, Uday C; Ratnakar Shukla

    2012-01-01

    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...

  14. Overgrowth of the indigenous gut microbiome and irritable bowel syndrome

    OpenAIRE

    Bye, William; Ishaq, Naveed; Bolin, Terry D; Duncombe, Vic M; Stephen M Riordan

    2014-01-01

    Culture-independent molecular techniques have demonstrated that the majority of the gut microbiota is uncultivable. Application of these molecular techniques to more accurately identify the indigenous gut microbiome has moved with great pace over recent years, leading to a substantial increase in understanding of gut microbial communities in both health and a number of disorders, including irritable bowel syndrome (IBS). Use of culture-independent molecular techniques already employed to char...

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

    OpenAIRE

    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 bacteri...

  16. Food components and irritable bowel syndrome.

    Science.gov (United States)

    Gibson, Peter R; Varney, Jane; Malakar, Sreepurna; Muir, Jane G

    2015-05-01

    Ingestion of food has long been linked with gut symptoms, and there is increasing interest in using diet in the management of patients with irritable bowel syndrome (IBS). The West has developed an intense interest in specialized, restrictive diets, such as those that target multiple food groups, avoid gluten, or reduce fermentable oligo-, di-, and mono-saccharides and polyols. However, most gastroenterologists are not well educated about diets or their effects on the gut. It is important to understand the various dietary approaches, their putative mechanisms, the evidence that supports their use, and the benefits or harm they might produce. The concepts behind, and delivery of, specialized diets differ from those of pharmacologic agents. High-quality research is needed to determine the efficacy of different dietary approaches and the place of specific strategies. PMID:25680668

  17. Restriction of FODMAP in the management of bloating in irritable bowel syndrome.

    Science.gov (United States)

    Wong, Wei Mon

    2016-09-01

    Irritable bowel syndrome (IBS) is a common functional bowel disorder. Up to 96% of IBS patients experience bloating, resulting in poor response to conventional therapies and high consultation rates. Many IBS patients report that food triggers symptoms, particularly diets with poorly absorbed, short-chain carbohydrates, and restrict intake of certain foods to control their symptoms. IBS patients are especially susceptible to an attack due to visceral hypersensitivity. An emerging therapeutic strategy excludes fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) from the diet. There is evidence supporting the efficacy of a low FODMAP diet in improving symptoms of bloating in IBS patients. Individualised, structured dietary guidance may benefit those with persistent troublesome symptoms despite traditional therapies. In view of the multifactorial aetiology of the condition, it is probably best to use a multipronged approach, involving combination therapies, to address bloating in IBS patients. PMID:27664186

  18. Quality of Life in Irritable Bowel Syndrome: A Narrative Overview

    Directory of Open Access Journals (Sweden)

    Liang

    2016-02-01

    Full Text Available Context Health-related quality of life (HRQoL is increasingly important in the assessment of chronic conditions, especially for irritable bowel syndrome (IBS, which has no associated mortality, but is prevalent and significantly impacts patient’s lives. Disease-specific instruments such as the irritable bowel syndrome quality of life instrument (IBS-QOL, in addition to generic instruments such as the short form (SF-36, are useful in measuring health-related quality of life, and have been shown to be reliable in assessing disease severity and as an endpoint to monitor treatment response. We reviewed the impact of IBS on patients’ HRQoL, the factors causing HRQoL impairments, and the utility of HRQoL instruments in the assessment of IBS. Evidence Acquisition We performed electronic literature searches in Medline, the Cochrane library, and digestive disease week (DDW meeting abstracts. Across all databases searched, common keywords included “Irritable bowel syndrome”, “Quality of life” and “Health related quality of life”. For databases that accommodated Boolean searches, terms specifically related to QOL and military were added. Results We summarized the data available in the literature to show that HRQoL is poorer in patients with IBS compared to healthy controls, and compared to most serious chronic conditions. There are several factors that contribute to HRQoL impairments in IBS, of which gastrointestinal symptoms, physical co-morbidities, psychosocial factors and demographics all play significant roles. Conclusions It is crucial for clinicians to be aware of the importance of measuring HRQoL. Understanding the factors causing impairment of HRQoL is also important for clinicians seeing these patients as it helps to individualise treatment and treat the patient more holistically, to achieve greater patient satisfaction.

  19. 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...

  20. Rifaximin: The Revolutionary Antibiotic Approach for Irritable Bowel Syndrome.

    Science.gov (United States)

    Triantafyllou, Konstantinos; Sioulas, Athanasios D; Giamarellos-Bourboulis, Evangelos J

    2015-01-01

    A large number of clinical studies using breath testing and a smaller number of studies using quantitative cultures of the upper small intestine established a link between irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). A series of 12 studies both prospective and retrospective in design in a population of patients with SIBO without IBS showed that the non-absorbable antibiotic rifaximin can eradicate SIBO as proved through decrease of the exhaled hydrogen and methane in breath tests. The efficacy of rifaximin was superior over the comparator treatment in most of these studies. Based on these findings, short course rifaximin was tested in various concentrations in eight open-label trials in patients with IBS and proven SIBO by breath test. Similar efficacy of rifaximin was shown in SIBO eradication; this was accompanied by improvement of the global score for IBS symptoms. Finally, five double-blind randomized clinical trials were conducted in patients with IBS; four were placebo-controlled. The larger trials were TARGET 1 and TARGET 2 studies testing rifaximin at a regimen of 550 mg tid for 14 days. All trials showed a significant superiority of rifaximin over comparator for the improvement of global symptoms of IBS and bloating. Although the aforementioned results render rifaximin a revolutionary therapeutic approach for IBS, several concerns on induction of antimicrobial resistant flora remain. PMID:26202193

  1. 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.

  2. 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. PMID:27605876

  3. Personality factors and profiles in variants of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To study the association between irritable bowel syndrome (IBS) variants (constipation, diarrhea, or both)and personality traits in non-psychiatric patients.METHODS: 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. Personality traits and the score of each factor were evaluated using the NEO Five Factor Inventory.RESULTS: One hundred and fifty patients were studied.The mean age (±SD) was 33.4 (±11.0) year (62% female). Subjects scored higher in neuroticism (26.25±7.80 vs 22.92±9.54, P < 0.0005), openness (26.25±5.22 vs 27.94±4.87, P < 0.0005) and conscientiousness (32.90 ±7.80 vs 31.62±5.64, P < 0.01) compared to our general population derived from universities of Iran. Our studied population consisted of 71 patients with Diarrhea dominant-IBS, 33 with Constipation dominant-IBS and 46 with Altering type-IBS. Scores of conscientiousness and neuroticism were significantly higher in C-IBS compared to D-IBS and A-IBS (35.79±5.65 vs 31.95±6.80,P = 0.035 and 31.97±9.87, P = 0.043, respectively).Conscientiousness was the highest dimension of personality in each of the variants. Patients with C-IBS had almost similar personality profiles, composed of higher scores for neuroticism and conscientiousness, with low levels of agreeableness, openness and extraversion that were close to those of the general population.CONCLUSION: Differences were observed between IBS patients and the general population, as well as between IBS subtypes, in terms of personality factors.Patients with constipation-predominant IBS showed similar personality profiles. Patients with each subtype of IBS may benefit from psychological interventions, which can be focused considering the characteristics of each subtype.

  4. Long-term Impact on Gastrointestinal Symptoms, Quality of Life and Nutritional Adequacy after Group Intervention in patients with Irritable Bowel Syndrome

    OpenAIRE

    Kjøsnes, Norene Grytten

    2015-01-01

    Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder often associated with complex clinical manifestations. There is no cure for IBS, however potent management strategies have been proposed, including the FODMAP diet. Haukeland University Hospital provides group based IBS interventions. There is a need for critical evaluation of group-based management of IBS. Aim: To quality assess the long-term impact of the group based IBS inte...

  5. Diet in subjects with irritable bowel syndrome: A cross-sectional study in the general population

    Directory of Open Access Journals (Sweden)

    Ligaarden Solveig C

    2012-06-01

    Full Text Available Abstract Background Patients with irritable bowel syndrome (IBS often relate symptoms to the intake of certain foods. This study assesses differences in diet in subjects with and without IBS. Methods The cross-sectional, population-based study was conducted in Norway in 2001. Out of 11078 invited subjects, 4621 completed a survey about abdominal complaints and intake of common food items. IBS and IBS subgroups were classified according to Rome II criteria. Results IBS was diagnosed in 388 subjects (8.4% and, of these, 26.5% had constipation-predominant IBS (C-IBS, 44.8% alternating IBS (A-IBS, and 28.6% diarrhoea-predominant IBS (D-IBS. Low intake of dairy products (portions/day (Odds Ratio 0.85 [CI 0.78 to 0.93], p = 0.001 and high intake of water (100 ml/day (1.08 [1.02 to 1.15], p = 0.002, tea (1.05 [1.01 to 1.10], p = 0.019 and carbonated beverages (1.07 [1.01 to 1.14], p = 0.023 were associated with IBS. A lower intake of dairy products and a higher intake of alcohol and carbonated beverages were associated with D-IBS and a higher intake of water and tea was associated with A-IBS. In subjects with IBS the severity of symptoms was associated with a higher intake of vegetables and potatoes in subjects with C-IBS, with a higher intake of vegetables in subjects with A-IBS, and with a higher intake of fruits and berries, carbonated beverages and alcohol in subjects with D-IBS. Conclusions In this study, the diet differed in subjects with and without IBS and between IBS subgroups and was associated with the severity of symptoms.

  6. 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.

  7. 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. PMID:25083061

  8. IBS Treatment Options

    Science.gov (United States)

    ... Last Updated: 14 June 2016 Print Tweet A short bout of abdominal pain and diarrhea or constipation now and then is not unusual. But long-term or recurring symptoms are not normal. They may signal irritable bowel syndrome (IBS) – and are generally treatable. IBS Treatments ...

  9. Chromogranin A cell density in the rectum of patients with irritable bowel syndrome

    OpenAIRE

    El-Salhy, M.; Mazzawi, T; Gundersen, D.; Hausken, T.

    2012-01-01

    In a previous study, chromogranin A (CgA) cell density in the colon of patients with irritable bowel syndrome (IBS) was found to be reduced. It has been suggested that intestinal CgA cell density may be used as a marker for the diagnosis of IBS. The rectum harbours a larger number of large intestinal endocrine cells and is more accessible for biopsies than the colon. The present study aimed at determining the CgA cell density in the rectum of IBS patients. A total of 47 patients with IBS that...

  10. 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.

  11. Gastrointestinal symptoms related to the irritable bowel syndrome - a longitudinal population-based register study

    DEFF Research Database (Denmark)

    Poulsen, Chalotte Heinsvig; Eplov, Lene Falgaard; Hjorthoj, Carsten;

    2016-01-01

    significant interactions between symptom groups and coexisting symptoms in relation to the two outcomes. Conclusions GI diseases were seen more frequently, but IBS was not associated with severe GI diseases or increased mortality. Clinicians should be more aware when patients do not fulfil the IBS definition......Objective Functional gastrointestinal (GI) symptoms can develop into persistent states often categorised as the irritable bowel syndrome (IBS). In the severe end of the GI symptom continuum, other coexisting symptoms are common. We aimed to investigate the GI symptom continuum in relation......-based IBS definition. The pooled cohort (n = 7278) was followed until December 2013 in Central Registries. Results Fifty-one percent had no GI symptoms, 39% had GI symptoms but never fulfilled the IBS definition, 8% had fluctuating IBS and 2% had persisting IBS. There was no significant association between...

  12. The Importance of Relationships in Patients with Irritable Bowel Syndrome: A Review

    Directory of Open Access Journals (Sweden)

    Mary-Joan Gerson

    2012-01-01

    Full Text Available Chronic illnesses such as irritable bowel syndrome are not experienced by patients in isolation. They live in a context of relationships, including spouses and partners, other family members, friends and business associates. Those relationships can have an effect, both positive and negative, on the course of illness and may also be affected by the experience of living with a chronic illness like IBS. We review the general literature regarding the effect of relationship factors on chronic illness followed by a focus on IBS symptomatology. We then discuss the challenges experienced by partners of IBS patients, followed by the effects of spousal violence, the particular relationship of mothers with IBS and their children, the effects of social support, and the importance of family dynamics and IBS. The final segment includes conclusions and recommendations. The topic, relationships and IBS, may have a significant effect on the lives of IBS patients and deserves more attention than it has received.

  13. 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.

  14. Irritable Bowel Syndrome: A Global Challenge Among Medical Students.

    Science.gov (United States)

    Qureshi, Sarah Rauf; Abdelaal, Ahmed M; Janjua, Zaynab A; Alasmari, Hajar A; Obad, Adam S; Alamodi, Abdulhadi; Shareef, Mohammad Abrar

    2016-01-01

    Irritable bowel syndrome (IBS) has been identified as one of the more highly prevalent and costly gastrointestinal disorders. Despite its uncertain etiology, risk factors, such as stress and academic load, are well correlated with the prevalence of the disease. Being in one of the most stressful and challenging environments, medical students are predisposed to have high rates of IBS. The socioeconomic burden of the disease on its sufferers is devastating as their quality of life is reduced, mandating additional health care precautions. The aim of this article, therefore, is to review the current literature about IBS among medical students, its prevalence, associated risk factors, and diagnostic criteria. Additionally, different solutions and management options are recommended to control the disease. PMID:27625907

  15. Overgrowth of the indigenous gut microbiome and irritable bowel syndrome.

    Science.gov (United States)

    Bye, William; Ishaq, Naveed; Bolin, Terry D; Duncombe, Vic M; Riordan, Stephen M

    2014-03-14

    Culture-independent molecular techniques have demonstrated that the majority of the gut microbiota is uncultivable. Application of these molecular techniques to more accurately identify the indigenous gut microbiome has moved with great pace over recent years, leading to a substantial increase in understanding of gut microbial communities in both health and a number of disorders, including irritable bowel syndrome (IBS). Use of culture-independent molecular techniques already employed to characterise faecal and, to a lesser extent, colonic mucosal microbial populations in IBS, without reliance on insensitive, traditional microbiological culture techniques, has the potential to more accurately determine microbial composition in the small intestine of patients with this disorder, at least that occurring proximally and within reach of sampling. Current data concerning culture-based and culture-independent analyses of the small intestinal microbiome in IBS are considered here. PMID:24627582

  16. Role of antispasmodics in the treatment of irritable bowel syndrome.

    Science.gov (United States)

    Annaházi, Anita; Róka, Richárd; Rosztóczy, András; Wittmann, Tibor

    2014-05-28

    Irritable bowel syndrome (IBS) is a long-lasting, relapsing disorder characterized by abdominal pain/discomfort and altered bowel habits. Intestinal motility impairment and visceral hypersensitivity are the key factors among its multifactorial pathogenesis, both of which require effective treatment. Voltage-gated calcium channels mediate smooth muscle contraction and endocrine secretion and play important roles in neuronal transmission. Antispasmodics are a group of drugs that have been used in the treatment of IBS for decades. Alverine citrate, a spasmolytic, decreases the sensitivity of smooth muscle contractile proteins to calcium, and it is a selective 5-HT1A receptor antagonist. Alverine, in combination with simethicone, has been demonstrated to effectively reduce abdominal pain and discomfort in a large placebo-controlled trial. Mebeverine is a musculotropic agent that potently blocks intestinal peristalsis. Non-placebo-controlled trials have shown positive effects of mebeverine in IBS regarding symptom control; nevertheless, in recent placebo-controlled studies, mebeverine did not exhibit superiority over placebo. Otilonium bromide is poorly absorbed from the GI tract, where it acts locally as an L-type calcium channel blocker, an antimuscarinic and a tachykinin NK2 receptor antagonist. Otilonium has effectively reduced pain and improved defecation alterations in placebo-controlled trials in IBS patients. Pinaverium bromide is also an L-type calcium channel blocker that acts locally in the GI tract. Pinaverium improves motility disorders and consequently reduces stool problems in IBS patients. Phloroglucinol and trimethylphloroglucinol are non-specific antispasmodics that reduced pain in IBS patients in a placebo-controlled trial. Antispasmodics have excellent safety profiles. T-type calcium channel blockers can abolish visceral hypersensitivity in animal models, which makes them potential candidates for the development of novel therapeutic agents in the

  17. Irritable bowel syndrome, inflammatory bowel disease and the microbiome

    OpenAIRE

    Major, Giles; Robin C. Spiller

    2014-01-01

    Purpose of review The review aims to update the reader on current developments in our understanding of how the gut microbiota impact on inflammatory bowel disease and the irritable bowel syndrome. It will also consider current efforts to modulate the microbiota for therapeutic effect. Recent findings Gene polymorphisms associated with inflammatory bowel disease increasingly suggest that interaction with the microbiota drives pathogenesis. This may be through modulation of the immune response,...

  18. 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.

  19. State-of-the-art of irritable bowel syndrome and inflammatory bowel disease research in 2008

    Institute of Scientific and Technical Information of China (English)

    Lynne V McFarland

    2008-01-01

    Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two of the leading causes of chronic intestinal conditions in the world.This issue of World Journal of Gastroenterology (WJG) presents a series of papers from world experts who discuss the current knowledge and opinions on these important conditions.Although great strides have been made in the diagnosis,treatment and pathology of IBS and IBD;much has yet to be explained.The etiologies and risk factors of these multifactorial conditions remain elusive.Specific diagnostic biomarkers need to be developed and safer treatments developed.The burden of IBS and IBD on the healthcare system is felt with repeated medical care visits and high costs.IBS and IBD patients can account for 30%-50% of office visits at gastroenterology services/clinics.Over one million people have IBD in the United States,with 30000 new cases being diagnosed every year.One-quarter million people in the UK are afflicted with IBD.The cost of medical care in the United States for IBD is estimated to be $1.8 billion/year.

  20. 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. PMID:24627581

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

    Directory of Open Access Journals (Sweden)

    Shilan Mozaffari

    2011-01-01

    Full Text Available 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

  2. Functional findings in irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Iris Posserud; Amanda Ersryd; Magnus Simrén

    2006-01-01

    The pathophysiology of IBS is complex and still incompletely known. Both central and peripheral factors, including psychosocial factors, abnormal GI motility and secretion, and visceral hypersensitivity, are thought to contribute to the symptoms of IBS. Several studies have demonstrated altered GI motor function in IBS patients and the pattern differs between IBS subgroups based on the predominant bowel pattern. Few studies have so far addressed GI secretion in IBS, but there are some evidence supporting altered secretion in the small intestine of IBS patients. Visceral hypersensitivity is currently considered to be perhaps the most important pathophysiological factor in IBS. Importantly, several external and internal factors can modulate visceral sensitivity, as well as GI motility, and enhanced responsiveness within the GI tract to for instance stress and nutrients has been demonstrated in IBS patients. Today IBS is viewed upon as a disorder of dysregulation of the so-called brain-gut axis, involving abnormal function in the enteric, autonomic and/or central nervous systems, with peripheral alterations probably dominating in some patients and disturbed central processing of signals from the periphery in others.

  3. Depression in patients with irritable bowel syndrome in Jos,Nigeria

    Institute of Scientific and Technical Information of China (English)

    Nimzing G Ladep; Taiwo J Obindo; Moses D Audu; Edith N Okeke; Abraham O Malu

    2006-01-01

    AIM: To study the brain-gut interaction and the effect of behavioral or psychiatric conditions on irritable bowel syndrome (IBS) in an African population.METHODS: IBS was diagnosed using the Rome Ⅱ diagnostic criteria. The entry of each patient was confirmed following detailed explanations of the questions. Four hundred and eighteen patients were studied. Subjects satisfying the Rome Ⅱ criteria for IBS were physically examined and stool microscopy was done to identify the presence of "alarm factors". Depression was diagnosed using the symptom-check list adapted from the Research Diagnostic Criteria (DSM-Ⅳ) of the American Psychiatric Association.RESULTS: Seventy-five (56.8%) of the 132 IBS patients were depressed whereas only 54 (20.1%) of the 268 non-IBS patients were depressed. There was a significant relationship between IBS and depression (x2= 54.29,Odds ratio = 5.21, 56.8 ± 8.4 vs 20.1 ± 5.2, P = 0.001).Even though constipation predominant IBS patients were more likely to be depressed, no significant relationship was found between the subtype of IBS and depression (x2= 0.02, OR = 0.95, P = 0.68).CONCLUSION: IBS is significantly associated with major depression but not gender and bowel subtypes of the patients. Patients with IBS need to be evaluated for depression due to the highly significant relationship between the two conditions.

  4. 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 André 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...

  5. Long-term efficacy and safety of otilonium bromide in the management of irritable bowel syndrome: a literature review

    OpenAIRE

    Triantafillidis, John K.; Malgarinos, George

    2014-01-01

    Irritable bowel syndrome (IBS) is a very common functional gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits. The disease affects a large part of the world population. The clinical course is mostly characterized by a cyclic recurrence of symptoms. Therefore, IBS patients should receive, as an initial therapeutic approach, a short course of treatment, and long-term treatment should be reserved for those patients with recurrent symptoms. The availa...

  6. Recommendations for the management of irritable bowel syndrome in family practice

    OpenAIRE

    Paterson, W G; Thompson, W G; Vanner, S J; Faloon, T R; Rosser, W.W.; Birtwhistle, R W; Morse, J L; Touzel, T A

    1999-01-01

    To help family physicians manage patients with irritable bowel syndrome (IBS), a consensus conference was convened in June 1997 at which 5 internationally recognized experts in IBS presented position papers on selected topics previously circulated to the conference participants. Five working groups comprising family physicians, gastroenterologists and allied health care professionals from across Canada were then charged with developing recommendations for the diagnosis, patient education, psy...

  7. Association and symptom characteristics of irritable bowel syndrome among bronchial asthma patients in Kuwait

    Directory of Open Access Journals (Sweden)

    Panicker Radhakrishna

    2010-01-01

    Full Text Available Context : Excess prevalence of irritable bowel syndrome in asthma has been reported, suggesting a link between these two conditions. Aims: To investigate the association between irritable bowel syndrome (IBS and asthma, and explore the symptoms of IBS among asthma patients in Kuwait. Settings and Design: Case control study. Methods: In a tertiary center, for allergy and asthma, 138 patients aged 20-65 years, with asthma, diagnosed clinically and by spirometry,were compared with 145 healthy, non-asthmatic controls matched for age, gender and nationality. Cases and controls completed a self-administered questionnaire of irritable bowel syndrome diagnosis (ROME II criteria. Statistical Analysis Used: The data were analyzed using SPSS software, and proportions were tested with Chi-square or Fisher′s test. Odds ratio (OR with 95% Confidence Interval (CI were calculated to identify the associated risk factors. The demographic variables were selected for logistic regression analysis. Results : A significantly large proportion (39.13% of asthmatics had IBS as compared to 7.93% controls (P < 0.001. A higher proportion of females with IBS were observed in cases and controls (74%, 61.54%. IBS was seen in 87% cases using inhalers, and in 13% with additional oral theophylline (P < 0.001. As many as 66.6% cases, had IBS with relatively short duration of asthma (1-5 years, P < 000. Predominant symptoms of IBS in asthmatics were abdominal discomfort or distension (64.8% vs. 11.5%, (P < 0.000, OR = 14.1; 95%CI: 3.748-53.209, bloated feeling of abdomen (74.1% vs. 34.62% (P < 0.001, OR = 5.38; 95%CI:1.96-14.84, increased frequency of stools (63%, P < 0.006. Conclusions: Irritable bowel syndrome in asthmatics was significantly high, more in the female asthmatics. Abdominal discomfort, persistent bloated feeling, increased frequency of passing stools were the most common IBS symptoms observed.

  8. 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.

  9. A systematic review of effi cacy and tolerability of mebeverine in irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Mahnaz; Darvish-Damavandi; Shekoufeh; Nikfar; Mohammad; Abdollahi

    2010-01-01

    We evaluated the eff icacy and tolerability of mebeverine, a musculotropic antispasmodic agent, in irritable bowel syndrome (IBS) and compared its usual dosages by meta-analysis. Medical databases and all relevant literature were searched from 1965 to June 2009 for any placebo-controlled clinical trials of mebeverine, using search terms such as mebeverine, clinical trials, and IBS. Eight randomized trials met our criteria, including six trials that compared mebeverine with placebo and two that compared mebe...

  10. Development and Validation of a Biomarker for Diarrhea-Predominant Irritable Bowel Syndrome in Human Subjects

    OpenAIRE

    Mark Pimentel; Walter Morales; Ali Rezaie; Emily Marsh; Anthony Lembo; James Mirocha; Leffler, Daniel A.; Zachary Marsh; Stacy Weitsman; Kathleen S Chua; Gillian M Barlow; Enoch Bortey; William Forbes; Allen Yu; Christopher Chang

    2015-01-01

    Diarrhea-predominant irritable bowel syndrome (IBS) is diagnosed through clinical criteria after excluding "organic" conditions, and can be precipitated by acute gastroenteritis. Cytolethal distending toxin B (CdtB) is produced by bacteria that cause acute gastroenteritis, and a post-infectious animal model demonstrates that host antibodies to CdtB cross-react with vinculin in the host gut, producing an IBS-like phenotype. Therefore, we assessed circulating anti-CdtB and anti-vinculin antibod...

  11. Aspects of the non-pharmacological treatment of irritable bowel syndrome

    OpenAIRE

    Eriksson, Elsa Maria; Andrén, Kristina Ingrid; Kurlberg, Göran Karl; Eriksson, Henry Ture

    2015-01-01

    Irritable bowel syndrome (IBS) is one of the most commonly diagnosed gastrointestinal conditions. It represents a significant healthcare burden and remains a clinical challenge. Over the years IBS has been described from a variety of different perspectives; from a strict illness of the gastrointestinal tract (medical model) to a more complex multi-symptomatic disorder of the brain-gut axis (biopsychosocial/psychosomatic model). In this article we present aspects of the pathophysiology and the...

  12. Is the association between irritable bowel syndrome and abuse explained by neuroticism? A population based study

    OpenAIRE

    TALLEY, N.; BOYCE, P; Jones, M.

    1998-01-01

    Background—In outpatients and the community, an association between abuse (particularly sexual abuse) and irritable bowel syndrome (IBS) has been observed, but whether there is a causal link continues to be disputed. 
Aims—To test the hypothesis that psychological factors explain the apparent association between abuse and IBS. 
Methods—A sample of residents of Penrith (a Sydney suburb sociodemographically similar to the Australian population) selected randomly from the elect...

  13. Efficacy of Solifenacin on Irritable Bowel Syndrome With Diarrhea: Open-label Prospective Pilot Trial

    OpenAIRE

    Fukushima, Yasushi; SuzukI, Hidekazu; Matsuzaki, Juntaro; Kiyosue, Arihiro; Hibi, Toshifumi

    2012-01-01

    Background/Aims Solifenacin, a muscarinic type 3 receptor antagonist, is used to treat overactive bladder in adults. The aim of this study is to examine the efficacy of solifenacin on the symptomatic relief of diarrhea predominant irritable bowel syndrome (IBS-D). Methods A total of 20 patients with IBS-D were enrolled. After a 2-week observation period, all participants received solifenacin for 6 weeks. Subsequently, the administration of solifenacin was discontinued and ramosetron, a seroto...

  14. A single-blind trial of reflexology for irritable bowel syndrome.

    OpenAIRE

    Tovey, Philip

    2002-01-01

    BACKGROUND: Irritable bowel syndrome (IBS) is a significant problem for primary care, as treatment options are limited and it can frequently develop into a chronic condition. Complementary and alternative medicine, including reflexology, is being turned to increasingly in an attempt to manage symptoms. There are currently no studies which address the effectiveness of reflexology for IBS. Despite this, it continues to be advocated and used. AIM: To provide the first evidence on the effectivene...

  15. Effects of dietary guidance on the symptoms, quality of life and habitual dietary intake of patients with irritable bowel syndrome

    OpenAIRE

    MAZZAWI, TAREK; Hausken, Trygve; Gundersen, Doris Irene; El-Salhy, Magdy

    2013-01-01

    Diet is important in triggering the symptoms of irritable bowel syndrome (IBS). This study investigated the impact of dietary guidance on the symptoms, quality of life and habitual diet of patients with IBS. Forty‑six patients who fulfilled the Rome III criteria for the diagnosis of IBS were included. Of these patients, 17 completed the entire study. Each patient attended three sessions (~45 min in duration) and received individual guidance on their dietary management. The patients were asked...

  16. Diet and effects of diet management on symptoms and quality of life in patients with irritable bowel syndrome

    OpenAIRE

    Østgaard, Hege

    2011-01-01

    Background: Irritable bowel syndrome (IBS) is a gastrointestinal disorder manifested by abdominal discomfort or pain, bloating and abdominal distension, and changes in the defecation pattern between diarrhoea and constipation. A significant proportion of IBS patients attribute their symptoms to food items and food intolerance. More information is needed on the effect of diet management in the treatment of IBS and this thesis is a contribution with effort to adva...

  17. Brain regions involved in moxibustion-induced analgesia in irritable bowel syndrome with diarrhea: a functional magnetic resonance imaging study

    OpenAIRE

    Zhu, Yi; Wu, Zhiyuan; Ma, Xiaopeng; Liu, Huirong; Bao, Chunhui; YANG, LING; Cui, Yunhua; Zhou, Cili; Wang, Xiaomei; Wang, Yuemin; Zhang, Zhongwei; Zhang, Huan; Jia, Haipeng; Wu, Huangan

    2014-01-01

    Background Moxibustion is one of the most commonly used therapies in acupuncture practice, and is demonstrated to be beneficial for patients with diarrhea from irritable bowel syndrome (D-IBS). But its mechanism remains unclear. Because visceral hypersensitivity in IBS patients has been documented by evaluation of perceived stimulations through functional magnetic resonance imaging (fMRI) studies, we focused on observing brain imaging changes in D-IBS patients during rectal balloon distention...

  18. Gastrointestinal Endometriosis Causing Subacute Intestinal Obstruction with Gradual Development of Weight Loss and Misdiagnosed as Irritable Bowel Syndrome

    OpenAIRE

    Soumekh, Amir; Nagler, Jerry

    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...

  19. Changes in small intestinal chromogranin A-immunoreactive cell densities in patients with irritable bowel syndrome after receiving dietary guidance

    OpenAIRE

    Mazzawi, Tarek; El-Salhy, Magdy

    2016-01-01

    Chromogranin A (CgA) is a common marker for enteroendocrine cells in the gut, and CgA-immunoreactive cell densities are abnormal in patients with irritable bowel syndrome (IBS). The majority of patients with IBS report that their symptoms develop after consuming certain foodstuffs. In the present study, we investigated the effects of dietary guidance on the total enteroendocrine cell densities in the small intestine, as detected by CgA. A total of 14 patients with IBS underwent a gastroscopy ...

  20. 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, Andre 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 Co

  1. Food: The Main Course to Wellness and Illness in Patients With Irritable Bowel Syndrome.

    Science.gov (United States)

    Chey, William D

    2016-03-01

    Food sits at the intersection between gastrointestinal (GI) physiology and symptoms in patients with the irritable bowel syndrome (IBS). It is now clear that the majority of IBS sufferers associate eating a meal with their GI and non-GI symptoms. This is hardly surprising when one considers that food can affect a variety of physiologic factors (motility, visceral sensation, brain-gut interactions, microbiome, permeability, immune activation, and neuro-endocrine function) relevant to the pathogenesis of IBS. In recent years, clinical research has increasingly focused on diet as a treatment for IBS. There is a relative paucity of data from rigorous, randomized, controlled trials for any dietary intervention in IBS patients. Currently, the largest body of literature has addressed the efficacy of dietary restriction of fermentable oligo, di, monosaccharides, and polyols (FODMAPs). In the future, dietary treatments for IBS will move beyond the current focus on elimination to embrace supplementation with "functional" foods. PMID:26856749

  2. Irritable bowel syndrome and chronic pelvic pain: A singular or two different clinical syndrome?

    Institute of Scientific and Technical Information of China (English)

    Anna Matheis; Ute Martens; Johannes Kruse; Paul Enck

    2007-01-01

    Irritable bowel syndrome (IBS) and chronic pelvic pain (CPP) are both somatoform disorders with a high prevalence within the population in general. The objective was to compare both entities, to find the differences and the similarities related to epidemiology and psychosocial aspects like stressful life events, physical and sexual abuse, illness behaviour and comorbidity. The technical literature was reviewed systematically from 1971 to 2006 and compared. According to literature, IBS and CPP seem to be one rather than two different entities with the same localisation of pain. Both syndromes also are similar concerning prevalence, the coexistence of mental and somatoform disorders, the common history of sexual and physical abuse in the past and their health care utilization. It could be shown that there were many similarities between IBS and CPR Nevertheless both are traded as different clinical pictures as far. Therefore it seems to be reasonable and necessary to generate a common diagnosis algorithm and to bring gynaecologists and gastroenterologists into dialogue.

  3. 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.

  4. 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. PMID:25157984

  5. Methylglyoxal induces systemic symptoms of irritable bowel syndrome.

    Directory of Open Access Journals (Sweden)

    Shuang Zhang

    Full Text Available Patients with irritable bowel syndrome (IBS show a wide range of symptoms including diarrhea, abdominal pain, changes in bowel habits, nausea, vomiting, headache, anxiety, depression and cognitive impairment. Methylglyoxal has been proved to be a potential toxic metabolite produced by intestinal bacteria. The present study was aimed at investigating the correlation between methylglyoxal and irritable bowel syndrome. Rats were treated with an enema infusion of methylglyoxal. Fecal water content, visceral sensitivity, behavioral tests and serum 5-hydroxytryptamine (5-HT were assessed after methylglyoxal exposure. Our data showed that fecal water content was significantly higher than controls after methylglyoxal exposure except that of 30 mM group. Threshold volumes on balloon distension decreased in the treatment groups. All exposed rats showed obvious head scratching and grooming behavior and a decrease in sucrose preference. The serum 5-HT values were increased in 30, 60, 90 mM groups and decreased in 150 mM group. Our findings suggested that methylglyoxal could induce diarrhea, visceral hypersensitivity, headache as well as depression-like behaviors in rats, and might be the key role in triggering systemic symptoms of IBS.

  6. Lactose malabsorption and lactose intolerance in adults - a cause of irritable bowel syndrome?

    OpenAIRE

    Nilsson, Åke

    2001-01-01

    Gastroenterologists and general practitioners see many patients that have abdominal symptoms which are not explained when the patients are investigated for celiac disease, inflammatory bowel disease, peptic ulcer or tumours. The diagnosis is irritable bowel syndrome (IBS). Many of these patients report intolerance to certain foods including milk, and some develop symptoms after ingestion of lactose during the lactose tolerance test. In Northern European populations, lactose malabsorption is, ...

  7. The role of experimental models in developing new treatments for irritable bowel syndrome

    OpenAIRE

    Holschneider, Daniel P.; Bradesi, Sylvie; Mayer, Emeran A.

    2011-01-01

    Irritable bowel syndrome (IBS) is characterized by chronic, recurrent abdominal pain and altered bowel habits and is currently defined by symptom criteria and the absence of detectable organic disease. The underlying pathophysiology remains incompletely understood. Despite considerable efforts by the scientific community and the pharmaceutical industry to develop novel pharmacological treatments aimed at chronic visceral pain, the traditional approach to identifying and evaluating novel drugs...

  8. 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.

    2015-01-01

    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

  9. Maladjustment to Academic Life and Employment Anxiety in University Students with Irritable Bowel Syndrome.

    Directory of Open Access Journals (Sweden)

    Jun Tayama

    Full Text Available The present study tested our hypothesis that university students with irritable bowel syndrome (IBS may experience less satisfactory academic lives than those of students without IBS. We also verified the hypothesis that university students with IBS might have higher employment anxiety than students without IBS might. We conducted a cross-sectional study of 1,686 university students. Presence or absence of IBS was assessed via the Rome III Questionnaire. Two original items were used to evaluate academic life. The prevalence rates of IBS with diarrhea, IBS with constipation, mixed IBS, and unsubtyped IBS in the study population were 5%, 2%, 10%, and 3%, respectively. Regarding academic life, the proportions of participants who experienced maladjustment and employment anxiety were 29% and 50%, respectively. After adjusting for age, sex, and faculty, the odds ratios for maladjustment and employment anxiety were significantly higher in students who screened positively, relative to those who screened negatively, for IBS (OR, 1.62; 95% CI, 1.24-2.21; OR, 2.16; 95% CI, 1.68-2.81, respectively. In conclusion, maladjustment and anxiety over future employment were higher in university students with IBS relative to those without.

  10. Maladjustment to Academic Life and Employment Anxiety in University Students with Irritable Bowel Syndrome.

    Science.gov (United States)

    Tayama, Jun; Nakaya, Naoki; Hamaguchi, Toyohiro; Saigo, Tatsuo; Takeoka, Atsushi; Sone, Toshimasa; Fukudo, Shin; Shirabe, Susumu

    2015-01-01

    The present study tested our hypothesis that university students with irritable bowel syndrome (IBS) may experience less satisfactory academic lives than those of students without IBS. We also verified the hypothesis that university students with IBS might have higher employment anxiety than students without IBS might. We conducted a cross-sectional study of 1,686 university students. Presence or absence of IBS was assessed via the Rome III Questionnaire. Two original items were used to evaluate academic life. The prevalence rates of IBS with diarrhea, IBS with constipation, mixed IBS, and unsubtyped IBS in the study population were 5%, 2%, 10%, and 3%, respectively. Regarding academic life, the proportions of participants who experienced maladjustment and employment anxiety were 29% and 50%, respectively. After adjusting for age, sex, and faculty, the odds ratios for maladjustment and employment anxiety were significantly higher in students who screened positively, relative to those who screened negatively, for IBS (OR, 1.62; 95% CI, 1.24-2.21; OR, 2.16; 95% CI, 1.68-2.81, respectively). In conclusion, maladjustment and anxiety over future employment were higher in university students with IBS relative to those without. PMID:26083662

  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. Association of Psychological Disorders with Extra-intestinal Symptoms in Patients with Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Leila Mirbagher

    2015-03-01

    Full Text Available Background: Extraintestinal symptoms are common in patients with irritable bowel syndrome (IBS. In the present study, we determined the relationship between psychological disorders and extraintestinal symptoms in patients with IBS. Methods: Adult patients with IBS referred to 4 gastroenterology clinics in Isfahan, Iran, completed the irritable bowel severity scoring system, extraintestinal symptoms scale, Hospital Anxiety and Depression Scale, and Irritable Bowel Syndrome Quality of Life (IBS-QOL Questionnaire. Univariate and multivariate analyses were conducted. Results: The patients included 113 females and 45 males with mean age of 34.8 ± 11.1 years. Cumulative frequency of extraintestinal symptoms was 3.3 ± 2.4 (0 to 10. Anxiety and depression were present in 79.7% and 54.4% of the patients, respectively. Frequency of extraintestinal symptoms was correlated with anxiety and depression (r = 0.289 to 0.531, IBS severity (r = 0.373 to 0.505, and quality of life (r = -0.317 to -0.398. Severity of IBS was independently associated with extraintestinal digestive symptoms’ frequency (β = 0.248. Female gender, education level, and anxiety were independently associated with extraintestinal non-digestive symptoms’ frequency (β = -0.225 to 0.260. Severity of IBS and frequency of non-digestive symptoms were independent predictors of quality of life (β = -0.494 and -0.218. After controlling for psychological factors, IBS severity and depression were independent predictors of quality of life (β = -0.435 and -0.318. Conclusion: Extraintestinal symptoms and psychological disorders are common in patients with IBS and impact their quality of life. Psychological disorders are associated with extraintestinal symptoms, especially non-digestive symptoms. These results highlight the need for an integrated biopsychosocial approach to the management of IBS patients with physical and mental comorbidities.

  13. The Self-Rating Scale of Illness Conception and Health Seeking Behavior (ICHSB) Traits in Patients with Irritable Bowel Syndrome(IBS)%肠易激综合征患者的疾病观念与求医行为特征调查

    Institute of Scientific and Technical Information of China (English)

    刘小彦; 王嫱; 王敏; 李培凯; 苏萍; 杨建中

    2012-01-01

    目的 调查肠易激综合征患者疾病观念与求医行为特征对发病的影响.方法 2010年4月至2011年4月对云南省第二人民医院消化科门诊的126名肠易激综合征患者和126名健康人群进行"疾病观念与求医行为问卷"调查.结果 肠易激综合征患者存在一定的疾病观念与求医行为障碍:男性倾向于采取积极的求医行为(F=4.463,P=0.037);患者腹部症状与因子Ⅱ成年时期对疾病与健康的观念、态度上呈正相关(R=0.178,P<0.05).结论 肠易激综合征患者在求医行为方面采取积极求医的态度,可能对发病有一定的影响.%Objective To investigate the self-rating scale of illness conception and health seeking behavior traits in patients with Irritable Bowel Syndrome. Methods 126 patients with Irritable Bowel Syndrome were assessed by self-rating scale of illness conception and health seeking behavior at outpatient service of Gastroenterology Department in the Second People's Hospital of Yunnan Province during the year of 2010-2011. Results The patients with irritable bowel syndrome had certain disorders in health seeking behavior and the male patients were more serious than women in health seeking behavior. The symptoms of IBS patients were positively correlated to the severity in ICHSB (R =0.178; P <0.05). Conclusion The patients with irritable bowel syndrome have positive health seeking behavior , the social psychological factors have certain effect on the disease.

  14. Gut microbiota influences low fermentable substrate diet efficacy in children with irritable bowel syndrome

    Science.gov (United States)

    We sought to determine whether a low fermentable substrate diet (LFSD) decreases abdominal pain frequency in children with irritable bowel syndrome (IBS) and to identify potential microbial factors related to diet efficacy. Pain symptoms, stooling characteristics, breath hydrogen and methane, whole ...

  15. Serotonin transporter gene polymorphisms in irritable bowel syndrome and their impact on tegaserod treatment

    Institute of Scientific and Technical Information of China (English)

    李瑜元

    2006-01-01

    Objective To investigate the serotonin reuptake transporter (SERT) genetic polymorphisms in the 5 -hydroxytryptamine (5-HT) transporter gene-linked polymorphic region (5-HTTLPR) and the variable number tandem repeats (VNTRs) in intron 2 among Chinese people, and their relationship to the pathogenesis of irritable bowel syndrome (IBS);and to investigate the im-

  16. Gastrointestinal pH profile in subjects with irritable bowel syndrome

    OpenAIRE

    Lalezari, David

    2012-01-01

    Aim To investigate the small bowel pH profile and small intestine transit time (SITT) in healthy controls and patients with irritable bowel syndrome (IBS). Methods 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...

  17. Comparing administrative and survey data for ascertaining cases of irritable bowel syndrome: a population-based investigation

    Directory of Open Access Journals (Sweden)

    Targownick Laura E

    2010-02-01

    Full Text Available Abstract Background Administrative and survey data are two key data sources for population-based research about chronic disease. The objectives of this methodological paper are to: (1 estimate agreement between the two data sources for irritable bowel syndrome (IBS and compare the results to those for inflammatory bowel disease (IBD; (2 compare the frequency of IBS-related diagnoses in administrative data for survey respondents with and without self-reported IBS, and (3 estimate IBS prevalence from both sources. Methods This retrospective cohort study used linked administrative and health survey data for 5,134 adults from the province of Manitoba, Canada. Diagnoses in hospital and physician administrative data were investigated for respondents with self-reported IBS, IBD, and no bowel disorder. Agreement between survey and administrative data was estimated using the κ statistic. The χ2 statistic tested the association between the frequency of IBS-related diagnoses and self-reported IBS. Crude, sex-specific, and age-specific IBS prevalence estimates were calculated from both sources. Results Overall, 3.0% of the cohort had self-reported IBS, 0.8% had self-reported IBD, and 95.3% reported no bowel disorder. Agreement was poor to fair for IBS and substantially higher for IBD. The most frequent IBS-related diagnoses among the cohort were anxiety disorders (34.4%, symptoms of the abdomen and pelvis (26.9%, and diverticulitis of the intestine (10.6%. Crude IBS prevalence estimates from both sources were lower than those reported previously. Conclusions Poor agreement between administrative and survey data for IBS may account for differences in the results of health services and outcomes research using these sources. Further research is needed to identify the optimal method(s to ascertain IBS cases in both data sources.

  18. Sodium channel mutation in irritable bowel syndrome: evidence for an ion channelopathy

    OpenAIRE

    Saito, Yuri A; Strege, Peter R.; Tester, David J.; Locke, G. Richard; Talley, Nicholas J; Bernard, Cheryl E.; Rae, James L.; Makielski, Jonathan C.; Ackerman, Michael J.; Farrugia, Gianrico

    2008-01-01

    The SCN5A-encoded Nav1.5 Na+ channel is expressed in interstitial cells of Cajal and smooth muscle in the circular layer of the human intestine. Patients with mutations in SCN5A are more likely to report gastrointestinal symptoms, especially abdominal pain. Twin and family studies of irritable bowel syndrome (IBS) suggest a genetic basis for IBS, but no genes have been identified to date. Therefore, our aims were to evaluate SCN5A as a candidate gene involved in the pathogenesis of IBS and to...

  19. Small intestinal bacterial overgrowth and lactose intolerance contribute to irritable bowel syndrome symptomatology in Pakistan

    Directory of Open Access Journals (Sweden)

    Javed Yakoob

    2011-01-01

    Full Text Available Background /Aim: The symptoms of irritable bowel syndrome resemble those of small intestinal bacterial overgrowth (SIBO. The aim of this study was to determine the frequency of SIBO and lactose intolerance (LI occurrence in patients with diarrhea-predominant irritable bowel syndrome (IBS-D according to Rome III criteria. Patients and Methods: In this retrospective case-control study, patients over 18 years of age with altered bowel habit, bloating, and patients who had lactose Hydrogen breath test (H 2 BT done were included. The "cases" were defined as patients who fulfill Rome III criteria for IBS-D, while "controls" were those having chronic nonspecific diarrhea (CNSD who did not fulfill Rome III criteria for IBS-D. Demographic data, predominant bowel habit pattern, concurrent use of medications, etc., were noted. Results: Patients with IBS-D were 119 (51% with a mean age of 35 ± 13 years, while those with CNSD were 115 (49% with mean age 36 ± 15 years. Patients in both IBS-D and CNSD were comparable in gender, with male 87 (74% and female 77 (64%. SIBO was documented by lactose H 2 BT in 32/234 (14% cases. It was positive in 22/119 (19% cases with IBS-D, while 10/115 (9% cases had CNSD (P = 0.03. LI was positive in 43/234 (18% cases. Of these, 25/119 (21% cases had IBS-D and 18/115 (16% cases had CNSD (P = 0.29. Conclusion: SIBO was seen in a significant number of our patients with IBS-D. There was no significant age or gender difference in patients with or without SIBO.

  20. Rome Ⅲ survey of irritable bowel syndrome among ethnic Malays

    Institute of Scientific and Technical Information of China (English)

    Yeong Yeh Lee; Anuar Waid; Huck Joo Tan; Andrew Seng Boon Chua; William E Whitehead

    2012-01-01

    AIM:To survey irritable bowel syndrome (IBS) using Rome Ⅲ criteria among Malays from the north-eastern region of Peninsular Malaysia.METHODS:A previously validated Malay language Rome Ⅲ IBS diagnostic questionnaire was used in the current study.A prospective sample of 232 Malay subjects (80% power) was initially screened.Using a stratified random sampling strategy,a total of 221 Malay subjects (112 subjects in a "full time job" and 109subjects in "no full time job") were recruited.Subjects were visitors (friends and relatives) within the hospital compound and were representative of the local community.Red flags and psychosocial alarm symptoms were also assessed in the current study using previously translated and validated questionnaires.Subjects with IBS were sub-typed into constipation-predominant,diarrhea-predominant,mixed type and un-subtyped.Univariable and multivariable analyses were used to test for association between socioeconomic factors and presence of red flags and psychosocial alarm features among the Malays with IBS.RESULTS:IBS was present in 10.9% (24/221),red flags in 22.2% (49/221) and psychosocial alarm features in 9.0% (20/221).Red flags were more commonly reported in subjects with IBS (83.3%) than psychosocial alarm features (20.8%,P < 0.001).Subjects with IBS were older (mean age 41.4 years vs 36.9 years,P =0.08),but no difference in gender was noted (P =0.4).Using univariable analysis,IBS was significantly associated with a tertiary education,high individual income above RM1000,married status,exsmoker and the presence of red flags (all P < 0.05).In multiple logistic regression analysis,only the presence of red flags was significantly associated with IBS (odds ratio:0.02,95%CI:0.004-0.1,P < 0.001).The commonest IBS sub-type was mixed type (58.3%),followed by constipation-predominant (20.8%),diarrheapredominant (16.7%) and un-subtyped (4.2%).Four of 13 Malay females (30.8%) with IBS also had menstrual pain

  1. Fecal calprotectin: a marker for clinical differentiation of microscopic colitis and irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    von Arnim U

    2016-04-01

    Full Text Available Ulrike von Arnim, Thomas Wex, Christine Ganzert, Christian Schulz, Peter Malfertheiner Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany Background: The aim of this study is to compare two methods for measuring fecal calprotectin (FC concentration and to evaluate the possibility of differentiation between microscopic colitis (MC and irritable bowel syndrome (IBS. Methods: Twenty-three patients with MC (six patients with active disease and 17 patients retested in remission and 20 patients with IBS were prospectively included in this study. Active disease state of MC was determined by clinical symptoms of >3 bowel movements per day and histological correlate. All patients underwent ileocolonoscopy, including segmental biopsy samples for histology. FC levels in stool samples were analyzed using a rapid test system (Quantum Blue® and an enzyme-linked immunosorbent assay (ELISA. Results: FC levels were significantly higher in patients with active MC (median 48 µg/g [23–106] compared to patients with IBS (median 2 µg/g [1–111.83], P=0.0001 using an ELISA. FC level of patients with MC in remission was 22 µg/g (1–106.4, which is similar to those identified in patients with IBS. The difference of FC levels between active MC and IBS was not detected by the FC rapid test (P=0.635. Discussion: FC levels might serve as parameter for differentiation between patients with active MC and IBS. Since there is no surrogate marker available at present for MC, FC appears to be a candidate for differentiating MC from IBS. Conclusion: High FC levels, which were analyzed by ELISA, are a potential marker for patients with active MC compared to those with IBS. The FC rapid test was less suitable for this purpose. Keywords: microscopic colitis, fecal calprotectin, irritable bowel syndrome, IBS, diarrhea, chronic diarrhea

  2. Health-related quality of life of irritable bowel syndrome patients in different cultural settings

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    Johansson Saga

    2006-03-01

    Full Text Available Abstract Background Persons with Irritable bowel syndrome (IBS are seriously affected in their everyday life. The effect across different cultural settings of IBS on their quality of life has been little studied. The aim was to compare health-related quality of life (HRQOL of individuals suffering from IBS in two different cultural settings; Crete, Greece and Linköping, Sweden. Methods This study is a sex and age-matched case-control study, with n = 30 Cretan IBS cases and n = 90 Swedish IBS cases and a Swedish control group (n = 300 randomly selected from the general population. Health-related quality of life, measured by SF-36 and demographics, life style indicators and co-morbidity, was measured. Results Cretan IBS cases reported lower HRQOL on most dimensions of SF-36 in comparison to the Swedish IBS cases. Significant differences were found for the dimensions mental health (p Conclusion The results from this study tentatively support that the claim that similar individuals having the same disease, e.g. IBS, but living in different cultural environments could perceive their disease differently and that the disease might affect their everyday life and quality of life in a different way. The Cretan population, and especially women, are more seriously affected mentally by their disease than Swedish IBS cases. Coping with IBS in everyday life might be more problematic in the Cretan environment than in the Swedish setting.

  3. The relation of Cx43 and NMDA to visceral sensitization in rats with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Jing-yu ZHANG

    2016-01-01

    Full Text Available Objective  To study the relationship between connexin 43 (Cx43 and N-methyl-D-aspartate (NMDA receptors and visceral sensitization in the rats with irritable bowel syndrome (IBS. Methods  Thirty rats were gavaged with Triehinella spiralis to reproduce the IBS model. These rats were randomly divided into IBS group, IBS+colon distension group, and IBS+STI-571+colon distension group, and other groups of normal rats were randomized into normal group and normal+colon distension group, with 10 rats in each group. Immunofluorescent double staining were used to observe the expressions of intestine Cx43 and sacral NMDA re ceptors of rats in all the groups. Results  The Cx43 and sacral NMDA expressions in the normal group, normal+colon distension group and IBS group showed no significant changes (P>0.05, however, Cx43 and sacral NMDA expressions were significantly higher in IBS rats with colon distension as compared with those in normal group, normal+colon distension group, and IBS group (P<0.05, while they were significantly lower in the IBS+STI-571+colon distension group after STI-571 intervention (P<0.05. Conclusion  Cx43 and sacral NMDA may be the most important factor of visceral sensitization in IBS rats. DOI: 10.11855/j.issn.0577-7402.2015.12.02

  4. Evaluation of latent links between irritable bowel syndrome and sleep quality

    Institute of Scientific and Technical Information of China (English)

    Massimo Bellini; Remo Bedini; Nicola de Bortoli; Santino Marchi; Angelo Gemignani; Dario Gambaccini; Simona Toti; Danilo Menicucci; Cristina Stasi; Francesco Costa; Maria Gloria Mumolo; Angelo Ricchiuti

    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) were

  5. Questioning the bacterial overgrowth hypothesis of irritable bowel syndrome: an epidemiologic and evolutionary perspective.

    Science.gov (United States)

    Spiegel, Brennan M R

    2011-06-01

    Although studies indicate that small intestinal bacterial overgrowth (SIBO) is prevalent in irritable bowel syndrome (IBS), it remains unclear whether SIBO causes IBS. This review presents an epidemiologic and evolutionary inquiry that questions the bacterial overgrowth hypothesis of IBS, as follows. (1) Although the hypothesis may be biologically plausible, there is also a strong rationale for competing hypotheses; it is unlikely that SIBO is the predominant cause of IBS in all comers, because competing explanations are sensible and defensible. Moreover, data indicate that the test used to promulgate the SIBO hypothesis - the lactulose hydrogen breath test - may not have measured SIBO in the first place. (2) We do not have evidence of SIBO being absent before IBS symptoms, and present after IBS emerges. (3) There is not a dose-response relationship between small intestinal microbiota and IBS symptoms. (4) The relationship between SIBO and IBS is highly inconsistent among studies. (5) Many effective IBS therapies do not address SIBO at all, yet have a more favorable "number needed to treat" than antibiotics. (6) IBS does not behave like a traditional infectious disease, suggesting that microbes may not principally cause the syndrome. (7) Other factors may confound the relationship between SIBO and IBS, including proton pump inhibitors. (8) Whereas the brain-gut hypothesis is evolutionary sensible, the bacterial hypothesis is harder to defend from an evolutionary perspective. The article concludes that bacteria may contribute to some IBS symptoms, but that bacteria cannot be the only explanation, and a causal link between SIBO and IBS is not secure. PMID:21397724

  6. 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.

  7. 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. PMID:26523103

  8. Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome.

    Science.gov (United States)

    Ringel, Yehuda; Maharshak, Nitsan

    2013-10-15

    The pathophysiology of irritable bowel syndrome (IBS) is believed to involve alterations in the brain-gut axis; however, the etiological triggers and mechanisms by which these changes lead to symptoms of IBS remain poorly understood. Although IBS is often considered a condition without an identified "organic" etiology, emerging evidence suggests that alterations in the gastrointestinal microbiota and altered immune function may play a role in the pathogenesis of the disorder. These recent data suggest a plausible model in which changes in the intestinal microbiota and activation of the enteric immune system may impinge upon the brain-gut axis, causing the alterations in gastrointestinal function and the clinical symptoms observed in patients with IBS. This review summarizes the current evidence for altered intestinal microbiota and immune function in IBS. It discusses the potential etiological role of these factors, suggests an updated conceptual model for the pathogenesis of the disorder, and identifies areas for future research. PMID:23886861

  9. Rare Variants of the Serotonin Transporter Are Associated With Psychiatric Comorbidity in Irritable Bowel Syndrome.

    Science.gov (United States)

    Kohen, Ruth; Tracy, Julia H; Haugen, Eric; Cain, Kevin C; Jarrett, Monica E; Heitkemper, Margaret M

    2016-07-01

    Alterations in serotonin signaling are suspected in the pathophysiology of irritable bowel syndrome (IBS). By modulating the extracellular reuptake of serotonin, the serotonin transporter (SERT) acts as a key regulator of the bioavailability of serotonin. This study is the first to investigate the impact of rare SERT variants (i.e., those with a minor allele frequency of gastrointestinal (GI) symptom level, response to cognitive-behavioral treatment, and psychiatric comorbidity. We sequenced a 0.19 megabase chromosomal stretch containing the SERT gene and surrounding regions in a community sample of 304 IBS patients and 83 controls. We found no significant associations between rare variants in and around the SERT gene and IBS risk, GI symptom profile, or response to treatment. We found preliminary evidence, however, that IBS subjects with a history of either depression or anxiety were significantly more likely to carry multiple rare likely functional variant alleles than IBS patients without psychiatric comorbidity. PMID:26912503

  10. Complementary and alternative medicine modalities for the treatment of irritable bowel syndrome: facts or myths?

    Science.gov (United States)

    Wu, Justin C Y

    2010-11-01

    Due to unsatisfactory results from conventional treatment of irritable bowel syndrome (IBS), complementary and alternative medicine (CAM) modalities are increasingly popular treatment alternatives. Unfortunately, most CAM clinical trials have been of poor quality, and the efficacies of these therapies have not been adequately elucidated, even through systematic reviews or meta-analyses. There is also a general lack of understanding of their mechanisms of action. Currently, insufficient evidence exists to support the use of traditional Chinese medicine, acupuncture, meditation, and reflexology for treatment of IBS. However, there is some evidence supporting the use of peppermint oil and gut-directed hypnotherapy for IBS treatment. Due to mounting evidence of the microbiologic and immunologic basis of IBS, probiotics and exclusion diets are also becoming promising treatment modalities. This paper will review the current literature on various CAM practices for IBS treatment and appraise their advantages and disadvantages in clinical practice.

  11. Spectrum of short bowel syndrome in adults

    DEFF Research Database (Denmark)

    Jeppesen, Palle B

    2014-01-01

    Short bowel syndrome (SBS) refers to the malabsorptive state caused by physical or functional loss of portions of the small intestine, most commonly following extensive intestinal resection. Such resections hinder absorption of adequate amounts of macronutrients, micronutrients, electrolytes, and...

  12. Irritable bowel syndrome subtypes differ in body awareness, psychological symptoms and biochemical stress markers

    Institute of Scientific and Technical Information of China (English)

    Elsa M Eriksson; Kristina I Andrén; Henry T Eriksson; Gōran K Kurlberg

    2008-01-01

    AIM:To elucidate the differences in somatic,psycho-logical and biochemical pattern between the subtypes of irritable bowel syndrome(IBS).METHODS:Eighty IBS patients,30 diarrhoea pre-dominant(D-IBS),16 constipation predominant(C-IBS)and 34 alternating IBS(A-IBS)underwent physi-otherapeutic examinations for dysfunctions in body movements and awareness and were compared to an apparently healthy control group(AHC).All groups answered questionnaires for gastrointestinal and psycho-logical symptoms.Biochemical variables were analysed in blood.RESULTS:The D-IBS group showed less body awareness,less psychological symptoms,a more normal sense of coherence and psychosocial rating as well as higher C-peptide values.C-IBS had a higher degree of body dysfunction and psychological symptoms,as well as the lowest sense of coherence compared to controls and D-IBS.They also demonstrated the most elevated prolactin levels.A-IBS had the lowest degree of body disturbance,deteriorated quality of life and affected biochemical pattern.All subtypes had higher pain scores compared to controls.In addition they all had significantly increased triglycerides and elevated morning cortisol levels,however,without statistical significance compared with the controls.CONCLUSION:IBS subtypes showed different profiles in body awareness,somatic and psychological symptoms and in biochemicaI variables.D-IBS differed compared to the other groups by Iowered body awareness,less psychological symptoms and a higher sense of coherence and elevated C-Deptide values.C-IBS and A-IBS subtypes suffered more from depression and anxiety,associated with a lower quality of life.These differences may be important and will be taken into account in our treatment of these patients.

  13. Short Bowel Syndrome: A Case Report

    OpenAIRE

    Celayir, Sinan; Sarımurat, Nüvit; Ilıkkan, Barbaros; ERAY, Nur; Yeşildağ, Ebru; Yeker, Daver

    1996-01-01

    Necrotizing enterocolitis atresia volvulus gastroschisis are the most common causes of short bowel syndrome in the pediatric population Although the prognosis for patients with short bowel syndrome improved since the advent of parenteral nutrition the cost of long term total parenteral nutrition and attendant morbidity and mortality cannot be ignored in these patients Long term follow up of a case with short small intestine of 25 cm length following surgery is presented and the problems assoc...

  14. 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....

  15. The Relationship between Small-Intestinal Bacterial Overgrowth and Intestinal Permeability in Patients with Irritable Bowel Syndrome

    OpenAIRE

    Park, Jung Ho; Park, Dong Il; Kim, Hong Joo; Cho, Yong Kyun; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik; Won, Kyoung Hee; Park, Soon Min

    2009-01-01

    Background/Aims Small-intestinal bacterial overgrowth (SIBO) is a frequent finding in patients with irritable bowel syndrome (IBS). Many patients with IBS also have abnormal intestinal permeability, which is probably due to low-grade inflammation in the intestinal mucosa. Our aim was to verify the relationship between SIBO and small-intestinal permeability in IBS patients. Methods A cohort of 38 IBS patients (20 women and 18 men; age range 16-70 years; mean age 40.2 years) with symptoms that ...

  16. Natural History of Irritable Bowel Syndrome in Women and Dysmenorrhea: A 10-Year Follow-Up Study

    OpenAIRE

    Linda Bjork Olafsdottir; Hallgrimur Gudjonsson; Heidur Hrund Jonsdottir; Einar Björnsson; Bjarni Thjodleifsson

    2012-01-01

    Background. Studies have shown that women are more likely to have irritable bowel syndrome (IBS) and more women seek healthcare because of IBS than men. Aim. We wanted to examine the natural history of IBS and dysmenorrhea in women over a 10-year period and to assess the change in IBS after menopause. Method. A population-based postal study. A questionnaire was mailed to the same age- and gender-stratified random sample of the Icelandic population aged 18–75 in 1996 and again in 2006. Results...

  17. Gastrointestinal Endometriosis Causing Subacute Intestinal Obstruction with Gradual Development of Weight Loss and Misdiagnosed as Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Amir Soumekh

    2014-01-01

    Full Text Available 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 to have endometriosis of the small intestine. This case illustrates the need for constant vigilance in patients with IBS.

  18. Gender-related differences in irritable bowel syndrome: potential mechanisms of sex hormones.

    Science.gov (United States)

    Meleine, Mathieu; Matricon, Julien

    2014-06-14

    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

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

    Directory of Open Access Journals (Sweden)

    Anita D Stuart

    2003-04-01

    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.

  20. Clinical, endoscopical and morphological efficacy of mesalazine in patients with irritable bowel syndrome

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    Dorofeyev AE

    2011-06-01

    Full Text Available Andrey E Dorofeyev1, Elena A Kiriyan2, Inna V Vasilenko1, Olga A Rassokhina1, Andrey F Elin11National Medical University, Donetsk, Ukraine; 2Gastroenterological Center of Poltava Hospital Clinic, Poltava, UkraineObjectives: The aim of this study was to analyze the clinical efficacy and cytomorphologic changes of colon mucosa following the treatment of patients suffering from irritable bowel syndrome (IBS with mesalazine (5-aminosalicylic acid [5-ASA].Methods: In this controlled, randomized, blind clinical trial, a total of 360 patients with varying subtypes of IBS were randomly treated with 500 mg of mesalazine qid or by standard therapy without mesalazine for a period of 28 days. Pre- and post-treatment pain intensity, pain duration, meteorism, stool abnormalities and endoscopic parameters were monitored, and biopsies or brush biopsies were examined histologically.Results: Treatment of IBS patients with mesalazine significantly reduced intensity and duration of pain in all subtypes of IBS, except for duration of pain in the subtype “undifferentiated”, where the difference was not significant. In addition, in patients with diarrhea type and undifferentiated type of IBS, mesalazine also significantly reduced the abnormal stool pattern. In comparison to the control group, administration of mesalazine reduced the incidence of endoscopic and cytomorphologic changes of the bowel mucosa, including changes in colon mucus, mucus production, cytologic or histologic parameters, epithelial cell degeneration, appearance of leukocytes and macrophages and cell infiltrations.Conclusion: Mesalazine was effective in reducing several symptoms characteristic of IBS. It significantly reduced pain intensity and duration and improved cytohistologic parameters of the bowel mucosa.Keywords: 5-amino salicylic acid, 5-ASA, abdominal pain, irritable bowel syndrome, IBS, meteorism, stool abnormalities

  1. Kruis scoring system and Manning's criteria in diagnosis of irritable bowel syndrome: is it better to use combined?

    Science.gov (United States)

    Doğan, U B; Unal, S

    1996-01-01

    Irritable bowel syndrome (IBS) is characterized by abdominal pain and alteration of bowel habits. Manning et al. have reported that certain symptoms distinguished IBS from organic gastrointestinal disease (OGD); these were pain relieved by defecation, looser or more frequent stools at the onset of pain, abdominal distention, mucus, and a feeling of incomplete evacuation. Another simple scoring system for discriminating IBS from OGD that incorporated historical data, physical examination findings, and basic investigations was first devised by Kruis et al. In differential diagnosis of IBS from OGD, to evaluate the reliability of Manning's criteria and Kruis scoring system when used apart or combined; we studied 347 out-patients who completed a bowel disease questionnaire which objectively measured Manning's criteria and scoring system of Kruis. The group included 165 patients with IBS and 182 patients with OGD. The Manning's criteria discriminated IBS from OGD with a sensitivity of 90% and a specificity of 87% if three or more items were regarded as positive. Also the Kruis scoring system discriminated IBS from OGD with a sensitivity of 81% and a specificity of 91%. When used together, these systems discriminated IBS from OGD with a sensitivity of 80% and a specificity of 97%. Manning's criteria and Kruis scoring system had a strong correlation when compared in IBS, but not in OGD.

  2. Sex Differences of Brain Serotonin Synthesis in Patients with Irritable Bowel Syndrome Using α-[11C]methyl-L-tryptophan, Positron Emission Tomography and Statistical Parametric Mapping

    OpenAIRE

    NAKAI, Akio; Kumakura, Yoshikata; Boivin, Michel; Rosa, Pedro; Diksic, Mirko; D’Souza, Doreen; Kersey, Kathryn

    2003-01-01

    BACKGROUND: Irritable bowel syndrome (IBS) is the most common functional bowel disorder and has a strong predominance in women. Recent data suggest that the brain may play an important role in the pathophysiology of IBS in the brain-gut axis. It is strongly suspected that serotonin (5-HT), a neurotransmitter found in the brain and gut, may be related to the pathophysiology of IBS. It is reported that a 5-HT3 antagonist is effective only in female patients with diarrhea-predominant IBS.OBJECTI...

  3. The Urine Metabonomics Contrast Research on the Treatment of Irritable Bowel Syndrome(IBS) of Spleen Deficiency Type by Umbilical Moxibustion and Pinaverium Bromide%脐疗法与匹维溴铵治疗脾虚型肠易激综合征的血液代谢组学机制研究比较

    Institute of Scientific and Technical Information of China (English)

    张晓宁; 马玉侠

    2015-01-01

    目的:分别采用脐疗法与西药匹维溴铵治疗脾虚型肠易激综合征患者,检测两组患者治疗前与治疗后血样的代谢产物谱,探究相关生物标记物存在,以推导其代谢途径与治疗方法的相关性并比较两治疗方法的差异,阐明脐疗治疗脾虚型肠易激综合征的作用机理。方法:将24名脾虚型肠易激综合征患者随机分为两组,其中脐疗组12例,匹维溴铵组12例。对治疗前后两组患者血样进行代谢组学处理,分析各自代谢途径,比较两组之间的差异。结果:脐疗组和匹维溴铵组治疗前后的血液代谢谱均发生了明显变化。其中脐疗组变化较为显著的是色氨酸、精氨酸、胆汁酸、儿茶酚胺类代谢物,这些代谢物涉及到体内的氨基酸代谢、神经递质代谢等过程。匹维溴铵组主要是涉及神经递质代谢过程。结论:脐疗与西药治疗脾虚型肠易激综合征均有显著疗效,两者在抑制肠易激患者的内脏高敏性方面均有显著疗效,另外脐疗还可广泛改善肠道神经途径、调节内分泌,进而提高腹泻型肠易激患者的生活和生存质量。%Objective:The study was about the treatment of irritable bowel syndrome of spleen deficiency type by umbilical moxibustion and Pinaverium Bromide tablets.Before and after treatment,we detected the patients'blood samples metabolite spectral, identified potential biomarkers, inferred the related metabolic pathway and compared the contrasts between them in two groups.In order to expound the mechanism of the treatment of IBS of spleen deficiency type by umbilical moxibustion and to provide scientific basis for clinical promotion of um-bilical moxibustion.Methods:24 patients with IBS of spleen deficiency were randomly divided into two groups, and each group had 12 patients.We processed the blood sample before and after treatment and analyzed metabolomics pathway, in order to compare the contrast

  4. Factors associated with irritable bowel syndrome symptoms in hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    Bartosz Fiderkiewicz; Alicja Rydzewska-Rosolowska; Michal My(s)liwiec; Magdalena Birecka; Bo(z)enna Kaczanowska; Gra(z)yna Rydzewska; Andrzej Rydzewski

    2011-01-01

    AIM: To investigate clinical characteristics associated with the presence of irritable bowel syndrome (IBS) symptoms in hemodialysis (HD) patients.METHODS: This was a cross-sectional study. A ques-tionnaire based on the Bowel Disease Questionnaire that records gastrointestinal symptoms was given to 294 patients in 4 dialysis centers. A total of 196 (67%) subjects returned the survey. A multivariable logistic regression model was used to identify factors signifi-cantly associated with IBS symptoms. RESULTS: Symptoms compatible with IBS were present in 27 (13.8%) subjects and independently associated with low post-dialysis serum potassium [OR = 0.258, 95% CI (0.075-0.891), P = 0.032], paracetamol use [OR = 3.159, 95% CI (1.214-8.220), P = 0.018], and Kidney Disease Quality of Life (KDQOL) cognitive function score [OR = 0.977, 95% CI (0.956-0.999), P = 0.042]. Univari-ate regressions were also performed and the reported significance is for multivariate analysis. No association was detected for age, gender, depressed mood, smoking (present or past), body mass index, albumin level, Kt/V, sodium pre- or post-dialysis level, change in potassium level during HD, proton pump inhibitor or H2 blocker use, aspirin use, residual diuresis, hepatitis B or C infection, diabetes mellitus, marital status and education level.CONCLUSION: This study examined potential risk factors for symptoms compatible with IBS in HD pa-tients and identified an association with paracetamol use, post-dialysis potassium level and KDQOL-cognitive function score.

  5. Opinión de los médicos españoles sobre el síndrome de intestino irritable: Resultados de un estudio utilizando el método Delphi Spanish physicians´point of view on irritable bowel syndrome (IBS: Results of a Delphi survey

    Directory of Open Access Journals (Sweden)

    C. Almansa

    2007-04-01

    Full Text Available Introducción: el síndrome del intestino irritable (SII es una patología controvertida, donde ante la escasez de evidencia científica las recomendaciones sobre su manejo clínico y su definición vienen determinadas por métodos de consenso de expertos. Objetivo: obtener la opinión de los médicos de nuestro país implicados en el manejo de pacientes con SII y conocer los puntos de acuerdo en las principales cuestiones clínicas que plantea. Material y métodos: se realizó un estudio Delphi a nivel nacional mediante dos envíos a 100 médicos de atención primaria y gastroenterólogos. El cuestionario incluía preguntas sobre el concepto, diagnóstico y tratamiento del SII, evaluando el grado de acuerdo entre los participantes. Resultados: el 55% de los encuestados completó los dos envíos. Se obtuvo acuerdo respecto a los síntomas que caracterizan al SII y los de alarma. No existió una actitud clara ante el paciente sin síntomas de alarma, pero sí acuerdo respecto a la realización de colonoscopia en su presencia. Se señaló la necesidad de realizar estudios complementarios en mayores de 40 años. En el tratamiento no encontramos una actitud uniforme, aunque parece existir una orientación diferente según el síntoma predominante. Conclusiones: los médicos participantes en el estudio demuestran a través de sus respuestas un buen conocimiento conceptual del SII, si bien las discrepancias observadas en las cuestiones sobre diagnóstico y tratamiento demuestran la complejidad y falta de uniformidad que existe en el manejo diario de este síndrome.Introduction: lack of evidence in most clinical situations regarding irritable bowel syndrome (IBS enhances the importance of an expert's opinion, which will guide management and even the concept underlying the disease. Objective: to delve into the knowledge and degree of agreement on main clinical skills for this syndrome among physicians involved in its management. Material and method: two

  6. Endocrine dysregulation in women with irritable bowel syndrome according to Rome II criteria.

    Science.gov (United States)

    Markert, Charlotte; Suarez-Hitz, Kerstin; Ehlert, Ulrike; Nater, Urs M

    2016-06-01

    The etiology of the irritable bowel syndrome (IBS) is unexplained: biological, psychological and social factors must be considered. This study examined if differences in HPA-axis activity already exist in those who do not yet fulfill IBS criteria (i.e. "subthreshold IBS"). We also investigated whether there were differences between those who reported clinically relevant (i.e. distressing) IBS symptoms and those who did not. Thirty-six women were subdivided into three groups (IBS group, subthreshold IBS group, control group). Results showed differences in morning cortisol levels (U = 11.58; p < 0.05), with IBS patients showing a lower cortisol response compared to controls. Subthreshold IBS patients were comparable to controls regarding endocrine function. Diurnal cortisol levels did not differ between groups. Group comparisons between distressed subjects and non-distressed subjects regarding cortisol levels did not reach significance. The finding of endocrine abnormalities (at least in a sub-set of patients) is important since these might be associated with deficient pain processing in IBS.

  7. Pan-enteric dysmotility, impaired quality of life and alexithymia in a large group of patients meeting ROME II criteria for irritable bowel syndrome

    OpenAIRE

    Portincasa, Piero; Moschetta, Antonio; Baldassarre, Giuseppe; Donato F. Altomare; Palasciano, Giuseppe

    2003-01-01

    AIM: Psychological factors, altered motility and sensation disorders of the intestine can be variably associated with irritable bowel syndrome (IBS). Such aspects have not been investigated simultaneously. The aim of this paper was to evaluate gastrointestinal motility and symptoms, psychological spectrum and quality of life in a large group of IBS patients in southern Italy.

  8. Randomised clinical trial: Gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome

    Science.gov (United States)

    A low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet can ameliorate symptoms in adult irritable bowel syndrome (IBS) within 48 h. To determine the efficacy of a low FODMAP diet in childhood IBS and whether gut microbial composition and/or metabolic capacity ar...

  9. Biomarkers to distinguish functional constipation from irritable bowel syndrome with constipation.

    Science.gov (United States)

    Whitehead, W E; Palsson, O S; Simrén, M

    2016-06-01

    Treatments for functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C) differ, but symptom criteria do not reliably distinguish between them; some regard FC and IBS-C as parts of a single constipation spectrum. Our goal was to review studies comparing FC and IBS-C to identify possible biomarkers that separate them. A systematic review identified 15 studies that compared physiologic tests in FC vs IBS-C. Pain thresholds were lower in IBS-C than FC for 3/5 studies and not different in 2/5. Colonic motility was decreased more in FC than IBS-C for 3/3 studies, and whole gut transit was delayed more in FC than IBS-C in 3/8 studies and not different in 5/8. Pelvic floor dyssynergia was unrelated to diagnosis. Sympathetic arousal, measured in only one study, was greater in IBS-C than FC. The most reliable separation of FC from IBS-C was shown by a novel new magnetic resonance imaging technique described in this issue of the journal. These authors showed that drinking one liter of polyethylene glycol laxative significantly increased water content in the small intestine, volume of contents in the ascending colon, and time to first evacuation in FC vs IBS-C; and resulted in less colon motility and delayed whole gut transit in FC compared to IBS-C. Although replication is needed, this well-tolerated, non-invasive test promises to become a new standard for differential diagnosis of FC vs IBS-C. These data suggest that FC and IBS-C are different disorders rather than points on a constipation spectrum. PMID:27214096

  10. The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations.

    Science.gov (United States)

    Fadgyas-Stanculete, Mihaela; Buga, Ana-Maria; Popa-Wagner, Aurel; Dumitrascu, Dan L

    2014-01-01

    Irritable bowel syndrome (IBS) is a functional syndrome characterized by chronic abdominal pain accompanied by altered bowel habits. Although generally considered a functional disorder, there is now substantial evidence that IBS is associated with a poor quality of life and significant negative impact on work and social domains. Neuroimaging studies documented changes in the prefrontal cortex, ventro-lateral and posterior parietal cortex and thalami, and implicate alteration of brain circuits involved in attention, emotion and pain modulation. Emerging data reveals the interaction between psychiatric disorders including generalized anxiety disorder, panic disorder, major depressive disorder, bipolar disorder, and schizophrenia and IBS, which suggests that this association should not be ignored when developing strategies for screening and treatment. Psychological, social and genetic factors appear to be important in the development of IBS symptomatology through several mechanisms: alteration of HPA axis modulation, enhanced perception of visceral stimuli or psychological vulnerability. Elucidating the molecular mechanisms of IBS with or without psychiatric comorbidities is crucial for elucidating the pathophysiology and for the identification of new therapeutical targets in IBS. PMID:25408914

  11. Time Domain Measures of Heart Rate Variability to Assess Autonomic Dysfunction In Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammad Nayem, Noorzahan Begum, Sultana Ferdousi

    2012-12-01

    Full Text Available AbstractBackground: Autonomic nerve function impairment is related to development of Irritable Bowel Syndrome (IBS. Time domain measures of Heart rate variability (HRV is a useful tool to measure autonomic nerve function activity.Objective: To assess autonomic nerve function activity by time domain measures of heart rate variability in patients with Irritable Bowel Syndrome.Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU, Dhaka in 2011. Ninety patients aged 20-50 years of both sex with Irritable bowel syndrome were included in the study group. They were collected from the OPD of Gastroenterology in BSMMU. Age and sex matched 30 apparently healthy subjects served as control. For assessing HRV by time domain method, Mean heart rate Mean R-R interval, Max/Min R-R interval, SDNN, RMSSD, PNN50%, NN50% were recorded by a digital Polyrite. ANOVA, independent sample t-test and Pearson’s correlation coefficient tests were performed as applicable.Results: Mean heart rate were significantly higher and Mean R-R interval, Max/Min R-R interval, SDNN, RMSSD, PNN50%, NN50% were significantly lower in IBS groups compared to those of control. Correlation analysis showed negative correlations of SDNN, RMSSD, PNN50%, NN50% with duration of disease.Conclusion: This study concludes that parasympathetic activity was reduced in patients of IBS. In addition, decreased vagal modulation is inversely related to the duration IBS.

  12. New therapeutic option for irritable bowel syndrome: serum-derived bovine immunoglobulin.

    Science.gov (United States)

    Good, Larry; Rosario, Roxanne; Panas, Raymond

    2015-03-21

    Oral prescription medical foods have long been used in hospital settings but are also appropriate therapies for gastrointestinal disorders in outpatient medical practice. Oral serum-derived bovine immunoglobulin/protein isolate (SBI) has been shown in clinical studies to reduce loose stools and improve stool consistency as well as other symptoms (i.e., abdominal pain, bloating, and urgency) in patients with irritable bowel syndrome with diarrhea (IBS-D) and human immunodeficiency virus-associated enteropathy. This case series reports the outcomes of 14 IBS patients who received SBI as an addition to standard of care at an individual physician's clinical practice. The patients: 2 IBS with constipation (IBS-C), 7 IBS-D, 2 mixed diarrhea and constipation IBS (IBS-M) and 3 undefined IBS (IBS-U; also described by some physicians as IBS-Bloating), ranged in age from 22-87 years. SBI (5 g or 10 g daily dose) was added to the patient's current standard care and followed for several weeks to determine if symptoms were improved with the addition of SBI. Overall, 12 of the 14 patients indicated some level of improvement through direct questioning of the patients regarding changes from the prior visit. One IBS-Bloating patient had a resolution of symptoms and two patients (1 IBS-Bloating and 1 IBS-C) discontinued therapy because of insufficient relief. The 12 patients who continued on therapy reported an overall improvement in symptoms with better stool consistency, decreased frequency as well as reductions in abdominal pain, bloating, distention, and incontinence. In most cases, therapeutic effects of SBI were seen within the first four weeks of therapy with continued improvements at subsequent visits. SBI has a multifaceted mechanism of action and may help to manage IBS by providing a distinct protein source required to normalize bowel function, gastrointestinal microbiota, and nutritionally enhance tight junction protein expression between intestinal epithelial cells. SBI

  13. Blastocystis is associated with decrease of fecal microbiota protective bacteria: comparative analysis between patients with irritable bowel syndrome and control subjects.

    Directory of Open Access Journals (Sweden)

    Céline Nourrisson

    Full Text Available Blastocystis is a protistan parasite living in the digestive tract of many animals, including humans. This highly prevalent intestinal parasite is suspected to be linked to Irritable Bowel Syndrome (IBS, a chronic functional bowel disorder. Here, we first compared the prevalence of Blastocystis among 56 IBS patients (40 IBS with constipation (IBS-C, 9 IBS with diarrhea (IBS-D, 4 mixed IBS (IBS-M and 3 unsubtyped IBS (IBS-U according to the Rome III criteria and 56 control (i.e. without any diagnosed chronic or acute gastrointestinal disorder subjects. The highest prevalence of Blastocystis spp. was observed in the IBS group, but was only statistically significant in men (36.8% in the IBS group versus 4.8% in the control group. We then conducted a meta-analysis including epidemiological studies attempting to determine whether Blastocystis carriage could be linked to IBS, and highlighted that IBS patients had a relative risk of 2.34 to be infected by Blastocystis when compared to non-IBS subjects. We also looked for Dientamoeba fragilis, which is often associated with IBS, and identified this parasite only in some IBS patients (n = 6/56. Several studies provided evidence for a major role of the gut microbiota in the pathophysiology of IBS. Thus, we investigated the possible impact of Blastocystis carriage on the enteric bacterial community through quantification of 8 major bacterial groups from the enteric flora. Our data indicated that men with IBS-C had a significant decrease in Bifidobacterium sp. when infected by Blastocystis. Interestingly, in control subjects (i.e. without any gastrointestinal disorder positive for Blastocystis, Faecalibacterium prausnitzii, which is known for its anti-inflammatory properties, was significantly decreased in men. Our results support the hypothesis that Blastocystis might be linked to the pathophysiology of IBS-C and intestinal flora imbalance.

  14. Blastocystis is associated with decrease of fecal microbiota protective bacteria: comparative analysis between patients with irritable bowel syndrome and control subjects.

    Science.gov (United States)

    Nourrisson, Céline; Scanzi, Julien; Pereira, Bruno; NkoudMongo, Christina; Wawrzyniak, Ivan; Cian, Amandine; Viscogliosi, Eric; Livrelli, Valérie; Delbac, Frédéric; Dapoigny, Michel; Poirier, Philippe

    2014-01-01

    Blastocystis is a protistan parasite living in the digestive tract of many animals, including humans. This highly prevalent intestinal parasite is suspected to be linked to Irritable Bowel Syndrome (IBS), a chronic functional bowel disorder. Here, we first compared the prevalence of Blastocystis among 56 IBS patients (40 IBS with constipation (IBS-C), 9 IBS with diarrhea (IBS-D), 4 mixed IBS (IBS-M) and 3 unsubtyped IBS (IBS-U) according to the Rome III criteria) and 56 control (i.e. without any diagnosed chronic or acute gastrointestinal disorder) subjects. The highest prevalence of Blastocystis spp. was observed in the IBS group, but was only statistically significant in men (36.8% in the IBS group versus 4.8% in the control group). We then conducted a meta-analysis including epidemiological studies attempting to determine whether Blastocystis carriage could be linked to IBS, and highlighted that IBS patients had a relative risk of 2.34 to be infected by Blastocystis when compared to non-IBS subjects. We also looked for Dientamoeba fragilis, which is often associated with IBS, and identified this parasite only in some IBS patients (n = 6/56). Several studies provided evidence for a major role of the gut microbiota in the pathophysiology of IBS. Thus, we investigated the possible impact of Blastocystis carriage on the enteric bacterial community through quantification of 8 major bacterial groups from the enteric flora. Our data indicated that men with IBS-C had a significant decrease in Bifidobacterium sp. when infected by Blastocystis. Interestingly, in control subjects (i.e. without any gastrointestinal disorder) positive for Blastocystis, Faecalibacterium prausnitzii, which is known for its anti-inflammatory properties, was significantly decreased in men. Our results support the hypothesis that Blastocystis might be linked to the pathophysiology of IBS-C and intestinal flora imbalance. PMID:25365580

  15. Personality characteristics and irritable bowel syndrome in Shiraz, Southern Iran

    Directory of Open Access Journals (Sweden)

    Mousavinasab Seyed

    2007-01-01

    Full Text Available Background/Aims: Irritable bowel syndrome (IBS is the most common functional gastrointestinal disorder, and its definite etiology is still unclear. It has been shown that personality characteristics can affect the disease presentation and attitude of patient toward symptoms. This study was undertaken to evaluate the personality characteristics in patients with IBS in Shiraz, southern Iran. Materials and Methods: In a cross-sectional study, the personality characteristics of 60 patients with IBS and 55 healthy persons were compared using Minnesota II Multiphasic Personality Inventory (MMPI-2. The cases were selected from patients who were referred to the Mottahari clinic affiliated to the Shiraz University of Medical Sciences. Results: The patients recorded the highest scores on the hypochondriasis and psychoasthenia scales. The scores of the patient on the scales of lie, infrequency, hypochondriasis, depression and hysteria showed significant elevation in comparison to those of the control group. Furthermore, the scores on clinical scales in male subjects were higher for psychopathic-deviate, paranoia and social introversion scales in comparison to the males in the control group. Female subjects recorded lower scores on the social introversion scale in comparison to the females in the control group. Male subjects also recorded a higher score on the psychopathic-deviate, paranoia, psychoasthenia and social introversion scales in comparison to females. Female subjects had a relatively higher score on the masculinity/feminity scale. Based on the clinical interview using DMS-IV criteria, the most prevalent symptoms were anxiety and depression in patients with IBS. Conclusion: Due to the high prevalence of anxiety and depression in patients with IBS, psychotherapy and pharmacotherapy of these patients is recommended.

  16. Treatment of irritable bowel syndrome with probiotics: An etiopathogenic approach at last? Tratamiento con probióticos del síndrome de intestino irritable: ¿Por fin un enfoque etiopatogénico?

    OpenAIRE

    M. Bixquert Jiménez

    2009-01-01

    Irritable bowel syndrome (IBS) is the most common functional digestive disorder, and may affect 11-20% of the adult population in industrialized countries. In accordance with Rome III criteria (2006) IBS involves abdominal pain and bowel habit disturbance, which are not explained by structural or biochemical abnormalities. Several hypotheses attempt to account for the pathophysiology of IBS, but the etiology still remains uncertain or obscure, perhaps multifactorial. Abnormalities in colonic ...

  17. A global perspective on irritable bowel syndrome: a consensus statement of the World Gastroenterology Organisation Summit Task Force on irritable bowel syndrome.

    Science.gov (United States)

    Quigley, Eamonn M M; Abdel-Hamid, Hussein; Barbara, Giovanni; Bhatia, Shobna J; Boeckxstaens, Guy; De Giorgio, Roberto; Delvaux, Michel; Drossman, Douglas A; Foxx-Orenstein, Amy E; Guarner, Francisco; Gwee, Kok-Ann; Harris, Lucinda A; Hungin, A Pali S; Hunt, Richard H; Kellow, John E; Khalif, Igor L; Kruis, Wolfgang; Lindberg, Greger; Olano, Carolina; Moraes-Filho, Joaquim P; Schiller, Lawrence R; Schmulson, Max; Simrén, Magnus; Tzeuton, Christian

    2012-01-01

    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.

  18. 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.

  19. [Irritable bowel syndrome: diet and complementary medicine therapies?].

    Science.gov (United States)

    Gerkens, A

    2012-09-01

    Irritable bowel syndrome (IBS) is a frequent and invalidating functional bowel disorder with entangled mechanisms. Its therapeutic approach is therefore complex. Classical therapies, prescribed alone or in combination in light of the predominant symptom, consist of antispasmodics, fibers, laxatives, antidiarrheals, and psychotropic agents. Other emerging pharmacological therapies, such as prokinetics, prosecretory or serotoninergic agents, bile acid modulators and antibiotics have been recently studied in clinical trials. Dietary measures can include reduction of short-chain poorly absorbed carbohydrates (FODMAPs) and gluten restriction. Assessment of food allergy can be proposed in a subgroup of IBS patients. Complementary and alternative medicine therapies, that are generally low cost and safe, appear to be appreciated by patients. Probiotics have demonstrated action on the gut microbiote modulation, and may be helpful in a subset of patients. Peppermint oil has an established visceral analgesic effect. Hypnotherapy represents an original, global and effective approach. Finally, education, reassurance and listening to the patient, leading to a solid therapeutic relationship, represents an essential backdrop of remedy or diet effectiveness. PMID:23091952

  20. The Efficacy of Hypnotherapy in the Treatment of Irritable Bowel Syndrome: A Systematic Review and Meta-analysis

    OpenAIRE

    Lee, Han Hee; Choi, Yoon Young; Choi, Myung-Gyu

    2014-01-01

    Background/Aims Hypnotherapy is considered as a promising intervention for irritable bowel syndrome (IBS), but the evidence is still limited. The aims of this study were to conduct a systematic review and meta-analysis to estimate the efficacy of hypnotherapy for the treatment of IBS. Methods A literature search was performed using MEDLINE (PubMed), Embase, PsycINFO and the Cochrane Central Register of Controlled Trials (CENTRAL database). Only randomized controlled trials that compared hypno...

  1. Epidemiology of Functional Diarrhea and Comparison with Diarrhea-Predominant Irritable Bowel Syndrome: A Population-Based Survey in China

    OpenAIRE

    Yan-Fang Zhao; Xiao-Jing Guo; Zhan-Sai Zhang; Xiu-Qiang Ma; Rui Wang; Xiao-Yan Yan; Jia He

    2012-01-01

    BACKGROUND: The epidemiology of functional diarrhea and its impacts on Chinese remain unclear, and there are no data on the comparative epidemiology of functional diarrhea and diarrhea-predominant irritable bowel syndrome (IBS-D). This study was to explore the epidemiology of functional diarrhea and its impacts, and to identify its distinction from IBS-D. METHODS AND FINDINGS: A cross-sectional survey was conducted in 16078 respondents, who were interviewed under a randomized stratified multi...

  2. Increased Chromogranin A Cell Density in the Large Intestine of Patients with Irritable Bowel Syndrome after Receiving Dietary Guidance

    OpenAIRE

    Tarek Mazzawi; Doris Gundersen; Trygve Hausken; Magdy El-Salhy

    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...

  3. Changes in Enteric Neurons of Small Intestine in a Rat Model of Irritable Bowel Syndrome with Diarrhea

    OpenAIRE

    Li, Shan; Fei, Guijun; Fang, Xiucai; Yang, Xilin; Sun, Xiaohong; Qian, Jiaming; Wood, Jackie D.; Ke, Meiyun

    2016-01-01

    Background/Aims Physical and/or emotional stresses are important factors in the exacerbation of symptoms in irritable bowel syndrome (IBS). Several lines of evidence support that a major impact of stress on the gastrointestinal tract occurs via the enteric nervous system. We aimed to evaluate histological changes in the submucosal plexus (SMP) and myenteric plexus (MP) of the distal ileum in concert with the intestinal motor function in a rat model of IBS with diarrhea. Methods The rat model ...

  4. Prolonged Exposure Therapy and Irritable Bowel Syndrome: A Case Study Examining the Impact of a Trauma-Focused Treatment on a Physical Condition

    OpenAIRE

    Weaver, Terrí L.; Nishith, Pallavi; Resick, Patricia A.

    1998-01-01

    Previous research has shown that psychological treatments, particularly those employing cognitive techniques, are particularly effective in the treatment of irritable bowel syndrome (IBS). It is presumed that these psychological interventions are effective at ameliorating the IBS by treating an underlying psychological disorder (often an anxiety disorder), which may be contributing to the autonomic reactivity. This case study examined the change in the physical symptoms of IBS for a patient s...

  5. 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

  6. Small bowel bacterial overgrowth

    Science.gov (United States)

    ... Surgical procedures that create a loop of small intestine where excess bacteria can grow. An example is a Billroth II type of stomach removal ( gastrectomy ). Some cases of irritable bowel syndrome (IBS) Symptoms The most common symptoms are: Abdominal ...

  7. 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. PMID:26900286

  8. The Effectiveness of Cognitive Behavioral Therapy on Symptoms Intensity, Quality of Life, and Mental Health in Patients with Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Amrollah Ebrahimi

    2015-09-01

    Full Text Available Background: Irritable bowel syndrome (IBS is a functional gastrointestinal disorder with chronic abdominal pain, bowel habit variations, and lack of structural causes. Symptom intensity has a statistical relation with patients' quality of life (QOL and mental health. The first objective of the present study was to develop and provide a therapeutic plan based on cognitive behavioral therapy (CBT for IBS that was operated for the very first time in Iran. The second objective was to determine the effectiveness of these treatments on IBS symptoms intensity, health-related QOL, and psychological health among patients with IBS. Methods: The participants were 15 women with IBS. The participants were diagnosed on the basis of ROME-III diagnosis criteria. The data collection tools consisted of IBS Symptom Severity Scale (IBS-SSS, the Irritable Bowel Syndrome Quality of Life (IBS-QOL questionnaire, and the Symptom Checklist-90-Revised (SCL-90-R used to evaluate mental health. Data were collected during the weeks of 0, 4, 12, and 24, during the treatment process. The extracted data was examined statistically via repeated measures MANOVA in SPSS software. Results: CBT has a significant effect on IBS symptoms reduction, QOL improvement, and mental health promotion of the patients. The effect of the therapeutic plan persisted until the follow-up stage. Conclusion: According to the results, applied CBT can be specifically implemented as an effective treatment for IBS. Therefore, the use of this treatment is advised.

  9. Prevalence of Irritable Bowel Syndrome in Singapore and Its Association with Dietary, Lifestyle, and Environmental Factors

    Science.gov (United States)

    Siah, Kewin T H; Wong, Reuben K; Chan, Yiong H; Ho, Khek Y; Gwee, Kok-Ann

    2016-01-01

    Background/Aims The prevalence of irritable bowel syndrome (IBS) has risen considerably over the past decade in Singapore. We aim to explore the contribution of changes in diet, lifestyle and habits that may contribute to the increased prevalence and development of IBS. Methods This is a survey-based cross-sectional population study aimed to gather demographic, socio-economical, lifestyle, dietary, antibiotic usage and other related information. Subjects were adult male or female Singaporeans aged 21 years or above. Association of the factors gathered with the presence or absence of IBS (by Rome III criteria) was assessed using chi-square or Fisher’s exact test. Variables with a level of statistical significance of 0.1 or less in the univariate analysis were entered into a stepwise logistic regression model. Results A total of 297 subjects participated in the study (female 60.3%). Overall, 20.9% subjects fulfilled the Rome III IBS criteria. Univariate analysis showed that IBS was associated with pet ownership, antibiotic usage, late dinner, (> 9 PM) and consumption of Western meals, coffee, and bread. The multivariate logistic regression analyses showed that IBS was independently associated with being a pet owner (P = 0.008; OR, 2.5; 95% CI, 1.278–5.037). Conclusions The prevalence of IBS was 20.9% using the Rome III criteria in our study. The association between IBS and pet ownership will need further investigation. PMID:26951047

  10. Drug development for the irritable bowel syndrome: current challenges and future perspectives

    Directory of Open Access Journals (Sweden)

    Fabrizio eDe Ponti

    2013-02-01

    Full Text Available Medications are frequently used for the treatment of patients with the irritable bowel syndrome (IBS, although their actual benefit is often debated. In fact, the recent progress in our understanding of the pathophysiology of IBS, accompanied by a large number of preclinical and clinical studies of new drugs, has not been matched by a significant improvement of the armamentarium of medications available to treat IBS. The aim of this review is to outline the current challenges in drug development for IBS, taking advantage of what we have learnt through the Rome process (Rome I, Rome II and Rome III. The key questions that will be addressed are: a do we still believe in the "magic bullet", i.e. a very selective drug displaying a single receptor mechanism capable of controlling IBS symptoms? b IBS is a "functional disorder" where complex neuroimmune and brain-gut interactions occur and minimal inflammation is often documented: do we need to target gut motility, visceral sensitivity or minimal inflammation? c are there validated biomarkers (accepted by regulatory agencies for studies of sensation and motility with experimental medications in humans? d do animal models have predictive and translational value? d in the era of personalised medicine, does pharmacogenomics applied to these medications already play a role? Finally, this review will briefly outline medications currently used or in development for IBS. It is anticipated that a more focussed interaction between basic science investigators, pharmacologists and clinicians will lead to better treatment of IBS.

  11. 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.

  12. Linaclotide: evidence for its potential use in irritable bowel syndrome and chronic constipation

    Directory of Open Access Journals (Sweden)

    Lee N

    2012-06-01

    Full Text Available Noel Lee, Arnold WaldDivision of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USAAbstract: Both irritable bowel syndrome (IBS, characterized by chronic and recurrent abdominal pain and altered bowel habits, and functional constipation are highly prevalent gastrointestinal problems for which many patients seek medical advice. A diverse number of treatment approaches are currently recommended to treat persons with chronic constipation as well as patients with IBS in which constipation is the main gastrointestinal symptom (IBS-C. These approaches have had somewhat limited success, and many patients remain dissatisfied with available therapy. Recently, linaclotide, a novel intestinal secretagogue, which works by activating the guanylate cyclase C receptor on the luminal surface of the intestinal epithelium, has been demonstrated to be efficacious in patients with both chronic functional constipation and with IBS-C in a series of randomized, placebo-controlled studies in these populations. Evidence for this assertion is provided in this systematic review of the pharmacologic properties of this novel agent and the published pivotal studies which support the efficacy of this agent in targeted populations.Keywords: linaclotide, constipation, irritable bowel syndrome, safety, efficacy

  13. Ehealth monitoring in irritable bowel syndrome patients treated with low fermentable oligo-, di-, mono-saccharides and polyols diet

    DEFF Research Database (Denmark)

    Pedersen, Natalia; Vegh, Zsuzsanna; Burisch, Johan;

    2014-01-01

    In the present study we report on changes in irritable bowel syndrome-severity scoring system (IBS-SSS) and irritable bowel syndrome-quality of life (IBS-QoL) in 19 IBS patients, aged 18 to 74 years (F/M: 14/5), during 12 wk registering their symptoms on the web-application (www.......ibs.constant-care.dk). During a control period of the first 6-wk patients were asked to register their IBS-SSS and IBS-QoL on the web-application weekly without receiving any intervention. Thereafter, low fermentable oligo-, di-, mono-saccharides and polyols (FODMAP) diet (LFD) was introduced for the next 6 wk while continuing...... significantly during the LFD period, median: 67 (37-120), P < 0.01. The significant reduction in disease activity during the control period shows a positive effect of the web-application on IBS symptoms when presented as a "traffic light". However adding the diet reduced IBS-SSS to < 150, inactive to mild...

  14. Lubiprostone: evaluation of the newest medication for the treatment of adult women with constipation-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Tisha N Lunsford

    2010-10-01

    Full Text Available Tisha N Lunsford, Lucinda A HarrisDepartment of Gastroenterology and Hepatology, Mayo Clinic – School of Medicine, Scottsdale, Arizona, USAAbstract: Irritable bowel syndrome (IBS is a chronic disorder that affects primarily female patients and is thought also to afflict approximately 7%–10% of the population of the Western World. Although bowel habits may change over the course of years, patients with IBS are characterized according to their predominant bowel habit, constipation (IBS-C, diarrhea (IBS-D, or mixed type (IBS-M, and treatments are focused toward the predominant symptom. Current treatments for IBS-C have included fiber, antispasmodics, osmotic and stimulant laxatives, and the now severely limited 5-HT4 agonist tegaserod. No one agent has been universally successful in the treatment of this bothersome syndrome and the search for new agents continues. Lubiprostone (Amitiza®, a novel compound, is a member of a new class of agents called prostones and was approved for the treatment of chronic idiopathic constipation in 2006 at a dose of 24 µg twice daily and then in 2008 for the treatment of IBS-C in women only at a dose of 8 µg twice daily. Its purported mechanism is as a type 2 chloride channel activator, but recent evidence suggests that it may also work at the cystic fibrosis transport receptor. This article will compare the newly proposed mechanism of action of this compound to the purported mechanism and review the structure, pharmacology, safety, efficacy, and tolerability of this new therapeutic option. Clinical trial data leading to the approval of this agent for the treatment of IBS-C and the gender-based understanding of IBS, as well as this agent’s place among existing and emerging therapies, will be examined.Keywords: large intestine, functional bowel disorder, therapy

  15. 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.

  16. Effect of Moderate Physical Exercise on Autonomic Balance in Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Karma Tenzin,

    2015-06-01

    Full Text Available Background: Altered autonomic balance has been noted in Irritable bowel syndrome Regular physical exercise may cause restoration of autonomic balance in health and disease. Objective: To assess the effect of brisk walking on the autonomic balance by analysis of heart rate variability in patients with Irritable bowel syndrome (IBS. Methods: This prospective study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU in 2013.Seventy seven male IBS patients aged 20-50 years, were enrolled from Gastroenterology OPD, BSMMU, Dhaka. Twenty eight healthy sedentary male with similar age were control. HRV measures were recorded once prior to exercise and then after 3 months of brisk walking. For assessing autonomic balance, LF/HF ratio and Max/Min RR was evaluated by Polyrite D machine and software. ANOVA, Independent sample t-test and paired t-test were used for statistical analysis. Results: The pre-exercise mean values of LF/HF ratio were significantly higher (p<0.001 in all IBS patients compared to those of control. The post exercise LF/HF ratio were significantly lower (p<0.05 in all IBS patients compared to their pre-exercise values. Conclusion: This study concluded that the sympathovagal balance was towards sympathetic predominance in IBS and regular moderate physical exercise may shift the balance towards parasympathetic predominance in them

  17. Short bowel syndrom as a complication of Crohn's disease

    OpenAIRE

    Skok, Pavel; Ocepek, Andreja

    2015-01-01

    During the course of Crohn's disease, some patients require surgical bowel resection due to intestinal stenosis. Attention is drawn to a possible complication of such surgical procedures: in a patients with Crohn's disease, short bowel syndrome developed following several small and large intestine resections that were necessary in the treatment of recidiving acute bowel obstructions. When the remnant small bowel is shorter than 200 cm, characteristic symptoms of short bowel syndrome develop i...

  18. Overlapping gastroesophageal reflux disease and irritable bowel syndrome:Increased dysfunctional symptoms

    Institute of Scientific and Technical Information of China (English)

    Shadi; Sadeghi; Yarandi; Siavosh; Nasseri-Moghaddam; Pardis; Mostajabi; Reza; Malekzadeh

    2010-01-01

    AIM:To investigate the association of gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) in Iranian patients and examine the prevalence of functional symptoms of the gastrointestinal tract in patients presenting with either IBS, GERD or both.METHODS: Six thousand four hundred and seventy six patients presented to the Gastro-intestinal (GI) clinic with symptoms of functional dysfunction of GI tract, 1419 patients (62.0% women, 38.0% men; mean age: 37.4±11.5 years) met Rome or Rome crit...

  19. ["Theater of the body" -- the possibilities of psychodrama in the treatment of irritable bowel syndrome].

    Science.gov (United States)

    Pénzes, István; Bánki, Adrienn; Túry, Ferenc

    2014-01-01

    We present the case and psychodrama therapy of a patient suffering from irritable bowel syndrome (IBS). First we provide a review of the literature on IBS. The therapeutic possibilities of psychodrama are in the dramatization of the perception of one's own body. Interpersonal communication is the focus of group work: the greatest challenge for the patient is the expression of her emotions, impulses, wishes - without somatization. The source of the non-specific psychotherapeutic effect is the free, spontaneous and creative communication and the rediscovery of play.

  20. ["Theater of the body" -- the possibilities of psychodrama in the treatment of irritable bowel syndrome].

    Science.gov (United States)

    Pénzes, István; Bánki, Adrienn; Túry, Ferenc

    2014-01-01

    We present the case and psychodrama therapy of a patient suffering from irritable bowel syndrome (IBS). First we provide a review of the literature on IBS. The therapeutic possibilities of psychodrama are in the dramatization of the perception of one's own body. Interpersonal communication is the focus of group work: the greatest challenge for the patient is the expression of her emotions, impulses, wishes - without somatization. The source of the non-specific psychotherapeutic effect is the free, spontaneous and creative communication and the rediscovery of play. PMID:25411224

  1. Mindfulness for irritable bowel syndrome: protocol development for a controlled clinical trial

    Directory of Open Access Journals (Sweden)

    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

  2. Role of psychiatric disorders and irritable bowel syndrome in asthma patients

    Directory of Open Access Journals (Sweden)

    Ayse Yilmaz

    2011-01-01

    Full Text Available OBJECTIVES: The goals of the study were the following: 1 to determine the frequency of psychiatric disorders and irritable bowel syndrome in patients with asthma and 2 to compare the frequency of these disorders in patients with asthma to their frequency in healthy controls. INTRODUCTION: Patients with asthma have a higher frequency of irritable bowel syndrome and psychiatric disorders. METHODS: We evaluated 101 patients with bronchial asthma and 67 healthy subjects. All subjects completed the brief version of the Bowel Symptoms Questionnaire and a structured clinical interview for DSM-IV axis disorders (SCID-I/CV. RESULTS: There were 37 cases of irritable bowel syndrome in the group of 101 stable asthma patients (36.6% and 12 cases in the group of 67 healthy subjects (17.9% (p = 0.009. Irritable bowel syndrome comorbidity was not related to the severity of asthma (p = 0.15. Regardless of the presence of irritable bowel syndrome, psychiatric disorders in asthma patients (52/97; 53.6% were more common than in the control group (22/63, 34.9% (p = 0.02. Although psychiatric disorders were more common in asthma patients with irritable bowel syndrome (21/35, 60% than in those without irritable bowel syndrome (31/62, 50%, the difference was not significant (p = 0.34. In asthma patients with irritable bowel syndrome and psychiatric disorders, the percentage of forced expiratory volume in 1 s (FEV1 was lower than it was in those with no comorbidities (p = 0.02. CONCLUSIONS: Both irritable bowel syndrome and psychiatric disorders were more common in asthma patients than in healthy controls. Psychiatric disorders were more common in asthma patients with irritable bowel syndrome than in those without irritable bowel syndrome, although the differences failed to reach statistical significance. In asthma patients with IBS and psychiatric disorders, FEV1s were significantly lower than in other asthma patients. It is important for clinicians to accurately

  3. PREVALENCE OF IRRITABLE BOWEL SYNDROME IN COLLEGE STUDENTS AND ASSOCIATION WITH ANXIETY, DEPRESSION AND FODMAP DIET

    Directory of Open Access Journals (Sweden)

    Gopi K.

    2015-08-01

    Full Text Available BACKGROUND: I rritable bowel syndrome ( IBS is the most common functional gastro - intestinal disorder. The data regarding the prevalence of IBS in young adults is limited along with its association with anxiety and depression in a community setting in India . MATERIALS AND METHODS: the prevalence of IBS and its subtypes based on Rome iii criteria were assessed in 2078 college students above 18 year s of age along with the prevalence of anxiety and depression based on hospital anxiety depression scale. Frequency of intake of food containing fermentable oligo - di - monosaccharides and polyols ( F odmaps were obtained. RESULTS: T he mean age of the study gro up is 19.73±1.4 years. The prevalence of IBS is 5.2%, the prevalence in females (6.1% as compared with males (3.9%. Mixed type of IBS is the most common involving 47.9% of students followed by diarrhea predominant in 22.9%, un subtyped in 17.7% and const ipation predominant in 11.5%. The mean anxiety score in students with IBS is 9.61±3.74 as compared to 7.15±3.73 in students without IBS with a p - value of 0.000. The mean depression score as per hads - d in students with IBS is 5.79±3.290 as compared to 4.39± 2.942 in students without IBS with a p - value of 0.000. Among students with IBS 48.9% were found to have psychological disorders as compared to 21% without IBS . There was no difference in the intake of food containing fodmaps.

  4. 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.

    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 patien

  5. The Rome II and Rome III criteria identify the same subtype-populations in irritable bowel syndrome

    DEFF Research Database (Denmark)

    Engsbro, A L; Simrén, M; Bytzer, P

    2012-01-01

    For comparing trials using different classifications for irritable bowel syndrome (IBS) subtypes, it is important to know whether these identify the same sub-populations. Our aim was to determine the agreement between Rome II and Rome III subtypes, and to explore whether agreement depends...

  6. Long-term efficacy and safety of ramosetron in the treatment of diarrhea-predominant irritable bowel syndrome

    OpenAIRE

    Chiba T; Yamamoto K; Sato S.; Suzuki K.

    2013-01-01

    Toshimi Chiba, Kazunari Yamamoto, Shoko Sato, Kazuyuki Suzuki Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan Abstract: Irritable bowel syndrome (IBS) is a functional disease with persisting gastrointestinal symptoms that has been classified into four subtypes. Serotonin (5-hydroxytryptamine [5-HT]) plays important physiological roles in the contraction and relaxation of smooth muscle. Intralumin...

  7. Long-term efficacy and safety of ramosetron in the treatment of diarrhea-predominant irritable bowel syndrome

    OpenAIRE

    Chiba, Toshimi; Yamamoto, Kazunari; Sato, Shoko; Suzuki, Kazuyuki

    2013-01-01

    Toshimi Chiba, Kazunari Yamamoto, Shoko Sato, Kazuyuki Suzuki Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan Abstract: Irritable bowel syndrome (IBS) is a functional disease with persisting gastrointestinal symptoms that has been classified into four subtypes. Serotonin (5-hydroxytryptamine [5-HT]) plays important physiological roles in the contraction and relaxation of smooth muscle. Intralumi...

  8. The Role of Stress on Physiological Responses and Clinical Symptoms in Irritable Bowel Syndrome

    OpenAIRE

    Chang, Lin

    2011-01-01

    Studies support the concept that irritable bowel syndrome (IBS) is a biopsychosocial disorder that can be explained by a neurobiological model which postulates stress-induced alterations in central stress and arousal circuits and activation of parallel motor outputs from brain regions that can affect bodily function and behavior. Sustained stress can result in chronic overactivity or underactivity of allostatic (or adaptive) systems, including the hypothalamic-pituitary-adrenal (HPA) axis, au...

  9. Fecal calprotectin is a useful marker to diagnose ulcerative colitis from irritable bowel syndrome

    OpenAIRE

    Hamid Kalantari; Akhtar Taheri; Majid Yaran

    2015-01-01

    Background: This study was aimed to evaluate the predictive value of fecal calprotectin in patients with ulcerative colitis from patients with irritable bowel syndrome (IBS). Materials and Methods: Between May and October 2013, 88 adult patients, between the age 18 and 65 years with a history of chronic diarrhea of unknown origin were assessed. Standard colonoscopies were performed in all patients to assess ulcerative colitis. Before colonoscopies, they were asked to supply a stool speci...

  10. Fecal calprotectin: a marker for clinical differentiation of microscopic colitis and irritable bowel syndrome

    OpenAIRE

    von Arnim U; Wex T; Ganzert C; Schulz C; Malfertheiner P

    2016-01-01

    Ulrike von Arnim, Thomas Wex, Christine Ganzert, Christian Schulz, Peter Malfertheiner Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany Background: The aim of this study is to compare two methods for measuring fecal calprotectin (FC) concentration and to evaluate the possibility of differentiation between microscopic colitis (MC) and irritable bowel syndrome (IBS). Methods: Twenty-three patients with MC (six patient...

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

    OpenAIRE

    Nanayakkara WS; Skidmore PML; O’Brien L; Wilkinson TJ; Gearry RB

    2016-01-01

    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, Monosac...

  12. The Importance of Relationships in Patients with Irritable Bowel Syndrome: A Review

    OpenAIRE

    Mary-Joan Gerson; Gerson, Charles D.

    2012-01-01

    Chronic illnesses such as irritable bowel syndrome are not experienced by patients in isolation. They live in a context of relationships, including spouses and partners, other family members, friends and business associates. Those relationships can have an effect, both positive and negative, on the course of illness and may also be affected by the experience of living with a chronic illness like IBS. We review the general literature regarding the effect of relationship factors on chronic i...

  13. Long Term Effects of Mindfulness on Quality of life in Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Saeedeh Zomorrodi

    2015-10-01

    Full Text Available Objectives: This study aimed to investigate the long-term effects of mindfulness-based therapy on improving life quality of patients with irritable bowel syndrome.Method: This was an experimental study including 24 patients (12 from each group with IBS syndrome were selected based on the ROMEIII criteria and were randomly placed in the test and control groups. In both groups, the scales of the IBS-QOL34 Questionnaire were applied as assessment tool. Experiment group was subjected to the MFT (mindfulness-based therapy, while the control group received no intervention. After the two-month follow up, both groups were once again evaluated through the IBS-QOL34 scales.Results: There is not significant difference between trial and control group in starting of the study in demographic and quality of life status. The findings of covariance analysis revealed that the difference between the experiment and the control groups at follow-up was significant (p = 0.01. The results showed that the MFT has long-term effects on the life quality of patients suffering from IBS.Conclusion: The MFT could be considered as a new, effective and stable method in psychotherapy, particularly in psychosomatic disorders such as Irritable Bowel Syndrome.

  14. Parasites in Mexican patients with irritable bowel syndrome: a case-control study

    Directory of Open Access Journals (Sweden)

    Gonzalez-Angulo Alberto

    2010-10-01

    Full Text Available Abstract One hundred and fifteen patients with symptoms suggestive of irritable bowel syndrome (IBS according to Rome III criteria and 209 patients with gastrointestinal symptoms different from IBS (control were identified through medical records from the Gastroenterology Clinic of the "Dr. Manuel Gea Gonzalez General Hospital" from January 2008 to March 2010. No statistical differences in IBS data as compared with control groups were observed except in bloating, that was more frequent in the IBS group (P = 0.043. Although the pathogenicity of specific intestinal protozoa could not be demonstrated due to lack of association with the development of gastrointestinal symptoms, Blastocystis spp, in the IBS group, exhibited a trend of association to diarrhoea (odds ratio = 2.73, 95% confidence interval = 0.84-8.80, P = 0.053, while having any parasite and diarrhoea was significant (odds ratio = 3.38, 95% confidence interval = 1.33-8.57, P = 0.008. The association between Blastocystis and diarrhoea in IBS patients although not conclusive is an interesting finding; nonetheless more extensive case-controlled studies are required to clearly define the role of some "non-pathogenic" parasites in intestinal disease and IBS.

  15. Irritable bowel syndrome and visceral hypersensitivity : risk factors and pathophysiological mechanisms.

    Science.gov (United States)

    Deiteren, A; de Wit, A; van der Linden, L; De Man, J G; Pelckmans, P A; De Winter, B Y

    2016-03-01

    Irritable bowel syndrome (IBS) is a common functional gastro-intestinal disorder, characterized by abdominal pain and altered intestinal motility. Visceral hypersensitivity is an important hallmark feature of IBS and is believed to underlie abdominal pain in patients with IBS. The two main risk factors associated with the development of IBS are gastrointestinal inflammation and psychological distress. On a peripheral level, visceral sensitivity seems to be modulated by several mechanisms. Immune cells in the mucosal wall, such as mast cells, and enterochromaffin cells may sensitize afferent nerves by release of their mediators. Furthermore, increased mucosal permeability, altered intestinal microflora and dietary habits may contribute to this feature. On a central level, an increased prevalence of psychiatric comorbidities is demonstrated in IBS patients, alongside alterations in the hormonal brain-gut axis, increased vigilance towards intestinal stimuli and functional and structural changes in the brain. The pathogenesis of IBS is complicated and multifactorial and the treatment remains clinically challenging. Dietary measures and symptomatic control are the cornerstones for IBS treatment and may be sufficient for patients experiencing mild symptoms, alongside education, reassurance and an effective therapeutic physician-patient relationship. New pharmacological therapies are aimed at interfering with mediator release and/or blockade of the relevant receptors within the gut wall, while modulation of the intestinal flora and diet may also be of therapeutic benefit. Tricyclic anti-depressants and serotonin reuptake inhibitors act both on a central and peripheral level by modulating pain signalling pathways. PMID:26852761

  16. MicroRNA-24 inhibits serotonin reuptake transporter expression and aggravates irritable bowel syndrome.

    Science.gov (United States)

    Liao, Xiu-Jun; Mao, Wei-Ming; Wang, Qin; Yang, Guan-Gen; Wu, Wen-Jing; Shao, Shu-Xian

    2016-01-01

    Irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder. MicroRNAs (miRNAs) have been widely demonstrated to take part in various physiological and pathological processes. In the present study, the role of miR-24 in the pathogenesis of IBS and the potential mechanism in this process were evaluated. Human intestinal mucosa epithelial cells of colon from IBS patients and healthy subjects were collected. An IBS mouse model was established with the induction of trinitro-benzene-sulfonic acid (TNBS). The expression levels of miR-24 and serotonin reuptake transporter (SERT) were analyzed using Real-time PCR and western blot in both human specimen and mice. miR-24 was upregulated in IBS patients and mice intestinal mucosa epithelial cells. Luciferase reporter assay showed that SERT was a potential target gene of miR-24. The treatment of miR-24 inhibitor increased pain threshold and nociceptive threshold levels and reduced MPO activity in proximal colon of IBS mice, and up-regulated the mRNA and protein expression levels of SERT in intestinal mucosa epithelial cells. miR-24 played a role in the pathogenesis of IBS probably through regulating SERT expression. PMID:26631964

  17. Post-infectious irritable bowel syndrome: mechanistic insights into chronic disturbances following enteric infection.

    Science.gov (United States)

    Beatty, Jennifer K; Bhargava, Amol; Buret, Andre G

    2014-04-14

    Irritable bowel syndrome (IBS) is a commonly encountered chronic functional gastrointestinal (GI) disorder. Approximately 10% of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysentery. The appearance of new IBS symptoms following an infectious event is defined as post-infectious-IBS. Indeed, with the World Health Organization estimating between 2 and 4 billion cases annually, infectious diarrheal disease represents an incredible international healthcare burden. Additionally, compounding evidence suggests many commonly encountered enteropathogens as unique triggers behind IBS symptom generation and underlying pathophysiological features. A growing body of work provides evidence supporting a role for pathogen-mediated modifications in the resident intestinal microbiota, epithelial barrier integrity, effector cell functions, and innate and adaptive immune features, all proposed physiological manifestations that can underlie GI abnormalities in IBS. Enteric pathogens must employ a vast array of machinery to evade host protective immune mechanisms, and illicit successful infections. Consequently, the impact of infectious events on host physiology can be multidimensional in terms of anatomical location, functional scope, and duration. This review offers a unique discussion of the mechanisms employed by many commonly encountered enteric pathogens that cause acute disease, but may also lead to the establishment of chronic GI dysfunction compatible with IBS. PMID:24744587

  18. A new acupuncture method for management of irritable bowel syndrome: A randomized double blind clinical trial

    Directory of Open Access Journals (Sweden)

    Rahmatollah Rafiei

    2014-01-01

    Full Text Available Background: Irritable bowel syndrome (IBS is gastrointestinal functional disorder which is multifactorial with unknown etiology. There are several modalities for treatment of it. Acupuncture is increasingly used in numerous diseases, also in gastrointestinal disorders like IBS. The purpose of the study was to assess the effects of catgut embedding acupuncture in improving of IBS. Materials and Methods: A randomized double blind sham control clinical trial was designed. A total of 60 IBS patients assigned to three separated groups. The first group received clofac as drug only group (DO. The second one received catgut embedding acupuncture in special point (AP and the last group received sham acupuncture (SA. Symptoms, pain, depression and anxiety assessed before and after two weeks at the end of study. Results: There was statistically significant difference between AP and SA and DO in constipation and bloating. Differences that were statistically significant favored acupuncture on pain (F = 6.409, P = 0.003, and depression (F = 6.735, P = 0.002 as the other outcomes. The average (standard deviation (SD of weight loss was 2 kg (0.88 in acupuncture group. Conclusion: Our finding showed a significant positive associated between acupuncture and IBS. Catgut embedding acupuncture is a new method which can eliminated IBS symptoms and can use as alternative therapeutic method for improvement of IBS.

  19. Abnormal endogenous pain modulation and somatic and visceral hypersensitivity in female patients with irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Clive H Wilder-Smith; Joan Robert-Yap

    2007-01-01

    AIM: To investigate the role of endogenous pain modulatory mechanisms in the central sensitization implicated by the visceral hypersensitivity demonstrated in patients with irritable bowel syndrome (IBS).Dysfunction of modulatory mechanisms would be expected to also result in changes of somatic sensory function.METHODS: Endogenous pain modulatory mechanisms were assessed using heterotopic stimulation and somatic and visceral sensory testing in IBS. Pain intensities (visual analogue scale, VAS 0-100) during suprathreshold rectal distension with a barostat, cold pressor stimulation of the foot and during both stimuli simultaneously (heterotopic stimulation) were recorded in 40 female patients with IBS and 20 female healthy controls.RESULTS: Rectal hypersensitivity (defined by 95% CI of controls) was seen in 21 (53%), somatic hypersensitivity in 22 (55%) and both rectal and somatic hypersensitivity in 14 of these IBS patients. Heterotopic stimulation decreased rectal pain intensity by 6 (-11 to -1) in controls, but increased rectal pain by 2 (-3 to +6) in all IBS patients (P<0.05) and by 8 (-2 to +19) in IBS patients with somatic and visceral hypersensitivity (P<0.02).CONCLUSION: A majority of IBS patients had abnormal endogenous pain modulation and somatic hypersensitivity as evidence of central sensitization.

  20. Body awareness therapy: A new strategy for relief of symptoms in irritable bowel syndrome patients

    Institute of Scientific and Technical Information of China (English)

    EM Eriksson; IE M(o)ller; RH S(o)derberg; HT Eriksson; GK Kurlberg

    2007-01-01

    AIM: To compare irritable bowel syndrome (IBS) patients with apparently healthy persons and to evaluate body awareness therapy, which is a physiotherapeutic remedy focusing on normalising tensions in the body,for the treatment of IBS with the hypothesis that altered body tension is associated with the syndrome.METHODS: Twenty-one IBS patients received bodyawareness therapy two hours weekly for 24 wk. At baseline as well as after 12 and 24 wk, they underwent examinations including resource oriented body examination in combination with body awareness scale evaluation and filled in gastrointestinal and psychological symptom questionnaires. Saliva cortisol was analysed. A group of 21 apparently healthy persons underwent the same examinations once.RESULTS: Compared to the apparently healthy group,IBS patients scored higher at baseline for gastrointestinal and psychological symptoms. They showed more often alterations in normal body tension patterns, as well as deviating cortisol slopes in saliva. After 24 wk of body awareness therapy, their gastrointestinal and psychologicai symptoms were reduced overall. Somatic symptoms decreased in parallel with depressive symptoms. Whole body pain score decreased, coping ability as well as biochemical stress markers improved.CONCLUSION: IBS patients scored higher for gastrointestinal and psychological symptoms, and presented with altered biochemical stress markers. Their body tension deviated compared to healthy controls. Furthermore,body awareness therapy gave relief of both somatic complaints, psychological symptoms and normalised body tension. These findings indicate that distorted tension constitutes an important part of the symptoms in IBS.

  1. The short-bowel syndrome.

    Science.gov (United States)

    Nightingale, J M

    1995-06-01

    Patients with a short bowel have usually had a bowel resection for Crohn's disease. Two types of short-bowel patient can be distinguished: those with a jejunostomy and those with their jejunum anastomosed to a functioning colon. Both types of patient have problems with macronutrient absorption, although those with a colon experience fewer problems because some energy from unabsorbed carbohydrate is salvaged in the colon. Patients with a jejunostomy have problems with large stomal losses of water, sodium and magnesium, whereas those with a jejuno-colic anastomosis rarely have problems with water and electrolyte absorption. Patients with a jejunostomy 100-200 cm from the duodeno-jejunal flexure ('absorbers') usually absorb more from the diet than they pass through the stoma and therefore require oral electrolyte or nutrient supplements. Those with a residual jejunal length of less than 100 cm usually secrete more from the stoma than they take in orally ('secretors') and therefore require long-term parenteral fluid or nutrient supplements. A high output resulting from a jejunostomy is treated by reducing the oral intake of hypotonic fluid, administering a sipped glucose-saline solution and, often, by giving drugs that reduce intestinal motility (most effective in absorbers) or gastrointestinal secretions (most effective in secretors). Gallstones are common both in short-bowel patients with and in those without a colon (45%), and calcium oxalate renal stones occur in the former (25%). However, it is now possible to provide adequate nutrition and fluid supplements for most patients with a short bowel, and the prospects for the rehabilitation of such patients are good. PMID:7552632

  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. Case report: Congenital short bowel syndrome

    Directory of Open Access Journals (Sweden)

    Palle Lalitha

    2010-01-01

    Full Text Available Congenital short bowel syndrome (SBS is a relatively rare condition as compared to acquired SBS. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. It is important to suspect and diagnose this condition promptly, as early initiation of parenteral nutrition or surgery, if necessary, may result in a favorable outcome. We discuss a case of an infant aged 26 days, who presented with failure to thrive, recurrent vomiting, and weight loss. A contrast study of the gastrointestinal tract revealed a short small bowel, with malrotation. The infant was started on parenteral nutrition, but succumbed shortly thereafter to severe disseminated sepsis.

  4. Effects of oral pinaverium bromide on colonic response to food in irritable bowel syndrome patients.

    Science.gov (United States)

    Bouchoucha, M; Faye, A; Devroede, G; Arsac, M

    2000-08-01

    We have recently developed a simple method to investigate the colonic response to food (CRF). This study describes the modifications of CRF induced by treatment with oral pinaverium bromide in irritable bowel syndrome (IBS) patients. Thirty healthy subjects and 43 patients suffering from IBS were studied. Colonic transit time (CTT) was measured in fasting conditions and after eating a standard test meal. Colonic response to food was quantified by calculating the variation in number of markers in each zone of interest of the large bowel between the X-ray films of the abdomen taken before and after eating. CRF is characterized by caudal propulsion of colonic contents in the two groups. In controls, there is emptying of the caecum-ascending colon region and filling of the rectosigmoid. In IBS patients, only the left transverse colon and the splenic flexure empty. Pinaverium bromide exerts no effect in controls but reverses the CRF of the right colon in IBS patients by inhibiting right colon emptying. These results suggest that the inhibitory action of pinaverium bromide on CRF may support the clinical efficacy of this calcium channel blocker in the treatment of IBS. PMID:10989977

  5. Limited prolonged effects of rifaximin treatment on irritable bowel syndrome-related differences in the fecal microbiome and metabolome.

    Science.gov (United States)

    Zeber-Lubecka, Natalia; Kulecka, Maria; Ambrozkiewicz, Filip; Paziewska, Agnieszka; Goryca, Krzysztof; Karczmarski, Jakub; Rubel, Tymon; Wojtowicz, Wojciech; Mlynarz, Piotr; Marczak, Lukasz; Tomecki, Roman; Mikula, Michal; Ostrowski, Jerzy

    2016-09-01

    Irritable bowel syndrome (IBS) is a chronic functional disorder and its development may be linked, directly and indirectly, to intestinal dysbiosis. Here we investigated the interactions between IBS symptoms and the gut microbiome, including the relation to rifaximin (1200 mg daily; 11.2 g per a treatment). We recruited 72 patients, including 31 with IBS-D (diarrhea), 11 with IBS-C (constipation), and 30 with IBS-M (mixed constipation and diarrhea) and 30 healthy controls (HCs). Of them, 68%, 64%, and 53% patients with IBS-D, IBS-C, and IBS-M, respectively, achieved 10-12 week-term improvement after the rifaximin treatment. Stool samples were collected before and after the treatment, and fecal microbiotic profiles were analyzed by deep sequencing of 16S rRNA, while stool metabolic profiles were studied by hydrogen 1-nuclear magnetic resonance ((1)H-NMR) and gas chromatography-mass spectrometry (GC-MS). Of 26 identified phyla, only Bacteroidetes, Firmicutes, Proteobacteria, and Actinobacteria were consistently found in all samples. Bacteroidetes was predominant in fecal samples from HCs and IBS-D and IBS-M subjects, whereas Firmicutes was predominant in samples from IBS-C subjects. Species richness, but not community diversity, differentiated all IBS patients from HCs. Metabolic fingerprinting, using NMR spectra, distinguished HCs from all IBS patients. Thirteen metabolites identified by GC-MS differed HCs and IBS patients. However, neither metagenomics nor metabolomics analyses identified significant differences between patients with and without improvement after treatment. PMID:27662586

  6. Development and validation of a biomarker for diarrhea-predominant irritable bowel syndrome in human subjects.

    Directory of Open Access Journals (Sweden)

    Mark Pimentel

    Full Text Available Diarrhea-predominant irritable bowel syndrome (IBS is diagnosed through clinical criteria after excluding "organic" conditions, and can be precipitated by acute gastroenteritis. Cytolethal distending toxin B (CdtB is produced by bacteria that cause acute gastroenteritis, and a post-infectious animal model demonstrates that host antibodies to CdtB cross-react with vinculin in the host gut, producing an IBS-like phenotype. Therefore, we assessed circulating anti-CdtB and anti-vinculin antibodies as biomarkers for D-IBS in human subjects. Subjects with D-IBS based on Rome criteria (n=2375 were recruited from a large-scale multicenter clinical trial for D-IBS (TARGET 3. Subjects with inflammatory bowel disease (IBD (n=142, subjects with celiac disease (n=121, and healthy controls (n=43 were obtained for comparison. Subjects with IBD and celiac disease were recruited based on the presence of intestinal complaints and histologic confirmation of chronic inflammatory changes in the colon or small intestine. Subjects with celiac disease were also required to have an elevated tTG and biopsy. All subjects were aged between 18 and 65 years. Plasma levels of anti-CdtB and anti-vinculin antibodies were determined by ELISA, and compared between groups. Anti-CdtB titers were significantly higher in D-IBS subjects compared to IBD, healthy controls and celiac disease (P<0.001. Anti-vinculin titers were also significantly higher in IBS (P<0.001 compared to the other groups. The area-under-the-receiver operating curves (AUCs were 0.81 and 0.62 for diagnosis of D-IBS against IBD for anti-CdtB and anti-vinculin, respectively. Both tests were less specific in differentiating IBS from celiac disease. Optimization demonstrated that for anti-CdtB (optical density≥2.80 the specificity, sensitivity and likelihood ratio were 91.6%, 43.7 and 5.2, respectively, and for anti-vinculin (OD≥1.68 were 83.8%, 32.6 and 2.0, respectively. These results confirm that anti-CdtB and

  7. [Irritable bowel syndrome: a functional disorder?].

    Science.gov (United States)

    Man, Fernando; Bustos Fernández, Luis María

    2013-12-01

    Irritable bowel syndrome is a highly prevalent condition responsible for almost one third of visits to the gastroenterologist and huge expenses for diagnosis, treatment and loss of working days. A unique pathophysiologic mechanism has not been elucidated yet and several possibilities have been proposed such as senso-perception and motor disturbances, the effect of stress and anxiety, serotonin receptor failures, activation of abnormal brain areas and pain modulation differences, among others. The absence of a biological marker has led the investigators to consider this syndrome as an exclusion diagnostic condition, once the organic diseases have been discarded The changes in gut microbiota have recently raised great interest among gastroenterologists. The study of the small intestinal bowel overgrowth syndrome, the effect of antibiotics upon the flora, the recognition of post-infectious irritable bowel syndrome and the action of probiotics, together with the effect of malabsortion of diet carbohydrates have brought some new light in our knowledge. The present update will focus on the published evidence about the subject, bearing in mind that the mechanisms elicited here are only suitable for a subgroup of patients. PMID:24516961

  8. Inflammatory Bowel Disease (For Teens)

    Science.gov (United States)

    ... Just like other organs in your body, the intestines can develop problems or diseases. IBD (which is not the same thing as irritable bowel syndrome, or IBS), can cause more serious problems than ...

  9. Increase in neurokinin-1 receptor-mediated colonic motor response in a rat model of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Jun-Ho La; Tae-Wan Kim; Tae-Sik Sung; Hyn-Ju Kim; Jeom-Yong Kim; Il-Suk Yang

    2005-01-01

    AIM: Irritable bowel syndrome (IBS) is a functional bowel disorder. Its major symptom is bowel dysmotility, yet the mechanism of the symptom is poorly understood. Since the neurokinin-1 receptor (NK1R)-mediated signaling in the gut is important in the control of normal bowel motor function,we aimed to investigate whether the NK1R-mediated bowel motor function was altered in IBS, using a rat IBS model that was previously reported to show colonic dysmotility in response to restraint stress.METHODS: IBS symptoms were produced in male SpragueDawley rats by inducing colitis with acetic acid. Rats were left to recover from colitis for 6 d, and used for experiments 7 d post-induction of colitis. Motor activities of distal colon were recorded in vitro.RESULTS: The contractile sensitivity of isolated colon to a NK1R agonist [Sar9, Met(O2)11]-substance P (1-30 nmol/L)was higher in IBS rats than that in normal rats. After the enteric neurotransmission was blocked by tetrodotoxin (TTX, 1 μmol/L), the contractile sensitivity to the NK1R agonist was increased in normal colon but not in IBS rat colon. The NK1R agonist-induced contraction was not different between the two groups when the agonist was challenged to the TTX-treated colon or the isolated colonic myocytes. A nitric oxide synthase inhibitor Nω-nitro-L-arginine methyl ester (L-NAME, 100 μmol/L) augmented the NK1R agonist-induced contraction only in normal rat colon.CONCLUSION: These results suggest that the NK1R-meidated colonic motor response is increased in IBS rats, due to the decrease in the nitrergic inhibitory neural component.

  10. 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...... general practitioners (GPs) have no or limited knowledge of the diagnostic criteria, few use them, and many consider IBS a diagnosis of exclusion. The aim of this study is to explore the sensitivity of the Rome III criteria in relation to a GP-based clinical diagnosis of IBS, to identify differences...... between Rome III-positive and -negative patients, and to describe the agreement between the various symptom-based criteria....

  11. Long-term efficacy and safety of otilonium bromide in the management of irritable bowel syndrome: a literature review

    Directory of Open Access Journals (Sweden)

    Triantafillidis JK

    2014-04-01

    Full Text Available John K Triantafillidis, George Malgarinos Inflammatory Bowel Disease Unit, IASO General Hospital, Athens, Greece Abstract: Irritable bowel syndrome (IBS is a very common functional gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits. The disease affects a large part of the world population. The clinical course is mostly characterized by a cyclic recurrence of symptoms. Therefore, IBS patients should receive, as an initial therapeutic approach, a short course of treatment, and long-term treatment should be reserved for those patients with recurrent symptoms. The available clinical trials show that significant improvement of the symptoms over placebo could be achieved with various drugs, although this improvement is frequently time dependent and with high relapse rates after the cessation of the treatment. In a proportion of patients, clinically obvious relapse could appear long after stopping the treatment. Some of the available pharmacologic agents, including otilonium bromide (OB, are able to significantly prolong the time to the appearance of relapse, compared with placebo. As a consequence, some authors suggest that a cyclic treatment could be of benefit. Antispasmodic drugs have been used for many years in an effort to control the symptoms of IBS. OB is a poorly absorbed spasmolytic drug, exerting significantly greater control of the symptoms of IBS compared with placebo. Recent data suggest that the drug could effectively be used for the long-term management of patients with IBS. The aim of this review is to provide the reader with an evidence-based overview of the efficacy and tolerability of OB in the long-term management of IBS patients, based on the results of the clinical trials published so far. Keywords: irritable bowel syndrome, IBS, treatment, otilonium bromide

  12. Functional dyspepsia and irritable bowel syndrome, are they different entities and does it matter?

    Institute of Scientific and Technical Information of China (English)

    Kok-Ann Gwee; Andrew Seng Boon Chua

    2006-01-01

    A high prevalence of overlap between functional dyspepsia and irritable bowel syndrome has been consistently and universally reported. Recent studies demonstrating shared common pathophysiological disturbances including delayed gastric emptying and visceral hypersensitivity involving more than one region,suggest that these patients have a generalised rather than regional, disorder of the gut. Furthermore, a study of the natural history of dyspepsia suggests that with time, a substantial proportion will evolve into IBS. The recognition of IBS in dyspeptic patients has potentially profound therapeutic importance. It could help to reduce the risk of unnecessary cholecystectomy in IBS patients.The ability to appreciate the extent of involvement could allow us to address the disturbances more comprehensively, and thereby achieve greater patient satisfaction with their treatment.

  13. Effectiveness of Relaxation in life quality of Irritable Bowel Syndrome patients referring to Shohada Hospital, Dehloran, Iran; 2015

    OpenAIRE

    Reza Valizadeh; Elham Basereh; Shahram Mami; Zahra Amin Parast

    2016-01-01

    Background: Irritable Bowel Syndrome is a prevalent syndrome which is identified by change intestine movements. In this research the effect of relaxation on life quality of IBS patients referring to Dehloran’s Shohada hospital, Iran, in 2015 has been investigated. Materials and Methods: This research is a semi-experimental pre-test – post-test, which was conducted on 24 people with IBS. After the test and the pre-test, relaxation curing was conducted for eight weeks, each week 60 minutes, usi...

  14. The impact of Irritable Bowel Syndrome on health-related quality of life: a Singapore perspective

    Directory of Open Access Journals (Sweden)

    Wang Yu

    2012-08-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS is a common gastrointestinal disorder. The prevalence of IBS in Asian countries varies from 2.9% to 15.6%. IBS does not result in increased mortality, but is associated with psychological distress and disruption of work and sleep. Consequently, the evaluation of health-related quality of life (HRQoL is an important outcome measure for patients with IBS since it provides a holistic assessment of the patient's emotional, social and physical function. However, some HRQoL tools can be time-consuming to apply. EQ-5D is a brief HRQoL tool which has been validated in the Western IBS population but has thus far not been used in Asia. This study was conducted to determine whether persons with self-reported symptoms that met the Rome III criteria for IBS had a poorer quality of life than those without these symptoms. We also aimed to determine which specific aspects of quality of life were most affected and whether any risk factors distinguished those with and without IBS. Methods Self-administered questionnaires which included the Rome III diagnostic questionnaire modules for IBS and the EQ-5D questionnaire were obtained from participants of a health symposium in Singapore on 31th October 2010. IBS was diagnosed based on the Rome III Criteria. The main outcome measure was the EQ-5D index score. The relationship between the presence of IBS and the EQ-5D index score, individual dimensions of EQ-5D and demographic risk factors were examined. Results 449 completed questionnaires were analyzed. The mean EQ-5D index score for IBS was 0.739 which was a significant reduction compared to non-IBS participants [−0.11 (95% CI: -0.15 to −0.07, p  Conclusion IBS sufferers have significantly poorer quality of life. Assessment of HRQoL in IBS using the EQ-5D should be considered in further studies and routine clinical practice.

  15. 培菲康对IBS-D患者外周血清IL-18/IL-10的影响%The influence of Bifid Triple Viable on the level of IL-18/IL-10 of patients with diarrhea-predominant irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    田树英; 魏思忱; 宋慧; 李春英

    2013-01-01

    目的 观察培菲康治疗腹泻型肠易激综合征(IBS-D)的临床疗效并探讨其可能作用机制.方法 80例IBS-D患者随机分为2个试验组:培菲康联合匹维溴铵(A组)40例,匹维溴铵(商品名:得舒特)(B组)40例,并设健康对照组(C组)30例,疗程均为4周.采用双抗夹心ELISA法分别检测两组患者治疗前后和30名健康志愿者血清中IL-18/IL-10的含量.治疗结束后4周对治愈和显效患者进行随访.结果 (1)A组总有效率为88.89%,B组总有效率为65.62%,A组明显高于B组(P<0.05).远期疗效:停药4周后随访,A组有4例复发或加重,复发率为12.5%,B组有9例复发或加重,复发率为42.9%,两组间差异有统计学意义(P<0.01).(2)A组和B组治疗前IL-18水平明显高于C组,A组治疗后IL-18的水平与C组比较差异无统计学意义,而B组仍高于C组.两组患者治疗前IL-10水平明显低于C组,但在药物干预后A组IL-10的水平与C组比较差异无统计学意义,而B组仍低于C组.结论 培菲康能够有效治疗IBS-D,并能预防其复发,调节免疫可能是其主要治疗机制.%Objective To investigate the clinical efficacy of Bifid Triple Viable (BTV) on diarrhea-predominant irritable bowel syndrome (IBS-D) and its functional mechanism. Methods 80 patients with IBS-D were randomly divided into two experimental groups: BTV with Pinaverium Bromide group (Group A, n = 40) and Pinaverium Bromide group (brand name: Dicetel) (Group B, n = 40). 30 healthy people were included as the control group (Group C). The course of treatment was four weeks. The expressions of serum IL-18/ IL-10 in experimental groups were determined by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). The patients who were cured and responded after treatment were followed up for 4 weeks. Results (1) The total effective rate of Group A was 88.89%, which was much higher than Group B (65.62%) (P<0.05). 4 weeks after withdrawal, Group A had 4 cases of

  16. Contribution of Blastocystishominis subtypes and associated inflammatory factors in development of irritable bowel syndrome.

    Science.gov (United States)

    Azizian, Marzieh; Basati, Gholam; Abangah, Ghobad; Mahmoudi, Mohammad Reza; Mirzaei, Asad

    2016-05-01

    Blastocystis hominis with worldwide distribution is a human intestinal protozoa found in all countries. There have been differences in the severity of the pathogenesis of various Blastocystis spp. and a concomitant variation in the plasma concentration of the cytokines in patients with irritable bowel syndrome. In the present study, we aimed to demonstrate the contribution of B. hominis subtypes in the development of irritable bowel syndrome. Stool samples were collected from patients with gastrointestinal disorders. All samples were evaluated through native-lugol method. Total DNA was extracted. A PCR protocol was developed to amplify a specific region of the SSU ribosomal DNA (rDNA) gene. Serum levels of IL-6 and TNF-α were determined by immunoassay methods. The ClustalW algorithm was applied to align and blast the nucleotide sequences of the amplified region of the SSU rDNA gene. To evaluate the phylogenetic and molecular evolutionary of the nucleotide sequences, we used the MEGA software. In this study, we found 26 haplotypes of B. hominis in the studied samples which were collectively belong to five subtypes (ST1, ST2 in patients without irritable bowel syndrome vs. ST3 and two unknown subtypes in patients with irritable bowel syndrome). Result of ELISA showed a high level of IL-6 and TNF-α in the serum of patients with irritable bowel syndrome. The genetic heterogeneity of B. hominis and the existence of different subtypes of the protozoan in patients with IBS may shed light to the fact that some subtypes of parasites may involve in the pathogenesis of IBS. PMID:26841770

  17. Case report: Congenital short bowel syndrome

    OpenAIRE

    Palle Lalitha; Reddy Balaji

    2010-01-01

    Congenital short bowel syndrome (SBS) is a relatively rare condition as compared to acquired SBS. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. It is important to suspect and diagnose this condition promptly, as early initiation of parenteral nutrition or surgery, if necessary, may result in a favorable outcome. We discuss a case of an infant aged 26 days, who presented with failure to thrive, recur...

  18. Can Mindfulness-Based Cognitive Therapy Reduce the Symptoms of Irritable Bowel Syndrome in Women?

    Directory of Open Access Journals (Sweden)

    Fatemeh Asadollahi

    2014-09-01

    Full Text Available Background: Irritable bowel syndrome (IBS is a functional disorder of the lower gastrointestinal (GI tract caused by stress, which may benefit from a biopsychosocial treatment such as mindfulness-based cognitive therapy (MBCT. The thrust of the study was to examine the efficacy of MBCT on physical and psychological symptoms of women who suffered from IBS. It was hypothesized that MBCT patients would experience greater reduction in overall IBS symptoms in comparison to control patients. Methods: This survey was conducted in Isfahan, Iran, to investigate the impact of MBCT on a group of Iranian women diagnosed with IBS. In this quasi-experimental study 20 women with the diagnosis of IBS were randomly and equally assigned to experimental and control groups. Severity of IBS was measured by the IBS Severity Scoring System (IBS-SSS while the patients’ psychopathology was assessed by Symptom Checklist 90-R (SCL-90-R. The experimental group was exposed to 8 sessions of MBCT on a weekly basis; each session lasting 90 minutes. Data were analyzed using SPSS software and MANCOVA. Results: A significant reduction was noted in anxiety, depression, and somatization symptoms after the intervention and in anxiety and obsessive–compulsive disorder (OCD at follow-up (p < 0.05. However, during the follow-up there was no significant progress in the level of somatization and depression. Apparently our treatment modality did not have any impact on the severity of physical symptoms. Conclusion: Psychological symptoms of IBS can be managed largely with the help of MBCT, resulting in the promotion of mental health in women afflicted by this disorder.

  19. Irritable bowel syndrome in a Bangladeshi urban community: Prevalence and health care seeking pattern

    Directory of Open Access Journals (Sweden)

    Perveen Irin

    2009-01-01

    Full Text Available Background/Aims : Although irritable bowel syndrome (IBS is a common gastrointestinal disorder, its prevalence is unknown, especially in the urban population of Bangladesh. This community-based study aimed to find out the prevalence of IBS and healthcare-seeking patterns using the Rome-II definition. Materials and Methods : A population-based cross-sectional survey of 1503 persons aged 15 years and above was carried out in an urban community of Bangladesh. The subjects were interviewed using a valid questionnaire based on Rome-II criteria in a home setting. Statistical analysis was performed with Statistical Package for Social Science (SPSS Programmers and the level of significance was set at P ≤ 0.05. Results : A response rate of 97.2% yielded 1503 questionnaires for analysis. The prevalence of IBS was found to be 7.7% (n = 116 with a male to female ratio of 1:1.36 (49 vs. 67. "Diarrhoea-predominant IBS" (50%, n = 58 was the predominant IBS subgroup. Symptoms of abdominal pain associated with a change in stool frequency (100% and consistency (88.8% were quite common. All IBS symptoms were more prevalent among women (P < 0.000. In the past one year, 65.5% (n = 76 IBS subjects had consulted a physician with a slightly higher rate of women consulters (68.6 vs. 61.2%. The main predictor for healthcare-seeking was the presence of multiple dyspeptic symptoms. Conclusions : The prevalence of IBS in the urban community was found to be similar to that in rural communities. A higher rate of consultation was found among urban IBS subjects than in the rural subjects, with sex not seen to be a discriminator to seek consultation.

  20. The scintigraphic determination of small intestinal transit time in patients with irritable bowel syndrome

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    Marano, A.R.; Caride, V.J.; Shah, R.V.; Prokop, E.K.; Troncale, F.J.; McCallum, R.W.

    1984-01-01

    Diffuse disturbance in gastrointestinal motility may be present in patients with irritable bowel syndrome (IBS). To further investigate small intestinal motility in IBS patients small intestinal transit time (SITT) was determined and related to the symptom status. 11 female patients with IBS (mean age 29 years) were divided into those whose predominate symptom was diarrhea (N=6), and those with only constipation (N=5). All subjects ingested an isosmotic solution of lactulose (10 gm in 150cc of water) labeled with 99m-Tc-DTPA (Sn). The patient was studied supine under a 25 inch gamma camera with data collected at 1 frame per minute for 180 minutes or until activity appeared in the ascending colon. Regions of interest were selected over the cecum and ascending colon. The time of first appearance of radioactivity in the region of the cecum was taken as the small intestinal transit time. SITT in the 5 normal females was 98.7 +- 13 min (mean +- SEM). SITT in the IBS patients with diarrhea, 67.3 +- 7 min was significantly faster (p< 0.08). SITT in the constipated IBS patients, 126 +- 12 min, was slower than normals and significantly different from diarrhea patients (p< 0.001). These studies show that IBS patients with diarrhea have significantly faster SITT than normals while constipated IBS patients have significantly slower SITT than the diarrhea subgroup. Further, this study emphasizes the need to study the various symptomatic subgroups of IBs patients independently and indicates a possible role for abnormal SITT in the pathogenesis of IBS.

  1. Influence of irritable bowel syndrome on treatment outcome in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Hubert M(o)nnikes; Robert C Heading; Holger Schmitt; Hubert Doerfler

    2011-01-01

    AIM: To investigate the influence of irritable bowel syndrome (IBS)-like symptoms on treatment outcomes with pantoprazole in gastroesophageal reflux disease (GERD) in a real life setting. METHODS: For this prospective, open-label, multinational, multicentre study, 1888 patients assessed by the investigators as suffering from GERD were recruited. The patients were additionally classified as with or without IBS-like symptoms at baseline. They were treated with pantoprazole 40 mg once daily and completed the Reflux Questionnaire? (ReQuest?) short version daily. Response rates and symptom scores were compared after 4 and 8 wk of treatment for subgroups defined by the subclasses of GERD [erosive(ERD) and non-erosive reflux disease (NERD)] and the presence of IBS-like symptoms. RESULTS: IBS-like symptoms were more prevalent in NERD than in ERD (18.3% vs 12.7%, P = 0.0015). Response rates after 4 and/or 8 wk of treatment were lower in patients with IBS-like symptoms than in patients without IBS-like symptoms in both ERD (Week 4: P < 0.0001, Week 8: P < 0.0339) and NERD (Week 8: P = 0.0088). At baseline, ReQuest? "lower abdominal complaints" symptom scores were highest in NERD patients with IBS-like symptoms. Additionally, these patients had the strongest symptom improvement after treatment compared with all other subgroups. CONCLUSION: IBS-like symptoms influence treatment outcome and symptom burden in GERD and should be considered in management. Proton pump inhibitors can improve IBS-like symptoms, particularly in NERD.

  2. Fecal Calprotectin and serum chromogranin A as potential biomarkers of irritable bowel syndrome symptom severity.

    Science.gov (United States)

    Pletikosic, Sanda; Plavsic, Ivana; Hauser, Goran; Tkalcic, Mladenka

    2015-09-01

    Irritable bowel syndrome (IBS) is a disorder of the lower gastrointestinal (GI) tract, which manifests as abdominal pain and/or discomfort accompanied by altered bowel function, in the absence of structural pathology. The onset and precipitation of IBS is the result of an interaction among several factors, including psychological distress, altered GI sensation and processing of sensory information as well as GI inflammation. These factors have varying contributions to disorder etiology in different patients, and in line with that, there is now emerging evidence about a low-grade inflammation in a subgroup of IBS patients. Because IBS diagnosis is based on the ROME III criteria, with the exclusion of structural pathology, patients are often exposed to numerous invasive and unpleasant tests. In order to decrease the cost of repeated testing, while simultaneously alleviating patients' anxiety, research should be aimed at detecting cost-effective biomarkers. We hypothesize chromogranin A (CgA) and fecal Calprotectin (FC) could be used to eliminate possible organic causes of IBS symptoms. Also, we hypothesize FC could be helpful in detecting IBS patients with low-grade inflammation. Forty-eight outpatients with IBS (76% females) completed a set of psychosocial measures (HRQoL, STAI, BDI, VSI, SF-36), and their FC and CgA levels were obtained. We found elevated CgA levels in 4 patients, but CgA levels were not related to any of the psychological measures used. Elevated FC levels were found in 12 patients. FC levels significantly correlated with the physical component of health related quality of life (HRQoL) (r48=-.42, p<.01). In addition, one-way ANOVA's were performed to test possible differences in psychosocial measures depending on the patient's FC status. The analysis showed only one significant difference. Patients with the highest levels of FC had significantly lower physical component of HRQoL compared to the other two groups of patients. PMID:26112162

  3. Cerebral processing of auditory stimuli in patients with irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Viola Andresen; Peter Kobelt; Claus Zimmer; Bertram Wiedenmann; Burghard F Klapp; Hubert Monnikes; Alexander Poellinger; Chedwa Tsrouya; Dominik Bach; Albrecht Stroh; Annette Foerschler; Petra Georgiewa; Marco Schmidtmann; Ivo R van der Voort

    2006-01-01

    AIM: To determine by brain functional magnetic resonance imaging (fMRI) whether cerebral processing of non-visceral stimuli is altered in irritable bowel syndrome (IBS) patients compared with healthy subjects. To circumvent spinal viscerosomatic convergence mechanisms,we used auditory stimulation, and to identify a possible influence of psychological factors the stimuli differed in their emotional quality.METHODS: In 8 IBS patients and 8 controls, fMRI measurements were performed using a block design of 4 auditory stimuli of different emotional quality (pleasant sounds of chimes, unpleasant peep (2000 Hz), neutral words, and emotional words). A gradient echo T2*-weighted sequence was used for the functional scans.Statistical maps were constructed using the general linear model.RESULTS: To emotional auditory stimuli, IBS patients relative to controls responded with stronger deactivations in a greater variety of emotional processing regions, while the response patterns, unlike in controls, did not differentiate between distressing or pleasant sounds.To neutral auditory stimuli, by contrast, only IBS patients responded with large significant activations.CONCLUSION: Altered cerebral response patterns to auditory stimuli in emotional stimulus-processing regions suggest that altered sensory processing in IBS may not be specific for visceral sensation, but might reflect generalized changes in emotional sensitivity and affectire reactivity, possibly associated with the psychological comorbidity often found in IBS patients.

  4. Molecular Characterization and Subtyping of Blastocystis Species in Irritable Bowel Syndrome Patients from North India.

    Science.gov (United States)

    Das, Rojaleen; Khalil, Shehla; Mirdha, B R; Makharia, Govind K; Dattagupta, Siddharta; Chaudhry, Rama

    2016-01-01

    Blastocystis species has been extensively studied in recent few years to establish its pathogenecity. Present study was designed to identify and examine the association of Blastocystis sp. and its subtypes with Irritable Bowel Syndrome (IBS).Blastocystis sp. detected using wet-mount microscopy, trichrome staining, in-vitro culture and Polymerase Chain Reaction (PCR) assay in a cohort of IBS patients (n = 150) and healthy controls (n = 100). Isolates of Blastocystis sp.were subtyped using Sequence Tagged Site and representative samples were sequenced at SSUrRNA locus.A total of sixty five isolates of Blastocystis sp. were identified [IBS (n = 50); Controls (n = 15)] of which 91% belonged to ST3 and 9% belonged to ST1. No other subtypes could be identified. Statistically significant association was observed between Blastocystis sp. and IBS patients; however no particular subtype could be ascertained to any particular clinical type of IBS.The frequency of occurrence of Blastocystis sp. was more in IBS patients as compared to the controls and ST3 being the most prevalent subtype. The genetic polymorphism of SSU-rRNA gene amongst the different Blastocystis sp.isolates found in this study reinforces the fact that these organisms are genetically highly divergent. PMID:26784888

  5. Infectious causation of chronic disease: Examining the relationship between Giardia lamblia infection and irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Alice S Penrose; Eden V Wells; Allison E Aiello

    2007-01-01

    AIM: To evaluate whether a higher prevalence of Giardia lamblia infection is associated with an increase in irritable bowel syndrome (IBS) prescriptions at the county level in Michigan.METHODS: The Michigan Disease Surveillance System (MDSS) was used to ascertain both the numbers of Giardia lamblia infections as well as the total number of foodborne illnesses per population by county in Michigan during 2005. This was compared with Blue Cross Blue Shield (BCBS) of Michigan numbers of drug prescriptions for IBS per one thousand members per county in 2005.These data were also analyzed for associations with per capita income by county and the number of refugees entering each county in 2005.RESULTS: There were a total of 786 confirmed cases of Giardia lamblia reported to MDSS in 2005. During the same time period, the number of prescriptions for IBS varied from 0.5 per 1000 members up to 6.0 per 1000members per month. There was no trend towards higher numbers of IBS prescriptions in the counties with more Giardia lamblia infections. Per capita income was not associated with either IBS prescriptions or Giardiasis.There was a significant linear association between the number of refugees entering each county, and the number of Giardia lamblia cases per 100 000 population.CONCLUSION: In this ecological study, there was no association found between BCBS prescriptions for IBS and Giardia lamblia infections in Michigan counties. Our findings may have been influenced by the disparate number of refugees admitted per county.

  6. What about OMT and nutrition for managing the irritable bowel syndrome? An overview and treatment plan.

    Science.gov (United States)

    Collebrusco, Luca; Lombardini, Rita

    2014-01-01

    A chronic continuous or intermittent gastrointestinal tract dysfunction, the irritable bowel syndrome (IBS), appears to be due to dysregulation of brain-gut-microbiota communication. Furthermore, the "microbiota" greatly impacts the bi-directional brain-gut axis communication. This article describes IBS in relation to similar diseases, presents the background to osteopathy, and proposes osteopathic manipulative treatment (OMT) to manage IBS. In IBS, OMT focuses on the nervous and circulatory systems, spine, viscera, and thoracic and pelvic diaphragms in order to restore homeostatic balance, normalize autonomic activity in the intestine, promote lymphatic flow, and address somatic dysfunction. Lymphatic and venous congestion are treated by the lymphatic pump techniques and stimulation of Chapman׳s reflex points. A simple treatment plan designed to lessen chronic pain and inflammation in IBS is presented based on current evidence-based literature. Since food itself, food allergies, and intolerance could contribute to symptom onset or even cause IBS, this article also provides dietary modifications to consider for patients. PMID:25224307

  7. Systematic review of modulators of benzodiazepine receptors in irritable bowel syndrome:Is there hope?

    Institute of Scientific and Technical Information of China (English)

    Pooneh Salari; Mohammad Abdollahi

    2011-01-01

    Several drugs are used in the treatment of irritable bowel syndrome (IBS) but all have side effects and variable efficacy.Considering the role of the gut-brain axis,immune,neural,and endocrine pathways in the patho-genesis of IBS and possible beneficial effects of ben-zodiazepines (BZD) in this axis,the present systematic review focuses on the efficacy of BZD receptor modulators in human IBS.For the years 1966 to February 2011,all literature was searched for any articles on the use of BZD receptor modulators and IBS.After thorough evaluation and omission of duplicate data,10 out of 69 articles were included.BZD receptor modulators can be helpful,especially in the diarrhea-dominant form of IBS,by affecting the inflammatory,neural,and psychologic pathways,however,controversies still exist.Recently,a new BZD receptor modulator,dextofisopam was synthesized and studied in human subjects,but the studies are limited to phase II b clinical trials.None of the existing trials considered the neuroimmunomodulatory effectof BZDs in IBS,but bearing in mind the concentration-dependent effect of BZDs on cytokines and cell proliferation,future studies using pharmacodynamic and pharmacokinetic approaches are highly recommended.

  8. Segmental reversal of the small bowel as treatment of short bowel syndrome in adults

    DEFF Research Database (Denmark)

    Burgdorf, Stefan K; Qvist, Niels; Gögenur, Ismail

    2014-01-01

    Short bowel syndrome is the result of extensive surgical resection, inherited defects or loss of functional absorbing intestine. Parenteral nutrition is associated with high economical expenses, increased morbidity and decreased quality of life. Intestinal transplantation is associated with high...... morbidity and mortality rates. Segmental reversal of the small bowel can prolong the transit time in the small bowel and in many cases permanently end parenteral nutrition dependency. Segmental reversal of the small bowel should be integrated in the surgical treatment of adults with short bowel syndrome....

  9. 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. PMID:25410635

  10. Competences Required for the Delivery of High and Low-Intensity Cognitive Behavioural Interventions for Chronic Fatigue, Chronic Fatigue Syndrome/ME and Irritable Bowel Syndrome

    OpenAIRE

    Rimes, Katharine A.; Wingrove, Janet; Moss-Morris, Rona; Chalder, Trudie

    2014-01-01

    Background: Cognitive behavioural interventions are effective in the treatment of chronic fatigue, chronic fatigue syndrome (sometimes known as ME or CFS/ME) and irritable bowel syndrome (IBS). Such interventions are increasingly being provided not only in specialist settings but in primary care settings such as Improving Access to Psychological Therapies (IAPT) services. There are no existing competences for the delivery of "low-intensity" or "high-intensity" cognitive behavioural interventi...

  11. 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) per

  12. 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

  13. Effect of commensals and probiotics on visceral sensitivity and pain in irritable bowel syndrome.

    Science.gov (United States)

    Theodorou, Vassilia; Ait Belgnaoui, Afifa; Agostini, Simona; Eutamene, Helene

    2014-01-01

    The last ten years' wide progress in the gut microbiota phylogenetic and functional characterization has been made evidencing dysbiosis in several gastrointestinal diseases including inflammatory bowel diseases and irritable bowel syndrome (IBS). IBS is a functional gut disease with high prevalence and negative impact on patient's quality of life characterized mainly by visceral pain and/or discomfort, representing a good paradigm of chronic gut hypersensitivity. The IBS features are strongly regulated by bidirectional gut-brain interactions and there is increasing evidence for the involvement of gut bacteria and/or their metabolites in these features, including visceral pain. Further, gut microbiota modulation by antibiotics or probiotics has been promising in IBS. Mechanistic data provided mainly by animal studies highlight that commensals or probiotics may exert a direct action through bacterial metabolites on sensitive nerve endings in the gut mucosa, or indirect pathways targeting the intestinal epithelial barrier, the mucosal and/or systemic immune activation, and subsequent neuronal sensitization and/or activation.

  14. Factors Associated With Complementary and Alternative Medicine Use in Irritable Bowel Syndrome: A Literature Review

    Directory of Open Access Journals (Sweden)

    Lee Usher

    2013-11-01

    Full Text Available Aim: Irritable Bowel Syndrome (IBS is a chronic functional bowel condition, which has substantial impact on quality of life and use of healthcare services. Patients often report using complementary and alternative medicine (CAM for symptom management despite limited evidence to support its use. Psychological factors have been shown to be important in both influencing CAM use and as avenues of intervention to assist in managing IBS symptoms. Therefore, this review assessed prevalence of and psychological factors associated with CAM use by people with IBS. Method: Five electronic databases (including AMED, EMBASE and PsychINFO were searched for studies that examined both the extent of and the reasons for CAM use. Five studies met the inclusion criteria. Results: Prevalence of CAM use ranged from 9% to 38%. CAM use was associated with psychosocial factors, including concerns about conventional medical care (i.e., the perceived harmful effects of medication, perception that conventional medicine had failed, and lack of satisfaction with conventional care and anxiety. Conclusion: These findings identify psychological factors associated with CAM use which could be targeted through psychologically oriented management strategies for those affected with IBS.

  15. Genomic and clinical effects associated with a relaxation response mind-body intervention in patients with irritable bowel syndrome and inflammatory bowel disease.

    Directory of Open Access Journals (Sweden)

    Braden Kuo

    Full Text Available Irritable Bowel Syndrome (IBS and Inflammatory Bowel Disease (IBD can profoundly affect quality of life and are influenced by stress and resiliency. The impact of mind-body interventions (MBIs on IBS and IBD patients has not previously been examined.Nineteen IBS and 29 IBD patients were enrolled in a 9-week relaxation response based mind-body group intervention (RR-MBI, focusing on elicitation of the RR and cognitive skill building. Symptom questionnaires and inflammatory markers were assessed pre- and post-intervention, and at short-term follow-up. Peripheral blood transcriptome analysis was performed to identify genomic correlates of the RR-MBI.Pain Catastrophizing Scale scores improved significantly post-intervention for IBD and at short-term follow-up for IBS and IBD. Trait Anxiety scores, IBS Quality of Life, IBS Symptom Severity Index, and IBD Questionnaire scores improved significantly post-intervention and at short-term follow-up for IBS and IBD, respectively. RR-MBI altered expression of more genes in IBD (1059 genes than in IBS (119 genes. In IBD, reduced expression of RR-MBI response genes was most significantly linked to inflammatory response, cell growth, proliferation, and oxidative stress-related pathways. In IBS, cell cycle regulation and DNA damage related gene sets were significantly upregulated after RR-MBI. Interactive network analysis of RR-affected pathways identified TNF, AKT and NF-κB as top focus molecules in IBS, while in IBD kinases (e.g. MAPK, P38 MAPK, inflammation (e.g. VEGF-C, NF-κB and cell cycle and proliferation (e.g. UBC, APP related genes emerged as top focus molecules.In this uncontrolled pilot study, participation in an RR-MBI was associated with improvements in disease-specific measures, trait anxiety, and pain catastrophizing in IBS and IBD patients. Moreover, observed gene expression changes suggest that NF-κB is a target focus molecule in both IBS and IBD-and that its regulation may contribute to

  16. Predictors of health-related quality of life in patients with irritable bowel syndrome. A cross-sectional study in Norway

    OpenAIRE

    Michalsen, Vilde Lehne; Vandvik, Per Olav; Farup, Per Grønaas

    2015-01-01

    Background: Reduced quality of life (QoL) is often the main problem for patients with irritable bowel syndrome (IBS). This study aimed at finding predictors of reduced physical and mental quality of life (QoL) accessible for intervention. Methods: Consecutive patients with IBS (according to the Rome II criteria) visiting a general practitioner were included in a prospective cohort study and followed up for 6−9 months. At the last visit, information about sociodemographic charac...

  17. Pharmacokinetic Comparison of Berberine in Rat Plasma after Oral Administration of Berberine Hydrochloride in Normal and Post Inflammation Irritable Bowel Syndrome Rats

    OpenAIRE

    Zipeng Gong; Ying Chen; Ruijie Zhang; Yinghan Wang; Yan Guo; Qing Yang; Haixian Zhang; Yu Dong; Xiaogang Weng; Shuangrong Gao; Xiaoxin Zhu

    2014-01-01

    In the present study, post inflammation irritable bowel syndrome (PI-IBS) rats were firstly established by intracolonic instillation of acetic acid with restraint stress. Then the pharmacokinetics of berberine in the rat plasma were compared after oral administration of berberine hydrochloride (25 mg/kg) to normal rats and PI-IBS rats. Quantification of berberine in the rat plasma was achieved by using a sensitive and rapid UPLC-MS/MS method. Plasma samples were collected at 15 different poi...

  18. Acceptability, effectiveness, and cost-effectiveness of internet-based exposure treatment for irritable bowel syndrome in a clinical sample: a randomized controlled trial

    OpenAIRE

    Andréewitch Sergej; Lindfors Perjohan; Hedman Erik; Andersson Erik; Andersson Gerhard; Ljótsson Brjánn; Rück Christian; Lindefors Nils

    2011-01-01

    Background: Internet-based cognitive behavior therapy (ICBT) has shown promising effects in the treatment of irritable bowel syndrome (IBS). However, to date no study has used a design where participants have been sampled solely from a clinical population. We aimed to investigate the acceptability, effectiveness, and cost-effectiveness of ICBT for IBS using a consecutively recruited sample from a gastroenterological clinic. less thanbrgreater than less thanbrgreater thanMethods: Sixty-one pat...

  19. Morphological changes of intestinal mucosa in patients with different clinical variants of irritable bowel syndrome using tetracyclic antidepressants and selective serotonin reuptake inhibitor

    OpenAIRE

    Nagieva S.; Svintsitskyy A.; Kuryk O.; Korendovych I.

    2015-01-01

    Objective. To assess histological changes of colonic mucosa in patients with clinically different types of irritable bowel syndrome (IBS) before and after the treatment with tetracyclic antidepressant and selective serotonin reuptake inhibitor. Methods. Adult patients (over 18 years) with confirmed diagnosis of IBS were examined. Biopsy specimens were taken from colon during colonoscopy for the next histological examination. One expert gastrointestinal pathologist assessed all tissue samples....

  20. The Effects of Lifestyle Modification on Symptoms and Quality of Life in Patients with Irritable Bowel Syndrome: A Prospective Observational Study

    OpenAIRE

    Kang, Sun Hyung; Choi, Seong-Woo; Lee, Seung Jun; Chung, Woo Suk; Lee, Hye Ran; Chung, Ki-Young; Lee, Eaum Seok; Moon, Hee Seok; Kim, Seok Hyun; Sung, Jae Kyu; Lee, Byung Seok; Jeong, Hyun Yong

    2011-01-01

    Background/Aims Although notably common, irritable bowel syndrome (IBS) has no specific cure. Lifestyle modification may be as important as medication; however, few studies support the effectiveness of such modifications. We performed this observational study of IBS patients to explore further the role of lifestyle changes in treatment. Methods This study included 831 men who enlisted in 2010 as armed surgeon cadets and 85 women who concurrently entered the Armed Forces Nursing Academy. Of th...

  1. Effect of breadmaking process on in vitro gut microbiota parameters in irritable bowel syndrome.

    Directory of Open Access Journals (Sweden)

    Adele Costabile

    Full Text Available A variety of foods have been implicated in symptoms of patients with Irritable Bowel Syndrome (IBS but wheat products are most frequently cited by patients as a trigger. Our aim was to investigate the effects of breads, which were fermented for different lengths of time, on the colonic microbiota using in vitro batch culture experiments. A set of in vitro anaerobic culture systems were run over a period of 24 h using faeces from 3 different IBS donors (Rome Criteria-mainly constipated and 3 healthy donors. Changes in gut microbiota during a time course were identified by fluorescence in situ hybridisation (FISH, whilst the small-molecular weight metabolomic profile was determined by NMR analysis. Gas production was separately investigated in non pH-controlled, 36 h batch culture experiments. Numbers of bifidobacteria were higher in healthy subjects compared to IBS donors. In addition, the healthy donors showed a significant increase in bifidobacteria (P<0.005 after 8 h of fermentation of a bread produced using a sourdough process (type C compared to breads produced with commercial yeasted dough (type B and no time fermentation (Chorleywood Breadmaking process (type A. A significant decrease of δ-Proteobacteria and most Gemmatimonadetes species was observed after 24 h fermentation of type C bread in both IBS and healthy donors. In general, IBS donors showed higher rates of gas production compared to healthy donors. Rates of gas production for type A and conventional long fermentation (type B breads were almost identical in IBS and healthy donors. Sourdough bread produced significantly lower cumulative gas after 15 h fermentation as compared to type A and B breads in IBS donors but not in the healthy controls. In conclusion, breads fermented by the traditional long fermentation and sourdough are less likely to lead to IBS symptoms compared to bread made using the Chorleywood Breadmaking Process.

  2. Effect of Breadmaking Process on In Vitro Gut Microbiota Parameters in Irritable Bowel Syndrome

    Science.gov (United States)

    Costabile, Adele; Santarelli, Sara; Claus, Sandrine P.; Sanderson, Jeremy; Hudspith, Barry N.; Brostoff, Jonathan; Ward, Jane L.; Lovegrove, Alison; Shewry, Peter R.; Jones, Hannah E.; Whitley, Andrew M.; Gibson, Glenn R.

    2014-01-01

    A variety of foods have been implicated in symptoms of patients with Irritable Bowel Syndrome (IBS) but wheat products are most frequently cited by patients as a trigger. Our aim was to investigate the effects of breads, which were fermented for different lengths of time, on the colonic microbiota using in vitro batch culture experiments. A set of in vitro anaerobic culture systems were run over a period of 24 h using faeces from 3 different IBS donors (Rome Criteria–mainly constipated) and 3 healthy donors. Changes in gut microbiota during a time course were identified by fluorescence in situ hybridisation (FISH), whilst the small -molecular weight metabolomic profile was determined by NMR analysis. Gas production was separately investigated in non pH-controlled, 36 h batch culture experiments. Numbers of bifidobacteria were higher in healthy subjects compared to IBS donors. In addition, the healthy donors showed a significant increase in bifidobacteria (Pbread produced using a sourdough process (type C) compared to breads produced with commercial yeasted dough (type B) and no time fermentation (Chorleywood Breadmaking process) (type A). A significant decrease of δ-Proteobacteria and most Gemmatimonadetes species was observed after 24 h fermentation of type C bread in both IBS and healthy donors. In general, IBS donors showed higher rates of gas production compared to healthy donors. Rates of gas production for type A and conventional long fermentation (type B) breads were almost identical in IBS and healthy donors. Sourdough bread produced significantly lower cumulative gas after 15 h fermentation as compared to type A and B breads in IBS donors but not in the healthy controls. In conclusion, breads fermented by the traditional long fermentation and sourdough are less likely to lead to IBS symptoms compared to bread made using the Chorleywood Breadmaking Process. PMID:25356771

  3. 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

  4. Risk factors for chronic diarrhoea in the community in the absence of irritable bowel syndrome.

    Science.gov (United States)

    Chang, J Y; Locke, G Richard; Schleck, C D; Zinsmeister, A R; Talley, N J

    2009-10-01

    In contrast to irritable bowel syndrome (IBS), the prevalence and risk factors for diarrhoea in the absence of IBS in the community are unknown. We aimed to evaluate potential risk factors for chronic diarrhoea (non-IBS). A valid questionnaire that recorded gastrointestinal symptoms required for a diagnosis of chronic diarrhoea, self-reported measures of potential risk factors, and a somatic symptom checklist was mailed to an age- and gender-stratified random sample of Olmsted County, Minnesota residents (30-64 year). Chronic diarrhoea was defined as reporting one or more of the following symptoms more than 25% of the time in the past 3 months: > or =3 bowel movements a day, loose or watery stools, or faecal urgency. Subjects with IBS (Rome III) were excluded. Of 892 eligible subjects, 653 (73%) responded. Among 523 respondents not reporting IBS, chronic diarrhoea was reported by 148 (28%); 90 (61%) had chronic painless diarrhoea. Chronic diarrhoea was significantly associated with self-reported food sensitivity (OR = 2.05 [1.31-3.20]) and stress (OR = 1.99 [1.03-3.85]). Both remained significant in the adjusted variable models that excluded subjects with any abdominal pain. Female gender (OR = 0.67 [0.45-0.98]) and higher education level (OR = 0.60 [0.39-0.92]) had smaller odds for chronic diarrhoea. No association was detected for age, marital status, body mass index, cigarette or alcohol use, coffee, analgesics, emotional support, pets or water source. Chronic diarrhoea in the absence of IBS is common; self-reported food sensitivity, male gender and a lower level of education are risk factors. PMID:19460105

  5. The Comparison of SerumVitamins A and E in Irritable Bowel Syndrome and Control Group

    Directory of Open Access Journals (Sweden)

    Hashemi,J

    2013-01-01

    Full Text Available AbstractBackground and objectives: Irritable bowel syndrome (IBS is one of the most common gastrointestinal diseases. It is a functional bowel disorder characterized by chronic abdominal pain and alternation of bowel habits with no structural abnormality. The prevalence of this disease was estimated 10-20 percent in the world. However, the cause of IBS is still unknown. Regarding to intestinal absorption disorder of nutrients, the malabsorption of vitamin may occur. The aim of this study is to evaluate serum levels of vitamins A and E in IBS patients.Materials & Methods: This case - control study was done on 94 patients whom their IBS disease were confirmed by a gastroenterologist in Golestan province. The control group was selected from healthy people, who didn't show any signs of digestive problems in past two years. The age and sex were matched with the cases group. Using HPLC method, Fasting blood samples were collected .Followed by measurement of Serum levels of vitamins A and E.Results: the meanserum levels of vitamin A and E in patients and control group were 57.0 ± 114.8μg / dl and23.8 ± 55.9 μg / dl, and 0.50 ± 0.24 mg / dl and 1.93 ± 1.86 mg / dl, respectively. (P <0.05. in men, the deficiency of Vitamin A and E, were7.70 and 7.10 percent and 6.76 and 3.7 in women. (P <0.05.In general, 1.1percent of IBS patients showed Vitamin A deficiency and 93.6 percent of them had vitamin E deficiency (P <0.05.Conclusion: In this study, a significant decrease in vitamin E levels was observed in patients with IBS. Due to antioxidant activity of vitamin E, the deficiency of this Vitamin, can increase the oxidative factors leading to intestinal damages and it is expected to decrease the amount of vitamins, subsequentlyKeywords: Irritable Bowel Syndrome, Vitamin A, Vitamin E, Gorgan

  6. 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…

  7. Small Intestinal Bacterial Overgrowth in Patients with Irritable Bowel Syndrome: Clinical Characteristics, Psychological Factors, and Peripheral Cytokines

    Science.gov (United States)

    Chu, Hua; Fox, Mark; Zheng, Xia; Deng, Yanyong; Long, Yanqin; Huang, Zhihui; Du, Lijun; Xu, Fei; Dai, Ning

    2016-01-01

    Small intestinal bacterial overgrowth (SIBO) has been implicated in the pathogenesis of irritable bowel syndrome (IBS). Psychosocial factors and low-grade colonic mucosal immune activation have been suggested to play important roles in the pathophysiology of IBS. In total, 94 patients with IBS and 13 healthy volunteers underwent a 10 g lactulose hydrogen breath test (HBT) with concurrent 99mTc scintigraphy. All participants also completed a face-to-face questionnaire survey, including the Hospital Anxiety and Depression Scale, Life Event Stress (LES), and general information. Serum tumour necrosis factor-α, interleukin- (IL-) 6, IL-8, and IL-10 levels were measured. The 89 enrolled patients with IBS and 13 healthy controls had no differences in baseline characteristics. The prevalence of SIBO in patients with IBS was higher than that in healthy controls (39% versus 8%, resp.; p = 0.026). Patients with IBS had higher anxiety, depression, and LES scores, but anxiety, depression, and LES scores were similar between the SIBO-positive and SIBO-negative groups. Psychological disorders were not associated with SIBO in patients with IBS. The serum IL-10 level was significantly lower in SIBO-positive than SIBO-negative patients with IBS. PMID:27379166

  8. Alteration of the intestinal microbiota as a cause of and a potential therapeutic option in irritable bowel syndrome.

    Science.gov (United States)

    König, J; Brummer, R J

    2014-09-01

    The intestinal microbiota forms a complex ecosystem that is in close contact with its host and has an important impact on health. An increasing number of disorders are associated with disturbances in this ecosystem. Also patients suffering from irritable bowel syndrome (IBS) show an altered composition of their gut microbiota. IBS is a multifactorial chronic disorder characterised by various abdominal complaints and a worldwide prevalence of 10-20%. Even though its aetiology and pathophysiology are complex and not well understood, it is widely accepted that aberrations along the microbe-gut-brain axis are involved. In this review, it will be discussed how exogenous factors, e.g. antibiotics, can cause disbalance in the intestinal microbiota and thereby contribute to the development of IBS. In addition, several new IBS treatment options that aim at re-establishing a healthy, beneficial ecosystem will be described. These include antibiotics, probiotics, prebiotics and faecal transplantation. PMID:24583610

  9. Long-term Clinical Course of Post-infectious Irritable Bowel Syndrome After Shigellosis: A 10-year Follow-up Study

    Science.gov (United States)

    Youn, Young Hoon; Kim, Hyeon Chang; Lim, Hyun Chul; Park, Jae Jun; Kim, Jie-Hyun; Park, Hyojin

    2016-01-01

    Background/Aims A limited number of studies are available regarding the long-term natural history of post-infectious irritable bowel syndrome (PI-IBS). We aimed to investigate the long-term clinical course of PI-IBS. Methods A prospective cohort study was conducted from a 2001 shigellosis outbreak in a Korean hospital with about 2000 employees. A cohort of 124 hospital employees who were infected by Shigella sonnei due to contaminated food in the cafeteria, and 105 sex- and age-matched, non-infected, controls were serially followed for their bowel symptoms by questionnaire surveys for 10 years. Results The Shigella-infected cohort showed significantly higher odds ratio for irritable bowel syndrome (IBS) at 1-year (11.90; 95% CI, 1.49–95.58) and 3-year (3.93; 95% CI, 1.20–12.86) follow-up, compared to their controls. However, corresponding odds ratio for PI-IBS was not significantly increased at 5-year (1.88; 95% CI, 0.64–5.54) and 8-year (1.87; 95% CI, 0.62–5.19) follow-up. At 10-year follow-up survey, the prevalence of IBS was similar for the Shigella-infected cohort and their controls (23.3% versus 19.7%, P = 0.703). Risk factors which were independently associated with PI-IBS among the Shigella-infected cohort included younger age, previous history of functional bowel disorder, and longer duration of diarrhea at baseline. Conclusions Patients who were infected by Shigella sonnei experienced significantly increased risk of IBS until 3 years after shigellosis, and modestly increased risk until 8 years, but showed similar risk of IBS with uninfected controls at 10 years post-infection. PI-IBS is quite a chronic disorder, and follows a long-term natural course. PMID:26908484

  10. Clinical Research of Irritable Bowel Syndrome Treated by Electroacupuncture on Tianshu(ST 25)

    Institute of Scientific and Technical Information of China (English)

    LIU Hui-rong; WU Huan-gan; WANG Xiao-long; ZUO Chuan-tao; GUAN Yi-hui; FANG Jian-qiao

    2007-01-01

    Objectives: By observing and evaluating the clinical curative effect systematically of electrical acupuncture (EA) on Tianshu (ST 25) on diarrhea-predominant irritable bowel syndrome (D-IBS), to make it benefit for the application and spread of EA on Tianshu (ST 25)on D-IBS. Methods: 103 D-IBS matched the involved standards were allocated into treatment group (EA on ST 25, n=53) and control group (EA on Daheng, SP 15, n=50) in randomized,controlled and single-blind ways. Curative effect differences were analyzed by Ridit analysis.Results: The incidence of diarrhea, abdominal pain, abdominal distention or abdominal discomfort, borborygmus, defecation urgency and defecation incompletion feeling were 100%,89.3%, 71.8%, 74.8%, 83.5% and 78.6% respectively in D-IBS. Generally, after treatment, 11cases got excellent results, 34 cases improved and 8 failed in treatment group, totally effective rate was 84.9%; while in control group, 4 cases got excellent effects, 26 improved and 20 failed,totally the effective rate was 60.0%. Conclusion: Compared with control group, EA on Tianshu (ST 25) has a better curative effect on D-IBS.

  11. The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review.

    Science.gov (United States)

    Heizer, William D; Southern, Susannah; McGovern, Susan

    2009-07-01

    This review summarizes what is known about the effect of diet on irritable bowel syndrome (IBS) symptoms emphasizing data from randomized, controlled clinical trials. Studies suggest that IBS symptoms in one quarter of patients may be caused or exacerbated by one or more dietary components. Recent studies indicate that a diet restricted in fermentable, poorly absorbed carbohydrates, including fructose, fructans (present in wheat and onions), sorbitol, and other sugar alcohols is beneficial, but confirmatory studies are needed. Despite a long history of enthusiastic use, fiber is marginally beneficial. Insoluble fiber may worsen symptoms. Some patients with IBS, especially those with constipation, will improve with increased intake of soluble fiber. Prebiotic fibers have not been adequately tested. Daily use of peppermint oil is effective in relieving IBS symptoms. The usefulness of probiotics in the form of foods such as live-culture yogurt and buttermilk for IBS symptoms is not established. In clinical practice, it is very difficult to establish that a patient's symptoms result from an adverse reaction to food. A double blind placebo-controlled food challenge is the most reliable method, but it is not suitable for routine clinical use. A modified exclusion diet and stepwise reintroduction of foods or trials of eliminating classes of food may be useful. PMID:19559137

  12. A review of the role of the gut microflora in irritable bowel syndrome and the effects of probiotics.

    Science.gov (United States)

    Madden, J A J; Hunter, J O

    2002-09-01

    Irritable bowel syndrome (IBS) is a multi-factorial gastrointestinal condition affecting 8-22 % of the population with a higher prevalence in women and accounting for 20-50 % of referrals to gastroenterology clinics. It is characterised by abdominal pain, excessive flatus, variable bowel habit and abdominal bloating for which there is no evidence of detectable organic disease. Suggested aetiologies include gut motility and psychological disorders, psychophysiological phenomena and colonic malfermentation. The faecal microflora in IBS has been shown to be abnormal with higher numbers of facultative organisms and low numbers of lactobacilli and bifidobacteria. Although there is no evidence of food allergy in IBS, food intolerance has been identified and exclusion diets are beneficial to many IBS patients. Food intolerance may be due to abnormal fermentation of food residues in the colon, as a result of disruption of the normal flora. The role of probiotics in IBS has not been clearly defined. Some studies have shown improvements in pain and flatulence in response to probiotic administration, whilst others have shown no symptomatic improvement. It is possible that the future role of probiotics in IBS will lie in prevention, rather than cure. PMID:12215182

  13. SEVERE SHORT-BOWEL SYNDROME AFTER TOTAL SMALL BOWEL RESECTION

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Extensive intestine resection may result in short bowel syndrome (SBS) which is difficult to manage. This study reports a rare SBS case in a 6-year-old boy following resection of total jujunoileum and right colon. Our experience in 4-years follow-up and literature reports on SBS is discussed. The purpose of this study was also to evaluate the nutritional absorptive capacity and intestinal adaptation. In the 15th postoperative month, barium x-ray study showed a significantly extended and enlarged duodenum and colon. The intestinal transit time was prolonged to 22 hours. The absorption rate of palmic acid, glycine and D-xylose had increased from 57%, 50% and 4% respectively in the 15th postoperative month, to 75%, 65% and 6% in the 2nd postoperative year. His absorptive capacity allowed him normal oral feeding and normal school life. Our data confirmed the reports of the colon as an energy-salvage organ, and suggested that it may have some capacity to absorb long-chain fatty acids and amino acids.

  14. Altered gastrointestinal microbiota in irritable bowel syndrome and its modification by diet: probiotics, prebiotics and the low FODMAP diet.

    Science.gov (United States)

    Staudacher, Heidi M; Whelan, Kevin

    2016-08-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder characterised by abdominal pain or discomfort with disordered defecation. This review describes the role of the gastrointestinal (GI) microbiota in the pathogenesis of IBS and how dietary strategies to manage symptoms impact on the microbial community. Evidence suggests a dysbiosis of the luminal and mucosal colonic microbiota in IBS, frequently characterised by a reduction in species of Bifidobacteria which has been associated with worse symptom profile. Probiotic supplementation trials suggest intentional modulation of the GI microbiota may be effective in treating IBS. A smaller number of prebiotic supplementation studies have also demonstrated effectiveness in IBS whilst increasing Bifidobacteria. In contrast, a novel method of managing IBS symptoms is the restriction of short-chain fermentable carbohydrates (low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet). Studies consistently demonstrate clinical effectiveness of the low FODMAP diet in patients with IBS. However, one unintentional consequence of this dietary intervention is its impact on the microbiota. This leads to an interesting paradox; namely, increasing luminal Bifidobacteria through probiotic supplementation is associated with a reduction in IBS symptoms while in direct conflict to this, the low FODMAP diet has clinical efficacy but markedly reduces luminal Bifidobacteria concentration. Given the multifactorial aetiology of IBS, the heterogeneity of symptoms and the complex and diverse nature of the microbiome, it is probable that both interventions are effective in patient subgroups. However combination treatment has never been explored and as such, presents an exciting opportunity for optimising clinical management, whilst preventing potentially deleterious effects on the GI microbiota. PMID:26908093

  15. TREATMENT OF DIARRHEA-PREDOMINANT IRRITABLE BOWEL SYNDROME WITH MESALAZINE AND/OR SACCHAROMYCES BOULARDII

    Directory of Open Access Journals (Sweden)

    Mauro BAFUTTO

    2013-12-01

    Full Text Available Context Irritable bowel syndrome (IBS is a functional bowel disease characterized by abdominal pain and altered intestinal habits. The pathophysiology of IBS remains unclear. Recent studies have demonstrated that some IBS patients, especially in diarrhea-predominant IBS (IBS-D, display persistent signs of minor mucosal inflammation and a modified intestinal microflora. The mesalazine has known intestinal anti-inflammatory properties. Saccharomyces boulardii is a probiotic used for a long time in treatment of diarrhea, including infectious diarrhea. Objective Evaluate the effects of mesalazine alone, combined therapy of mesalazine with liophylised Saccharomyces boulardii or alone on symptoms of IBS-D patients. Methods Based on Rome III criteria, 53 IBS-D patients (18 year or more were included. To exclude organic diseases all patients underwent colonoscopy, stool culture, serum anti-endomisium antibody, lactose tolerance test and ova and parasite exam. Patients were divided in three groups: mesalazine group (MG - 20 patients received mesalazine 800 mg t.i.d. for 30 days; mesalazine and Saccharomyces boulardii group (MSbG - 21 patients received mesalazine 800 mg t.i.d. and Saccharomyces boulardii 200 mg t.i.d. for 30 days and; Saccharomyces boulardii group (SbG – 12 patients received Sb 200 mg t.i.d. for 30 days. Drugs that might have any effect on intestinal motility or secretion were not allowed. Symptom evaluations at baseline and after treatment were performed by means of a 4-point likert scale including: stool frequency, stool form and consistency (Bristol scale, abdominal pain and distension. Paired t test and Kruskal-Wallis test were used for statistical analyses. Results Compared to baseline, there were statistically significant reduction of symptom score after 30 th day therapy in all three groups: MG (P<0.0001; MSbG (P<0.0001 and in SbG (P = 0.003. There were statistically significant differences in the symptom score at 30 th day

  16. Randomized,parallel-control and multi-centered research on venlafaxine sustained release tablet and pinaverium bromide in treating patients with diarrhea-predominant irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To observe the efficacy,adverse effects and the influence on the depression and anxiety scoringof combined venlafaxine sustained release tablet with pinaverium for treating patients with dominant-diarrhea irritable bowel syndrome (IBS-D) .Methods With randomized,parallel control,multi-center and opening study

  17. Relationship between cognitive appraisals of symptoms and negative mood for subtypes of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Nomura Shinobu

    2008-04-01

    Full Text Available Abstract Background The onset and course of irritable bowel syndrome (IBS are strongly influenced by psychological factors, and treatment often includes cognitive-behavioral therapy. We conducted a study of the relationships between cognitive appraisal of IBS symptoms and negative mood for the subtypes of IBS. Method The participants were 1087 college students who completed a set of questionnaires that included the Rome II Modular Questionnaire, Self-reported IBS Questionnaire, Cognitive Appraisal Rating Scale, and the Hospital Anxiety and Depression Scale. Results The participants included 206 individuals with IBS; 61 had diarrhea-predominant IBS (IBSD and 45 had constipation-predominant IBS (IBSC. The overall IBS group scored higher on anxiety and depression than the control group. The IBSD and IBSC groups each had significantly higher scores for anxiety but did not significantly differ from the control group in scores for depression. There were no significant differences between the IBSD and IBSC groups in their cognitive appraisal of IBS symptoms. For the IBSD group, anxiety was significantly, positively correlated with commitment, effect, and threat, and depression was significantly, negatively correlated with controllability. In contrast, there were no significant correlations between mood and cognitive appraisal for the IBSC group. Multiple regression analyses with abdominal symptoms as dependent variables and cognitive appraisals as independent variables showed that for the IBSD group, abdominal pain was significantly, positively correlated with commitment, and abdominal discomfort was significantly, positively correlated with appraisal of effect and threat. For the IBSC group, abdominal pain and hard stool were significantly, positively correlated with commitment, and abdominal discomfort was significantly, positively correlated with appraisal of effect and threat. Conclusion IBS patients as a general group report high levels of anxiety

  18. Improved Health-Related Quality of Life After Surgical Management of Severe Refractory Constipation-Dominant Irritable Bowel Syndrome

    OpenAIRE

    Lam, Jennifer Y.; Kidane, Biniam; Manji, Farouq; Taylor, Brian M.

    2015-01-01

    Irritable bowel syndrome (IBS) is the most common of the functional gastrointestinal disorders (FGIDs). Despite its prevalence and health-care costs, there are few effective therapies for patients with severe symptoms. Our objective was to determine whether surgical management would improve health-related quality of life (HRQOL) in severe refractory constipation-dominant FGIDs. From 2003 to 2005, 6 patients underwent total colectomy with end ileostomy or primary anastomosis. They completed Sh...

  19. Effect of Electroacupuncture on Visceral Hyperalgesia, Serotonin and Fos Expression in an Animal Model of Irritable Bowel Syndrome

    OpenAIRE

    Wu, Justin CY; Ziea, Eric TC; Lao, Lixing; Lam, Emma FC; Chan, Catherine SM; Liang, Angela YQ; Chu, Sunny LH; Yew, David TW; Berman, Brian M; Sung, Joseph JY

    2010-01-01

    Background/Aims While it is well established that acupuncture relieves somatic pain, its therapeutic effect on visceral pain such as irritable bowel syndrome (IBS) is unclear. We evaluated the effect of acupuncture in treating visceral hyperalgesia in an animal model. Methods Sprague-Dawley rats (n = 8 per group) with prior neonatal maternal separation stress were randomly allocated to receive 3-day treatment of either electroacupuncture (EA) or sham acupuncture at acupoint ST-36. Another gro...

  20. Long-term efficacy and safety of ramosetron in the treatment of diarrhea-predominant irritable bowel syndrome

    OpenAIRE

    Chiba, Toshimi; Yamamoto, Kazunari; Sato, Shoko; Suzuki, Kazuyuki

    2013-01-01

    Irritable bowel syndrome (IBS) is a functional disease with persisting gastrointestinal symptoms that has been classified into four subtypes. Serotonin (5-hydroxytryptamine [5-HT]) plays important physiological roles in the contraction and relaxation of smooth muscle. Intraluminal distension of the intestine is known to stimulate the release of endogenous 5-HT from enterochromaffin cells, activating 5-HT3 receptors located on primary afferent neurons and leading to increases in intestinal sec...

  1. Differentiating Coeliac Disease from Irritable Bowel Syndrome by Urinary Volatile Organic Compound Analysis – A Pilot Study

    OpenAIRE

    Ramesh P Arasaradnam; Eric Westenbrink; Michael J McFarlane; Ruth Harbord; Samantha Chambers; Nicola O'Connell; Catherine Bailey; Chuka U. Nwokolo; Bardhan, Karna D.; Richard Savage; James A. Covington

    2014-01-01

    Coeliac disease (CD), a T-cell-mediated gluten sensitive enteropathy, affects ∼ 1% of the UK population and can present with wide ranging clinical features, often being mistaken for Irritable Bowel Syndrome (IBS). Heightened clinical awareness and serological screening identifies those with potential coeliac disease; the diagnosis is confirmed with duodenal biopsies, and symptom improvement with a gluten-free diet. Limitations to diagnosis are false negative serology and reluctance to undergo...

  2. Pembrolizumab in Treating Patients With Relapsed or Refractory Stage IB-IVB Mycosis Fungoides or Sezary Syndrome

    Science.gov (United States)

    2016-07-29

    Recurrent Mycosis Fungoides and Sezary Syndrome; Stage IB Mycosis Fungoides and Sezary Syndrome; Stage IIA Mycosis Fungoides and Sezary Syndrome; Stage IIB Mycosis Fungoides and Sezary Syndrome; Stage IIIA Mycosis Fungoides and Sezary Syndrome; Stage IIIB Mycosis Fungoides and Sezary Syndrome; Stage IVA Mycosis Fungoides and Sezary Syndrome; Stage IVB Mycosis Fungoides and Sezary Syndrome

  3. Meta-analysis of probiotics for the treatment of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Lynne V McFarland; Sascha Dublin

    2008-01-01

    Irritable bowel syndrome (IBS) is a chronic condition affecting 3%-25% of the general population.As no curative treatment is available,therapy is aimed at reducing symptoms,often with little success.Because alteration of the normal intestinal microflora has been observed in IBS,probiotics (beneficial microbes taken to improve health) may be useful in reducing symptoms.This paper systematically reviews randomized,controlled,blinded trials of probiotics for the treatment of IBS and synthesizes data on efficacy across trials of adequate quality.PubMed,Medline,Google Scholar,NIH registry of clinical trials,metaRegister,and the Cochrane Central Register of Controlled Trials were searched from 1982-2007.We also conducted secondary searches of reference lists,reviews,commentaries,relevant articles on associated diseases,books and meeting abstracts.Twenty trials with 23 probiotic treatment arms and a total of 1404 subjects met inclusion criteria.Probiotic use was associated with improvement in global IBS symptoms compared to placebo [pooled relative risk (RRpooled) 0.77,95% confidence interval (95% CI) 0.62-0.94].Probiotics were also associated with less abdominal pain compared to placebo [RRpooled=0.78 (0.69-0.88)].Too few studies reported data on other IBS symptoms or on specific probiotic strains to allow estimation of a pooled RR.While our analyses suggest that probiotic use may be associated with improvement in IBS symptoms compared to placebo,these results should be interpreted with caution,given the methodological limitations of contributing studies.Probiotics warrant further study as a potential therapy for IBS.

  4. Aspects of the non-pharmacological treatment of irritable bowel syndrome.

    Science.gov (United States)

    Eriksson, Elsa Maria; Andrén, Kristina Ingrid; Kurlberg, Göran Karl; Eriksson, Henry Ture

    2015-10-28

    Irritable bowel syndrome (IBS) is one of the most commonly diagnosed gastrointestinal conditions. It represents a significant healthcare burden and remains a clinical challenge. Over the years IBS has been described from a variety of different perspectives; from a strict illness of the gastrointestinal tract (medical model) to a more complex multi-symptomatic disorder of the brain-gut axis (biopsychosocial/psychosomatic model). In this article we present aspects of the pathophysiology and the non-pharmacological treatment of IBS based on current knowledge. Effects of conditioned stress and/or traumatic influences on the emotional system (top-down) as well as effects on the intestine through stressors, infection, inflammation, food and dysbiosis (bottom-up) can affect brain-gut communication and result in dysregulation of the autonomic nervous system (ANS), playing an important role in the pathophysiology of IBS. Conditioned stress together with dysregulation of the autonomic nervous system and the emotional system may involve reactions in which the distress inside the body is not recognized due to low body awareness. This may explain why patients have difficulty identifying their symptoms despite dysfunction in muscle tension, movement patterns, and posture and biochemical functions in addition to gastrointestinal symptoms. IBS shares many features with other idiopathic conditions, such as fibromyalgia, chronic fatigue syndrome and somatoform disorders. The key to effective treatment is a thorough examination, including a gastroenterological examination to exclude other diseases along with an assessment of body awareness by a body-mind therapist. The literature suggests that early interdisciplinary diagnostic co-operation between gastroenterologists and body-mind therapists is necessary. Re-establishing balance in the ANS is an important component of IBS treatment. This article discusses the current knowledge of body-mind treatment, addressing the topic from a

  5. Aspects of the non-pharmacological treatment of irritable bowel syndrome.

    Science.gov (United States)

    Eriksson, Elsa Maria; Andrén, Kristina Ingrid; Kurlberg, Göran Karl; Eriksson, Henry Ture

    2015-10-28

    Irritable bowel syndrome (IBS) is one of the most commonly diagnosed gastrointestinal conditions. It represents a significant healthcare burden and remains a clinical challenge. Over the years IBS has been described from a variety of different perspectives; from a strict illness of the gastrointestinal tract (medical model) to a more complex multi-symptomatic disorder of the brain-gut axis (biopsychosocial/psychosomatic model). In this article we present aspects of the pathophysiology and the non-pharmacological treatment of IBS based on current knowledge. Effects of conditioned stress and/or traumatic influences on the emotional system (top-down) as well as effects on the intestine through stressors, infection, inflammation, food and dysbiosis (bottom-up) can affect brain-gut communication and result in dysregulation of the autonomic nervous system (ANS), playing an important role in the pathophysiology of IBS. Conditioned stress together with dysregulation of the autonomic nervous system and the emotional system may involve reactions in which the distress inside the body is not recognized due to low body awareness. This may explain why patients have difficulty identifying their symptoms despite dysfunction in muscle tension, movement patterns, and posture and biochemical functions in addition to gastrointestinal symptoms. IBS shares many features with other idiopathic conditions, such as fibromyalgia, chronic fatigue syndrome and somatoform disorders. The key to effective treatment is a thorough examination, including a gastroenterological examination to exclude other diseases along with an assessment of body awareness by a body-mind therapist. The literature suggests that early interdisciplinary diagnostic co-operation between gastroenterologists and body-mind therapists is necessary. Re-establishing balance in the ANS is an important component of IBS treatment. This article discusses the current knowledge of body-mind treatment, addressing the topic from a

  6. Auricular-Plaster Therapy for Treatment of IBS

    Institute of Scientific and Technical Information of China (English)

    敖学艳; 王宁

    2004-01-01

    @@ Irritable bowel syndrome (IBS), a disease of the digestive system related to mental factors, is clinically characterized by diarrhea (or alternation of diarrhea and constipation) and abdominal pain. In recent years, the authors have used auricular-plaster therapy plus pressing on the back-shu points to treat IBS, and obtained good therapeutic results.

  7. IRRITABLE BOWEL SYNDROME: Relationships with Abuse in Childhood

    OpenAIRE

    Sansone, Randy A.; Sansone, Lori A.

    2015-01-01

    Irritable bowel syndrome is allegedly the most common gastrointestinal diagnosis in the United States. The etiology of this syndrome appears to entail the interaction of both genes and the environment. One potential environmental contributory factor to irritable bowel syndrome is abuse in childhood. Of the various forms of abuses previously examined, sexual abuse in childhood appears to be the most patent contributor. However, both emotional and physical abuses may also contribute to irritabl...

  8. Effect of TongXie-YaoFang on Cl− and HCO3- Transport in Diarrhea-Predominant Irritable Bowel Syndrome Rats

    OpenAIRE

    Lu, Xiaofang; Zhang, Shengsheng; Yang, Cheng; Wang, Zhengfang; Zhao, Luqing; Wu, Zhenyu,; Xie, Jing

    2016-01-01

    TongXie-YaoFang (TXYF) can effectively alleviate the symptoms of diarrhea-predominant irritable bowel syndrome (D-IBS) patients. However, the curative mechanism has not been fully clarified. The study was designed to investigate the effect of TXYF on the colonic ion transport induced by serotonin (5-HT) in D-IBS rats. A method of multiple stress (neonatal maternal separation (NMS) combined with restraint stress (RS)) was used to induce the D-IBS model. The model rats were randomly divided int...

  9. Are Food Constituents Relevant to the Irritable Bowel Syndrome in Young Adults? - A Rome III Based Prevalence Study of the Korean Medical Students

    OpenAIRE

    Jung, Hyun Joo; Park, Moo In; Moon, Won; Park, Seun Ja; Kim, Hyung Hun; Noh, Eun Ji; Lee, Gyu Jin; Kim, Joo Hoon; Kim, Dong Gyu

    2011-01-01

    Background/Aims Irritable bowel syndrome (IBS) is prevalent in general population. This study investigates the prevalence of IBS in medical college students in Korea as well as the influence of dietary habits and nutritional intake on IBS. Methods This study is a cross-sectional study of 319 students (239 males and 80 females, age 22.3 ± 2.5 years) from the 6 grade levels of the Medical College in Korea. All students filled out a self-reported questionnaire for ROME III criteria. They also co...

  10. The relationship between the val158met catechol-O-methyltransferase (COMT polymorphism and irritable bowel syndrome.

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    Pontus Karling

    Full Text Available BACKGROUND: The catechol-O-methyltransferase (COMT enzyme has a key function in the degradation of catecholamines and a functional polymorphism is val158met. The val/val genotype results in a three to fourfold higher enzymatic activity compared with the met/met genotype, with the val/met genotype exhibiting intermediate activity. Since pain syndromes as well as anxiety and depression are associated to low and high COMT activity respectively and these conditions are all associated with irritable bowel syndrome (IBS we wanted for the first time to explore the relationship between the polymorphism and IBS. METHODOLOGY/PRINCIPAL FINDINGS: 867 subjects (445 women representative of the general population and 70 consecutively sampled patients with IBS (61 women were genotyped for the val158met polymorphism and the IBS patients filled out the Hospital-Anxiety-and-Depression-Scale (HADS questionnaire, and an IBS symptom diary. RESULTS: There was a significantly higher occurrence of the val/val genotype in patients compared with controls (30% vs 20%; Chi(2 (1 3.98; p = 0.046 and a trend toward a lower occurrence of the val/met genotype in IBS patients compared with controls (39% vs 49%; Chi(2 (1 2.89; p = 0.089. Within the IBS patients the val/val carriers exhibited significantly increased bowel frequency (2.6 vs 1.8 stools per day; Chi(2 (1 5.3; p = 0.03 and a smaller proportion of stools with incomplete defecation (41% vs 68%; Chi(2 (1 4.3; p = 0.04 compared with the rest (val/met+met/met carriers. The val/val carriers also showed a trend for a smaller proportion of hard stools (0% vs 15%; Chi(2 (1 3.2; p = 0.08 and a higher frequency of postprandial defecation (26% vs 21%; Chi(2 (1 3.0; p = 0.08. CONCLUSIONS/SIGNIFICANCE: In this study we found an association between the val/val genotype of the val158met COMT gene and IBS as well as to specific IBS related bowel pattern in IBS patients.

  11. [A feasibility analysis on individualized acupuncture treatment of irritable bowel syndrome under help of genetic polymorphism technique].

    Science.gov (United States)

    Wu, Xiao-Liang; Sun, Jian-Hua; Liu, Lan-Ying; Fu, Hai-Yang; Jiao, Dai-Yan; Shu, Yan-Ye; Chen, Dong; Liu, Cheng-Yong; Zhan, Dao-Wei; Zhang, Wei

    2014-06-01

    Along with the application of genetic polymorphism techniques to individualized treatment of clinical disorders, the screening of polymorphisms markers of serotonin (5-HT) transporter (SERT) is a hot-spot of researches on irritable bowel syndrome (IBS). In the present paper, the authors introduce 1) optimized schemes of diagnosis and treatment of IBS on the basis of syndrome-differentiation for acupuncture in combination with Chinese herbal medicines, and application of 5-HT transporter polymorphism, 2) application of genetic polymorphism to researches on IBS, and 3) feasibility of genetic polymorphism techniques for guiding individualized treatment of IBS. Up to now, serotonin transporter length polymorphic region (5-HTTLPR), serotonin transporter intron 2 variable number of tandem repeat (Stin 2 VNTR) and single nucleotide polymorphism rs 25531 in the long allele of the 5-HTTLPR have been identified. On the basis of the treatment of IBS, we need establishing a set of guide lines for the individualized acupuncture treatment. The genotyping methods for genetic polymorphism should be widely used in this research field. 5-HT TLPR/ Stin 2 VNTR/rs 25531 polymorphisms would have a bright future in the field of IBS research and treatment.

  12. Small intestinal bacterial overgrowth in irritable bowel syndrome: are there any predictors?

    Directory of Open Access Journals (Sweden)

    McCallum Richard W

    2010-02-01

    Full Text Available Abstract Background Small intestinal bacterial overgrowth (SIBO is a condition in which excessive levels of bacteria, mainly the colonic-type species are present in the small intestine. Recent data suggest that SIBO may contribute to the pathophysiology of Irritable bowel syndrome (IBS. The purpose of this study was to identify potential predictors of SIBO in patients with IBS. Methods Adults with IBS based on Rome II criteria who had predominance of bloating and flatulence underwent a glucose breath test (GBT to determine the presence of SIBO. Breath samples were obtained at baseline and at 30, 45, 60, 75 and 90 minutes after ingestion of 50 g of glucose dissolved in 150 mL of water. Results of the glucose breath test, which measures hydrogen and methane levels in the breath, were considered positive for SIBO if 1 the hydrogen or methane peak was >20 ppm when the baseline was Results Ninety-eight patients were identified who underwent a GBT (mean age, 49 y; 78% female. Thirty-five patients (36% had a positive GBT result suggestive of SIBO. A positive GBT result was more likely in patients >55 years of age (odds ratio [OR], 3.6; 95% confidence interval [CI], 1.4-9.0 and in females (OR, 4.0; 95% CI, 1.1-14.5. Hydrogen was detected more frequently in patients with diarrhea-predominant IBS (OR, 8; 95% CI, 1.4-45, and methane was the main gas detected in patients with constipation-predominant IBS (OR, 8; 95% CI, 1.3-44. There was no significant correlation between the presence of SIBO and the predominant bowel pattern or concurrent use of tegaserod, proton pump inhibitors, or opiate analgesics. Conclusions Small intestinal bacterial overgrowth was present in a sizeable percentage of patients with IBS with predominance of bloating and flatulence. Older age and female sex were predictors of SIBO in patients with IBS. Identification of possible predictors of SIBO in patients with IBS could aid in the development of successful treatment plans.

  13. Effect of herbal extract granules combined with probiotic mixture on irritable bowel syndrome with diarrhea: study protocol for a randomized controlled trial

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    Lee Beom-Joon

    2011-10-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS is a chronic gastrointestinal disorder characterized by abdominal pain and change of bowel habits without organic disease. Many patients seek alternative IBS treatments because of the limitations of conventional treatments. Gwakhyangjeonggisan (GJS, a herbal formula, has long been used for alleviating diarrhea-predominant IBS (D-IBS in traditional medicine. Duolac7S, which comprises 7 bacterial species as probiotics, has been frequently used for D-IBS. Although GJS and Duolac7S have been administered simultaneously in many D-IBS patients, no study has investigated the effects of GJS and Duolac7S combination therapy on D-IBS. Methods/Design The current trial is a randomized, double-blinded, placebo-controlled, 4-arm study. After a 2-week run-in period, 60 patients with D-IBS will be randomly assigned to one of the 4 combination groups consisting of GJS (water extract granules, 3 g/pack, 3 times a day with Duolac7S (powder form, 1 capsule, 2 times a day or their placebos and followed up for 2 weeks. The assigned treatments will last for 8 weeks. The primary outcomes are adequate relief of IBS pain and discomfort and the proportion of responders (on a weekly basis. The secondary outcomes are visual analog scale for IBS symptoms (on a daily basis, quality of life (at 0, 8, and 10 weeks, intestinal permeability, and composition of intestinal microbiota (at 0 and 8 weeks. Discussion The present study is designed to examine the safety and efficacy of GJS and Duolac7S combination therapy on D-IBS. Our study provides the clinical evidence of a new therapeutic strategy for D-IBS. Trial registration ClinicalTrials.gov NCT01342718.

  14. A meta-analysis and systematic review of the comorbidity between irritable bowel syndrome and bipolar disorder.

    Science.gov (United States)

    Tseng, Ping-Tao; Zeng, Bing-Syuan; Chen, Yen-Wen; Wu, Ming-Kung; Wu, Ching-Kuan; Lin, Pao-Yen

    2016-08-01

    Irritable bowel syndrome (IBS) and bipolar disorder (BD) are 2 distinct diseases but may share a similar pathophysiology. However, the comorbidity rate of these 2 diseases is unclear. Also, the current practice guidelines suggest prescribing antidepressants to IBS patients. However, this practice may increase the risk of phase-shift to manic episodes in IBS patients comorbid with BD.This study aimed to determine the relationship between IBS and BD through a meta-analysis.Electronic research through PubMed, Medline, ScienceDirect online, ClinicalTrials.gov, and additional resources.The inclusion criteria were studies investigating the prevalence rate of BD in subjects with IBS and control subjects; and articles on clinical trials on humans.Data from included studies were pooled by a random effects model, and possible confounding variables were examined by meta-regression and subgroup analysis.The current study consists of a total of 177,117 IBS patients and 192,092 control subjects extracted from 6 included studies. The prevalence rate of BD was significantly higher in the IBS patients than in the controls (odds ratio = 2.48, 95% confidence interval: 2.35-2.61, P < 0.001). However, the significance persists only in studies from database research, but not from primary studies. In addition, there was no significant association between the prevalence rate of BD in IBS and several clinical variables, including age, female proportion, prevalence of comorbid diabetes, or hypertension.The total number of included studies is small. Moreover, apparently different results from database research and primary research limit the generalization of our findings to a broad population. Also, we could only perform meta-regression on limited clinical variables.Our results support a significantly higher prevalence rate of BD in IBS patients than in controls. Clinicians should be cautious about the risk of phase-shift to manic episodes when prescribing antidepressants in IBS patients

  15. Neurobiology of Depression and Irritable Bowel Syndrome Comorbidity

    Directory of Open Access Journals (Sweden)

    Ozlem Donat Eker

    2009-08-01

    Full Text Available Irritable bowel syndrome is a disabling functional disorder with a frequent comorbidity of depression though underlying mechanisms remain yet little understood. Various signs and symptoms have been determined as diagnostic criteria in recent years and standardized as Rome-III criteria. Irritable bowel syndrome can have constipation-dominant, diarrhea-dominant or mixed clinical presentations. Main features can be summarized as continuous and recurrent abdominal pain or discomfort associated with a change of stool frequency or consistency and usually relief of symptoms with defe-cation in the absence of physical or laboratory abnormalities indicative of an organic etiology. The frequency of major depressive disorder diagnosis reaches up to two thirds of irritable bowel syndrome patients. Moreover, the comorbidity of irritable bowel syndrome among patients with major depression is highly frequent (30%. The mechanism underlying irritable bowel syndrome which have been considered as a kind of a somatization disorder for a long time and now as a functional bowel disease is in the brain-gut axis. Low grade mucosal inflammation and cytokines originating from mucosal inflammation have important functions in the pathophysiology of irritable bowel syndrome and its comorbidity with major depression. Besides the inflammatory factors lumbosacral visceral hyperexcitability which is an individual variation is proposed as the main underlying cause of irritable bowel syndrome. Visceral hyper-excitability is mediated by cytokines and neuro-mediators and stress is known to increase the effect of this mechanism. Furthermore, molecules participating in this mechanism (e.g. cytokines, corticotrophin releasing factor, neurokinins and monoamines play important roles in the pathophysiology of depression. Increased activation in the pain matrix (thalamus – insula – prefrontal cortex and insufficiency of endogenous pain inhibitory system are regarded as possible

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

    NARCIS (Netherlands)

    J.F. Olieman

    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 p

  17. Jejunitis and brown bowel syndrome with multifocal carcinogenesis of the small bowel.

    Science.gov (United States)

    Raithel, Martin; Rau, Tilman T; Hagel, Alexander F; Albrecht, Heinz; de Rossi, Thomas; Kirchner, Thomas; Hahn, Eckhart G

    2015-09-28

    This is the first report describing a case where prolonged, severe malabsorption from brown bowel syndrome progressed to multifocally spread small bowel adenocarcinoma. This case involves a female patient who was initially diagnosed with chronic jejunitis associated with primary diffuse lymphangiectasia at the age of 26 years. The course of the disease was clinically, endoscopically, and histologically followed for 21 years until her death at the age 47 due to multifocal, metastasizing adenocarcinoma of the small bowel. Multiple lipofuscin deposits (so-called brown bowel syndrome) and severe jejunitis were observed microscopically, and sections of the small bowel showed dense lymphoplasmacytic infiltration of the lamina propria as well as blocked lymphatic vessels. After several decades, multifocal nests of adenocarcinoma cells and extensive, flat, neoplastic mucosal proliferations were found only in the small bowel, along with a loss of the mismatch repair protein MLH1 as a long-term consequence of chronic jejunitis with malabsorption. No evidence was found for hereditary nonpolyposis colon carcinoma syndrome. This article demonstrates for the first time multifocal carcinogenesis in the small bowel in a malabsorption syndrome in an enteritis-dysplasia-carcinoma sequence. PMID:26420973

  18. IRRITABLE BOWEL SYNDROME: Relationships with Abuse in Childhood.

    Science.gov (United States)

    Sansone, Randy A; Sansone, Lori A

    2015-01-01

    Irritable bowel syndrome is allegedly the most common gastrointestinal diagnosis in the United States. The etiology of this syndrome appears to entail the interaction of both genes and the environment. One potential environmental contributory factor to irritable bowel syndrome is abuse in childhood. Of the various forms of abuses previously examined, sexual abuse in childhood appears to be the most patent contributor. However, both emotional and physical abuses may also contribute to irritable bowel syndrome, although less distinctly. Studies examining a combined childhood-abuse variable (i.e., sexual, emotional, and/or physical abuses) in relationship to irritable bowel syndrome also indicate inconsistent results. Given the presence of childhood abuse as a potential factor in the development of irritable bowel syndrome, a number of pathophysiological events are postulated to explain this relationship, including alterations in norepinephrine and serotonin levels as well as dysregulation of the hypothalamic-pituitary-adrenal axis. Only future research will clarify the specific abuse elements (i.e., further clarification of the individual types of abuse, duration of abuse, roles of the perpetrator/victim) and the pathophysiological changes that culminate in irritable bowel syndrome. PMID:26155376

  19. 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.

  20. The low-FODMAP diet for irritable bowel syndrome: Lights and shadows.

    Science.gov (United States)

    Molina-Infante, Javier; Serra, Jordi; Fernandez-Bañares, Fernando; Mearin, Fermín

    2016-02-01

    Irritable bowel syndrome (IBS) affects 10-15% of the western population. Drug therapy for this entity has shown limited efficacy. The low Fermentable Oligo-, Di-, Monosaccharides And Polyols (FODMAP) diet has recently emerged as an effective intervention for reducing gastrointestinal symptoms in IBS. Currently, several mechanistic studies have proven the rational basis of carbohydrate restriction. In addition, high-quality evidence (prospective studies and randomized controlled trials) from a variety of countries supports the high effectiveness of a low-FODMAP diet for IBS symptoms (70%), especially abdominal bloating, pain, and diarrhea. Importantly, this diet seems to be superior to a gluten-free diet for patients with non-celiac gluten sensitivity. The most controversial features of the low FODMAP diet are its short- and long-term limitations (a high level of restriction, the need for monitoring by an expert dietitian, potential nutritional deficiencies, significant gut microbiota reduction, lack of predictors of response), as well as the potential lack of advantage over alternative dietary, pharmacological and psychological interventions for IBS. Although liberalization of carbohydrate intake is recommended in the long-term, the reintroduction process remains to be clarified as, theoretically, global carbohydrate restriction is deemed to be necessary to avoid additive effects. PMID:26548734

  1. Catechol-O-methyltransferase val158met polymorphism predicts placebo effect in irritable bowel syndrome.

    Directory of Open Access Journals (Sweden)

    Kathryn T Hall

    Full Text Available Identifying patients who are potential placebo responders has major implications for clinical practice and trial design. Catechol-O-methyltransferase (COMT, an important enzyme in dopamine catabolism plays a key role in processes associated with the placebo effect such as reward, pain, memory and learning. We hypothesized that the COMT functional val158met polymorphism, was a predictor of placebo effects and tested our hypothesis in a subset of 104 patients from a previously reported randomized controlled trial in irritable bowel syndrome (IBS. The three treatment arms from this study were: no-treatment ("waitlist", placebo treatment alone ("limited" and, placebo treatment "augmented" with a supportive patient-health care provider interaction. The primary outcome measure was change from baseline in IBS-Symptom Severity Scale (IBS-SSS after three weeks of treatment. In a regression model, the number of methionine alleles in COMT val158met was linearly related to placebo response as measured by changes in IBS-SSS (p = .035. The strongest placebo response occurred in met/met homozygotes treated in the augmented placebo arm. A smaller met/met associated effect was observed with limited placebo treatment and there was no effect in the waitlist control. These data support our hypothesis that the COMT val158met polymorphism is a potential biomarker of placebo response.

  2. Interventional Mechanism of Tongxieyao Formula on Irritable Bowel Syndrome due to Liver Depression and Spleen Deficiency

    Directory of Open Access Journals (Sweden)

    Feng Qian

    2013-09-01

    Full Text Available Objective: To investigate the efficacy and interventional mechanism of Tongxieyao Formula (TXYF on rat model with irritable bowel syndrome (IBS due to liver depression and spleen deficiency. Methods: 75 newborn SD rats were randomly divided into groups A, B, C, D and E. Except group A, the rats in other groups were treated with senna and strained stress to establish IBS models due to liver depression and spleen deficiency. Groups A and B were fed with intra-gastric normal saline, group C pinaverium bromide, groups D and E TXYF. After treatment, animals were sacrificed to excise colons, and modified toluidine blue staining was applied to observe the changes of colonic mucosal mast cell (MC count and de-granulation conditions in rats. Then the levels of 5-hydroxytryptamine (5-HT, P substance (SP, calcitonin gene-related peptide (CGRP in blood samples were detected. Results: The counts of colonic mucosal MC and de-granulation increased significantly in model control group. The levels of 5-HT, SP significantly decreased while CGRP increased in C, D and group Es. Conclusion: TXYF can play its role of improving gastrointestinal mobility and reduce visceral sensitivity so as to treat IBS through reducing the counts of colonic mucosal MC and degranulation as well as the levels of serum 5-HT and plasma SP, and increasing the level of CGRP in IBS model rats.

  3. Corticotropin-Releasing Factor and Toll-Like Receptor Gene Expression Is Associated with Low-Grade Inflammation in Irritable Bowel Syndrome Patients with Depression

    Science.gov (United States)

    Jizhong, Song; Qiaomin, Wang; Chao, Wang

    2016-01-01

    The mechanism of low-grade inflammation in irritable bowel syndrome (IBS) is unclear; our research concentrates on the involvement of the corticotropin-releasing factor (CRF) and Toll-like receptor (TLR) gene expression in the process of low-grade inflammation in IBS patients with depression. This study suggests more IBS patients are presenting with the states of depression and anxiety. IBS patients with depression have shown a lower grade inflammatory response and an imbalance of the inflammatory response. CRF1, CRF2, TLR2, and TLR4 in IBS patients with depression are significantly higher than those without depression and controls. Thus, activation of the CRF-TLR associated pathways produces an inflammatory reaction, which can concurrently affect the digestive tract and the CNS and induce the corresponding digestive and psychiatric symptoms.

  4. Do published guidelines for evaluation of Irritable Bowel Syndrome reflect practice?

    Directory of Open Access Journals (Sweden)

    Bertram Susan L

    2001-10-01

    Full Text Available Abstract Background The only US guidelines listed in the National Guideline Warehouse for the diagnosis of Irritable Bowel Syndrome (IBS are the expert opinion guidelines published by The American Gastroenterology Association. Although the listed target audience of these guidelines includes family physicians and general internists, the care recommended in the guidelines has not been compared to actual primary care practice. This study was designed to compare expert opinion guidelines with the actual primary care provided and to assess outcomes in the 3 years following the IBS diagnosis. Methods This is a retrospective medical record review study using a random sample of incident IBS cases from all Olmsted County, Minnesota providers diagnosed between January 1, 1993 and December 31, 1995. Data was collected on all care and testing provided to the subjects as well as 3-year outcomes related to the IBS diagnosis. Results Of the 149 IBS patients, 99 were women and the mean age was 47.6 years. No patient had all of the diagnostic tests recommended in the guidelines. 42% had the basic blood tests of CBC and a chemistry panel. Sedimentation rate (2% and serum thyroxine level (3% were uncommon. Colon imaging studies were done in 41% including 74% of those over the age of 50. In the 3 years following the diagnosis, only one person had a change in diagnosis and no diagnoses of gastro-intestinal malignancies were made in the cohort. Conclusions Primary care practice based diagnostic evaluations for IBS differ significantly from the specialty expert opinion-based guidelines. Implementation of the specialty guidelines in primary care practice would increase utilization with apparent limited improvement in diagnostic outcomes.

  5. A focus group assessment of patient perspectives on irritable bowel syndrome and illness severity.

    Science.gov (United States)

    Drossman, Douglas A; Chang, Lin; Schneck, Susan; Blackman, Carlar; Norton, William F; Norton, Nancy J

    2009-07-01

    There is a growing need to understand from the patient's perspective the experience of irritable bowel syndrome (IBS) and the factors contributing to its severity; this has been endorsed by the Food and Drug Administration (FDA). Accordingly, we conducted focus groups to address this issue. A total of 32 patients with mostly moderate to severe IBS were recruited through advertising and were allocated into three focus groups based on predominant stool pattern. The focus groups were held using standard methodology to obtain a general assessment of the symptoms experienced with IBS, its impact, and of factors associated with self-perceived severity. Patients described IBS not only as symptoms (predominantly abdominal pain) but mainly as it affects daily function, thoughts, feelings and behaviors. Common responses included uncertainty and unpredictability with loss of freedom, spontaneity and social contacts, as well as feelings of fearfulness, shame, and embarrassment. This could lead to behavioral responses including avoidance of activities and many adaptations in routine in an effort for patients to gain control. A predominant theme was a sense of stigma experienced because of a lack of understanding by family, friends and physicians of the effects of IBS on the individual, or the legitimacy of the individual's emotions and adaptation behaviors experienced. This was a barrier to normal functioning that could be ameliorated through identifying with others who could understand this situation. Severity was linked to health-related quality of life (HRQOL) and was influenced by the intensity of abdominal pain and other symptoms, interference with and restrictions relating to eating, work, and social activities, and of the unpredictability of the condition. This study confirms the heterogeneous and multi-component nature of IBS. These qualitative data can be used in developing health status and severity instruments for larger-scale studies. PMID:19337833

  6. Expression and role of 5-HT7 receptor in brain and intestine in rats with irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    ZOU Bai-cang; DONG Lei; WANG Yan; WANG Sheng-hao; CAO Ming-bo

    2007-01-01

    Background The 5-hydroxytryptamine7 receptor(5-HT7 receptor,5-HT7R) 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-HT7 receptor in the pathogenesis of lBS.Methods 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℃ 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-HT7 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.Results 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<0.05),as well as more than were found in the IBS-C group in jejunum and ileum(P<0.05).There were more 5-HT positive cells in the IBS-C group than in the control hippocampus,hypothalamus,ileum,proximate colon,and distal colon(P<0.05).Real time-PCR results showed that the expression level of the 5-HT7 receptor in both the IBS-C and IBS-D groups were enhanced compared with the control group in the hippocampus and hypothalamus(P<0.05).The expression level of 5-HT7 receptors in the IBS-C group was notably greater when compared with the controls in the ileum and colon (P<0.05).The cAMP accumulation in the hippocampus and hypothalamus in both the IBS-C and IBS-D groups was

  7. 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.

  8. A Positive Diagnostic Strategy Is Noninferior to a Strategy of Exclusion for Patients With Irritable Bowel Syndrome

    DEFF Research Database (Denmark)

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

    2013-01-01

    BACKGROUND & AIMS: Guidelines recommend a positive strategy based on symptom criteria to diagnose patients with irritable bowel syndrome (IBS). We conducted a randomized noninferiority trial to determine whether a positive diagnostic strategy is noninferior to a strategy of exclusion, with regard...... to patients' health-related quality of life (HRQOL). METHODS: We studied 302 patients (18-50 years old) from primary care who were suspected of having IBS and referred by general practitioners. Patients who fulfilled the Rome III criteria for IBS with no alarm signals were randomly assigned to groups assessed...... by a strategy of exclusion (analyses of blood, stool samples for intestinal parasites, and sigmoidoscopies with biopsies) or a positive strategy (analyses of blood cell count and C-reactive protein). Patients were followed for 1 year. The primary end point was difference in change of HRQOL from baseline to 1...

  9. Management of irritable bowel syndrome: novel approaches to the pharmacology of gut motility.

    Science.gov (United States)

    Scarpignato, C; Pelosini, I

    1999-03-01

    Although it is unclear to what extent irritable bowel syndrome (IBS) symptoms represent a normal perception of abnormal function or an abnormal perception of normal function, many believe that IBS constitutes the clinical expression of an underlying motility disorder, affecting primarily the mid- and lower gut. Indeed, transit and contractile abnormalities have been demonstrated with sophisticated techniques in a subset of patients with IBS. As a consequence, drugs affecting gastrointestinal (GI) motility have been widely employed with the aim of correcting the major IBS manifestations, ie, pain and altered bowel function. Unfortunately, no single drug has proven to be effective in treating IBS symptom complex. In addition, the use of some medications has often been associated with unpleasant side effects. Therefore, the search for a truly effective and safe drug to control motility disturbances in IBS continues. Several classes of drugs look promising and are under evaluation. Among the motor-inhibiting drugs, gut selective muscarinic antagonists (such as zamifenacin and darifenacin), neurokinin2 antagonists (such as MEN-10627 and MEN-11420), beta3-adrenoreceptor agonists (eg, SR-58611A) and GI-selective calcium channel blockers (eg, pinaverium bromide and octylonium) are able to decrease painful contractile activity in the gut (antispasmodic effect), without significantly affecting other body functions. Novel mechanisms to stimulate GI motility and transit include blockade of cholecystokinin (CCK)A receptors and stimulation of motilin receptors. Loxiglumide (and its dextroisomer, dexloxiglumide) is the only CCKA receptor antagonist that is being evaluated clinically. This drug accelerates gastric emptying and colonic transit, thereby increasing the number of bowel movements in patients with chronic constipation. It is also able to reduce visceral perception. Erythromycin and related 14-member macrolide compounds inhibit the binding of motilin to its receptors on

  10. 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

  11. A meta-analysis and systematic review of the comorbidity between irritable bowel syndrome and bipolar disorder.

    Science.gov (United States)

    Tseng, Ping-Tao; Zeng, Bing-Syuan; Chen, Yen-Wen; Wu, Ming-Kung; Wu, Ching-Kuan; Lin, Pao-Yen

    2016-08-01

    Irritable bowel syndrome (IBS) and bipolar disorder (BD) are 2 distinct diseases but may share a similar pathophysiology. However, the comorbidity rate of these 2 diseases is unclear. Also, the current practice guidelines suggest prescribing antidepressants to IBS patients. However, this practice may increase the risk of phase-shift to manic episodes in IBS patients comorbid with BD.This study aimed to determine the relationship between IBS and BD through a meta-analysis.Electronic research through PubMed, Medline, ScienceDirect online, ClinicalTrials.gov, and additional resources.The inclusion criteria were studies investigating the prevalence rate of BD in subjects with IBS and control subjects; and articles on clinical trials on humans.Data from included studies were pooled by a random effects model, and possible confounding variables were examined by meta-regression and subgroup analysis.The current study consists of a total of 177,117 IBS patients and 192,092 control subjects extracted from 6 included studies. The prevalence rate of BD was significantly higher in the IBS patients than in the controls (odds ratio = 2.48, 95% confidence interval: 2.35-2.61, P limit the generalization of our findings to a broad population. Also, we could only perform meta-regression on limited clinical variables.Our results support a significantly higher prevalence rate of BD in IBS patients than in controls. Clinicians should be cautious about the risk of phase-shift to manic episodes when prescribing antidepressants in IBS patients under current practice guidelines. PMID:27537599

  12. Irritable Bowel Syndrome Is Associated with an Increased Risk of Dementia: A Nationwide Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Chien-Hua Chen

    Full Text Available Abnormal interaction in the brain-gut axis has emerged as one of the relevant pathophysiological mechanisms for the development of irritable bowel syndrome (IBS. Moreover, the brain-gut axis has recently been demonstrated to be crucial for the maintenance of cognitive performance. Therefore, we assessed the risk of dementia following diagnosis of IBS.Using the Taiwan National Health Insurance Research Database (NHIRD to obtain medical claims data from 2000 to 2011, we employed a random sampling method to enroll32 298 adult patients with IBS and frequency-matched them according to sex, age, and baseline year with 129 192 patients without IBS.The patients with IBS exhibited an increased risk of dementia [adjusted hazard ratio (aHR = 1.26, 95% confidence interval (CI = 1.17-1.35]after adjustment for age, sex, diabetes, hypertension, stroke, coronary artery disease (CAD, head injury, depression, and epilepsy, and the overall incidence of dementia for the cohorts with and without IBS was 4.86 and 3.41 per 1000 person-years, respectively. IBS was associated with an increased risk of dementia in patients older than 50 years in both male and female, and in those with comorbidity or without comorbidity. After adjustment for age, sex, and comorbidity, patients with IBS were also more likely to develop either non- Alzheimer's disease (AD dementia (aHR = 1.24, 95% CI = 1.15-1.33 or AD (aHR = 1.76, 95% CI = 1.28-2.43.IBS is associated with an increased risk of dementia, and this effect is obvious only in patients who are ≥50 years old.

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

    Directory of Open Access Journals (Sweden)

    Flik Carla E

    2011-12-01

    Full Text Available 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 limited. The IMAGINE-study is therefore designed to assess the overall benefit of hypnotherapy in IBS as well as comparing the efficacy of individual versus group hypnotherapy in treating this condition. Methods/Design The design is a randomised placebo-controlled trial. The study group consists of 354 primary care and secondary care patients (aged 18-65 with IBS (Rome-III criteria. Patients will be randomly allocated to either 6 sessions of individual hypnotherapy, 6 sessions of group hypnotherapy or 6 sessions of educational supportive therapy in a group (placebo, with a follow up of 9 months post treatment for all patients. Ten hospitals and four primary care psychological practices in different parts of The Netherlands will collaborate in this study. The primary efficacy parameter is the responder rate for adequate relief of IBS symptoms. Secondary efficacy parameters are changes in the IBS symptom severity, quality of life, cognitions, psychological complaints, self-efficacy as well as direct and indirect costs of the condition. Hypnotherapy is expected to be more effective than the control therapy, and group hypnotherapy is expected not to be inferior to individual hypnotherapy. Discussion If hypnotherapy is effective and if there is no difference in efficacy between individual and group hypnotherapy, this group form of treatment could be offered to more IBS patients, at lower costs. Trial registration number ISRCTN: ISRCTN22888906

  14. Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial.

    Science.gov (United States)

    Shinozaki, Masae; Kanazawa, Motoyori; Kano, Michiko; Endo, Yuka; Nakaya, Naoki; Hongo, Michio; Fukudo, Shin

    2010-09-01

    Autogenic training (AT) is a useful and comprehensive relaxation technique. However, no studies have investigated the effects of AT on irritable bowel syndrome (IBS). In this study we tested the hypothesis that AT improves symptoms of IBS. Twenty-one patients with IBS were randomly assigned to AT (n = 11, 5 male, 6 female) or control therapy (n = 10, 5 male, 5 female). AT patients were trained intensively, while the control therapy consisted of discussions about patients' meal habits and life styles. All patients answered a question related to adequate relief (AR) of IBS symptoms and four questionnaires: Self-induced IBS Questionnaire (SIBSQ), Self-reported Depression Scale (SDS), State-Trait Anxiety Inventory (STAI), and Medical Outcome Short Form 36 Health Survey (SF-36). The proportion of AR in the last AT session in the AT group (9/11, 81.8%) was significantly higher than that in the controls (3/10, 30.0%, Chi-square test, p = 0.048). Two subscales of the SF-36, i.e., social functioning and bodily pain, were significantly improved in the AT group (p < 0.05) as compared to the control group. Role emotional (p = 0.051) and general health (p = 0.068) showed a tendency for improvement in the AT group. AT may be useful in the treatment of IBS by enhancing self-control. PMID:19997775

  15. Lower Bifidobacteria counts in both duodenal mucosa-associated and fecal microbiota in irritable bowel syndrome patients

    Institute of Scientific and Technical Information of China (English)

    Angèle PM Kerckhoffs; Melvin Samsom; Michel E van der Rest; Joris de Vogel; Jan Knol; Kaouther Ben-Amor; Louis MA Akkermans

    2009-01-01

    AIM: To determine the composition of both fecal and duodenal mucosa-associated microbiota in irritable bowel syndrome (IBS) patients and healthy subjects using molecular-based techniques. METHODS: Fecal and duodenal mucosa brush samples were obtained from 41 IBS patients and 26 healthy subjects. Fecal samples were analyzed for the composition of the total microbiota using fluorescent in situ hybridization (FISH) and both fecal and duodenal brush samples were analyzed for the composition of bifidobacteria using real-time polymerase chain reaction. RESULTS: The FISH analysis of fecal samples revealed a 2-fold decrease in the level of bifidobacteria (4.2 ± 1.3 vs 8.3 ± 1.9, P < 0.01) in IBS patients compared to healthy subjects, whereas no major differences in other bacterial groups were observed. At the species level, Bifidobacterium catenulatum levels were significantly lower (6 ± 0.6 vs 19 ± 2.5, P < 0.001) in the IBS patients in both fecal and duodenal brush samples than in healthy subjects. CONCLUSION: Decreased bifidobacteria levels in both fecal and duodenal brush samples of IBS patients compared to healthy subjects indicate a role for microbiotic composition in IBS pathophysiology.

  16. Neutropenia, neutrophil dysfunction, and inflammatory bowel disease in glycogen storage disease type Ib : Results of the European Study on Glycogen Storage Disease Type I

    NARCIS (Netherlands)

    Visser, G; Rake, JP; Fernandes, J; Labrune, P; Leonard, JV; Moses, S; Ullrich, K; Smit, GPA

    2000-01-01

    Objective: To investigate the incidence, the severity, and the course of neutropenia, neutrophil dysfunction, and inflammatory bowel disease (IBD) in glycogen storage disease (GSD) type Ib. Method: As part of a collaborative European Study on GSD type I, a retrospective registry was established in 1

  17. Irritable bowel syndrome: Personality and health behaviours: A biopsychosocial approach

    Directory of Open Access Journals (Sweden)

    Anita D Stuart

    1999-01-01

    Full Text Available The goal of this study was to indicate the complex nature of functional gastrointestinal disorders by studying the interaction between Irritable Bowel Syndrome and person personality aspects and health behaviour. An ex post facto design was used to compare two groups of women, the one group with iBS (N = 60 and the other without (N = 60 in terms of the above mentioned variables. The NEO-Personality lnventory (Revised was used to compare the groups on five broad aspects of personality i.e. Neuroticism, Extraversion, Openness for Experience, Agreeableness and Conscientiousness. The Health Behaviour Checklist was used to measure health behaviours as indicated by the foilowing factors: Wellness Maintenance and Enhancement, Accident Control, Traffic Risk Taking and Substance Risk Taking. The results indicate that statistically significant differences do indeed exist between the groups in terms of certain personality aspects (neuroticism, extraversion, openness for experience and certain health aspects (especially wellness maintenance and enhancement and traffic risk taking. It seems then as if IBS sufferers share certain personality characteristics which influence their behaviour related to the maintenance and enhancement of their health. Finally, we recommend a holistic approach to treatment and therapeutic interventions.

    Opsomming
    Die studie het ten doel gehad om die komplekse aard van die Funksionele Maagderm Versteurings aan te dui deur die interaksie tussen Prikkelbare Dermsindroom en persoonlikheidsaspekte en gesondheidsgedrag ("health behavioui' te bestudeer. Daar is gebruik gemaak van 'n ex post facto ontwerp om twee groepe vrouens, die een groep met PDS (N = 60 en die ander daarsonder (N = 60, ten opsigte van die veranderlikes te vergelyk. Die NEO - Personality lnventory (Revised is gebruik om die groepe te vergelyk ten opsigte van vyf brei persoonlikheidsaspekte naamlik, Neurotisme, Ekstraversie, Oopheid vir Ervaring, Welgevalligheid

  18. Effectiveness of Relaxation in life quality of Irritable Bowel Syndrome patients referring to Shohada Hospital, Dehloran, Iran; 2015

    Directory of Open Access Journals (Sweden)

    Reza Valizadeh

    2016-01-01

    Full Text Available Background: Irritable Bowel Syndrome is a prevalent syndrome which is identified by change intestine movements. In this research the effect of relaxation on life quality of IBS patients referring to Dehloran’s Shohada hospital, Iran, in 2015 has been investigated. Materials and Methods: This research is a semi-experimental pre-test – post-test, which was conducted on 24 people with IBS. After the test and the pre-test, relaxation curing was conducted for eight weeks, each week 60 minutes, using the protocol relaxation which was prepared already. One week after the tests, the post-test questionnaire was filled up (sf-36 to measure the effect of the probable cure. Analysis of the data was performed using SPSS Version 20. Results: Most of the academic degrees were BA, 42% and the least was Diploma 16%. The results of this study showed significant difference in life quality improvement in IBS patients in both control and witness groups (P<0.001. Also there was a significant relationship among. Relaxation public health, bodily health overall criteria, psychological health overall criteria and pain in IBS patients (P<0.001. Conclusion: The attained results showed that relaxation can be useful beside other psychological cures as a psychological curer in improving the life quality of IBS patients.

  19. Quantitative Risk-Benefit Analysis of Probiotic Use for Irritable Bowel Syndrome and Inflammatory Bowel Disease.

    Science.gov (United States)

    Bennett, William E

    2016-04-01

    Probiotics have seen widespread use for a variety of gastrointestinal problems, especially in two common disorders: irritable bowel syndrome and inflammatory bowel disease. Since a wide variety of probiotic preparations has been used, and despite a large number of studies performed, a great deal of heterogeneity exists among them. Straightforward evidence-based recommendations for the use of probiotics in irritable bowel syndrome and inflammatory bowel disease have thus been difficult to formulate. In an effort to improve understanding of the risk-benefit balance of probiotics in these conditions, this study (1) queried the US FDA Adverse Event Reporting System (FAERS) database for all reported adverse drug events related to probiotics in 2013, and (2) constructed risk-benefit planes for both irritable bowel syndrome and inflammatory bowel disease using a geometric approximation of the confidence region between risk and benefit. The results show that adverse events from probiotics vary widely by disease, and when they occur, they are mild and may be difficult to distinguish from the natural history of the underlying disorders they are used to treat. The risk-benefit plane for irritable bowel syndrome straddles the risk-benefit threshold, so patients can expect a balance between a low chance of risk and also a low chance of benefit. The risk-benefit plane for inflammatory bowel disease largely lies above the risk-benefit threshold, so patients may expect more benefit than risk in most cases. More standardized and high-quality research is needed to improve our understanding of risk and benefit for these complex biopharmaceuticals. PMID:26467550

  20. Probiotics VSL#3 protect against development of visceral pain in murine model of irritable bowel syndrome.

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    Eleonora Distrutti

    Full Text Available BACKGROUND AND AIMS: Irritable bowel syndrome (IBS is linked to post-inflammatory and stress-correlated factors that cause changes in the perception of visceral events. Probiotic bacteria may be effective in treating IBS symptoms. Here, we have investigated whether early life administration of VSL#3, a mixture of 8 probiotic bacteria strains, protects against development of visceral hypersensitivity driven by neonatal maternal separation (NMS, a rat model of IBS. METHODS: Male NMS pups were treated orally with placebo or VSL#3 from days 3 to 60, while normal, not separated rats were used as controls. After 60 days from birth, perception of painful sensation induced by colorectal distension (CRD was measured by assessing the abdominal withdrawal reflex (score 0-4. The colonic gene expression was assessed by using the Agilent Whole Rat Genome Oligo Microarrays platform and confirmed by real time PCR. RESULTS: NMS rats exhibited both hyperalgesia and allodynia when compared to control rats. VSL#3 had a potent analgesic effect on CRD-induced pain without changing the colorectal compliance. The microarray analysis demonstrated that NMS induces a robust change in the expression of subsets of genes (CCL2, NOS3, THP1, NTRK1, CCR2, BDRKRB1, IL-10, TNFRSF1B, TRPV4, CNR1 and OPRL1 involved in pain transmission and inflammation. TPH1, tryptophan hydroxylase 1, a validated target gene in IBS treatment, was markedly upregulated by NMS and this effect was reversed by VSL#3 intervention. CONCLUSIONS: Early life administration of VSL#3 reduces visceral pain perception in a model of IBS and resets colonic expression of subsets of genes mediating pain and inflammation. TRANSCRIPT PROFILING: Accession number of repository for expression microarray data is GSE38942 (http://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE38942.

  1. Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia: A prospective study

    Institute of Scientific and Technical Information of China (English)

    Barbara Grazioli; Francesco Luzza; Giovanni Matera; Costanza Laratta; Giuseppina Schipani; Giovanni Guarnieri; Ester Spiniello; Maria Imeneo; Andrea Amorosi; Alfredo Focà

    2006-01-01

    AIM: To evaluate the prevalence of Giardia lamblia (G.lamblia) infection in patients with irritable bowel syndrome (IBS) and dyspepsia and to establish which is the most accurate test to diagnose the infection in this setting.METHODS: One hundred and thirty-seven patients who consecutively attended the Outpatient Gastroenterology Clinic for the first time between January 2002 and December 2003 due to symptoms of IBS and/or dyspepsia were recruited. All patients underwent clinical evaluation,first-step haematology and chemistry tests, serologic assays for celiac disease, lactose-H2 breath test, abdominal ultrasonography, and esophagogastroduodenoscopy.Helicobacter pylori status was evaluated. In patients with symptoms of IBS older than 45 years, colonoscopy was also performed. In all patients, duodenal biopsies and stool samples were examined for trophozoites and cysts of G.lamblia by several methods.RESULTS: G. lamblia was identified in 9 patients. The following diagnoses were also made: IBS (100/137, 73%), functional dyspepsia (62/137, 45%), organic dyspepsia (33/137, 24%), and lactose intolerance (75/137, 55%). A significant association was found between giardiasis and Hpylori infection (x2=6.632,OR= 12.4, CI= 1.5-68.1). There were no symptoms that reliably allowed the recognition of giardiasis.Direct search of the parasite in duodenal biopsy and stool sample examinations gave concordant results in all cases while histological examination of duodenal biopsies displayed a low sensitivity (e.g., 22.2%).CONCLUSION: In this consecutive series, diagnosis of G. lamblia infection accounted for 6.5% of patients with IBS and dyspepsia. Duodenal biopsies for diagnosis of giardiasis may be unnecessary if stool sample examination is performed.

  2. The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma

    Directory of Open Access Journals (Sweden)

    Archita Makharia

    2015-12-01

    Full Text Available The spectrum of gluten-related disorders has widened in recent times and includes celiac disease, non-celiac gluten sensitivity, and wheat allergy. The complex of symptoms associated with these diseases, such as diarrhea, constipation or abdominal pain may overlap for the gluten related diseases, and furthermore they can be similar to those caused by various other intestinal diseases, such as irritable bowel syndrome (IBS. The mechanisms underlying symptom generation are diverse for all these diseases. Some patients with celiac disease may remain asymptomatic or have only mild gastrointestinal symptoms and thus may qualify for the diagnosis of IBS in the general clinical practice. Similarly, the overlap of symptoms between IBS and non-celiac gluten sensitivity (NCGS often creates a dilemma for clinicians. While the treatment of NCGS is exclusion of gluten from the diet, some, but not all, of the patients with IBS also improve on a gluten-free diet. Both IBS and NCGS are common in the general population and both can coexist with each other independently without necessarily sharing a common pathophysiological basis. Although the pathogenesis of NCGS is not well understood, it is likely to be heterogeneous with possible contributing factors such as low-grade intestinal inflammation, increased intestinal barrier function and changes in the intestinal microbiota. Innate immunity may also play a pivotal role. One possible inducer of innate immune response has recently been reported to be amylase-trypsin inhibitor, a protein present in wheat endosperm and the source of flour, along with the gluten proteins.

  3. A randomised trial of ondansetron for the treatment of irritable bowel syndrome with diarrhoea

    Science.gov (United States)

    Garsed, Klara; Chernova, Julia; Hastings, Margaret; Lam, Ching; Marciani, Luca; Singh, Gulzar; Henry, Amanda; Hall, Ian; Whorwell, Peter; Spiller, Robin

    2014-01-01

    Background Irritable bowel syndrome with diarrhoea (IBS-D) is particularly debilitating due to urgency and episodic incontinence. Some 5-hydroxytryptamine 3 (5-HT3) receptor antagonists (5-HT3RAs) have proven effective but have serious side effects. Ondansetron, also a 5-HT3RA, has been widely used as an antiemetic with an excellent safety record for over two decades. Our aim was to assess its effectiveness in IBS-D. Methods 120 patients meeting Rome III criteria for IBS-D entered a randomised, double-blind, placebo-controlled crossover study of 5 weeks of ondansetron 4 mg versus placebo with dose titration allowed, up to two tablets three times daily in the first 3 weeks. Patients completed daily diaries documenting stool consistency using the Bristol Stool Form score. Gut transit was measured in the last week of each treatment. The primary endpoint was average stool consistency in the last 2 weeks of treatment. Results Ondansetron significantly improved stool consistency (mean difference in stool form between ondansetron and placebo −0.9, 95% CI −1.1 to −0.6, p<0.001). Compared with placebo, patients on ondansetron experienced fewer days with urgency (p<0.001), lower urgency scores (p<0.001), reduced frequency of defaecation (p=0.002) and less bloating (p=0.002), although pain scores did not change significantly. IBS symptom severity score fell more with ondansetron than placebo (83±9.8 vs 37±9.7, p=0.001). 65% reported adequate relief with ondansetron but not placebo compared with 14% reporting relief with placebo but not ondansetron, relative risk 4.7, 95% CI 2.6 to 8.5, p<0.001. Conclusions Ondansetron relieves some of the most intrusive symptoms of IBS-D, namely loose stools, frequency and urgency. PMID:24334242

  4. The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma.

    Science.gov (United States)

    Makharia, Archita; Catassi, Carlo; Makharia, Govind K

    2015-12-01

    The spectrum of gluten-related disorders has widened in recent times and includes celiac disease, non-celiac gluten sensitivity, and wheat allergy. The complex of symptoms associated with these diseases, such as diarrhea, constipation or abdominal pain may overlap for the gluten related diseases, and furthermore they can be similar to those caused by various other intestinal diseases, such as irritable bowel syndrome (IBS). The mechanisms underlying symptom generation are diverse for all these diseases. Some patients with celiac disease may remain asymptomatic or have only mild gastrointestinal symptoms and thus may qualify for the diagnosis of IBS in the general clinical practice. Similarly, the overlap of symptoms between IBS and non-celiac gluten sensitivity (NCGS) often creates a dilemma for clinicians. While the treatment of NCGS is exclusion of gluten from the diet, some, but not all, of the patients with IBS also improve on a gluten-free diet. Both IBS and NCGS are common in the general population and both can coexist with each other independently without necessarily sharing a common pathophysiological basis. Although the pathogenesis of NCGS is not well understood, it is likely to be heterogeneous with possible contributing factors such as low-grade intestinal inflammation, increased intestinal barrier function and changes in the intestinal microbiota. Innate immunity may also play a pivotal role. One possible inducer of innate immune response has recently been reported to be amylase-trypsin inhibitor, a protein present in wheat endosperm and the source of flour, along with the gluten proteins. PMID:26690475

  5. Symptoms and Causes of Irritable Bowel Syndrome

    Science.gov (United States)

    ... sometimes present in people who have reported past physical or sexual abuse. Experts think people who have been abused tend to express psychological stress through physical symptoms. If you have IBS, your colon may ...

  6. Definition and Facts for Irritable Bowel Syndrome

    Science.gov (United States)

    ... management resources; and commonly used funding mechanisms, including diversity and small business programs Research Programs & Contacts Research ... patterns—that occur together. Doctors call IBS a functional gastrointestinal (GI) disorder . Functional GI disorders happen when ...

  7. Analysis of the efficacy of the peppermint oil (Mentha piperita L. on irritable bowel syndrome: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Joana Costa Gomes

    2013-04-01

    Full Text Available Objective: To evaluate the efficacy of peppermint oil (Mentha piperita L. on individuals diagnosed with irritable bowel syndrome (IBS regarding symptom improvement and quality of life enhancement. Methods: Literature search was conducted according to evidence based on methodology review at Trip database, National Guideline Clearinghouse, Guidelines finder, Cochrane Library, Dare, Bandolier and Medline, as well as using the MeSH index terms “Irritable bowel syndrome” and “peppermint oil”. We selected practice guidelines, systematic reviews, meta-analysis and randomized controlled trials that evaluated peppermint oil (PO efficacy in improving symptoms and/or quality of life when compared to placebo or other approved therapy for IBS. Results and Discussion: A total of eight articles were selected including five practice guidelines and three systematic reviews/ meta-analysis. Existing evidence suggests that there are enough data to support the use of peppermint oil in IBS for overall symptomatic relief, especially when abdominal pain is the dominant symptom, when compared to placebo (with an odds ratio of 2.7; CI 95%, 1.6 to 4.8 and NNT of 3. There is also evidence regarding overall quality of life improvement when using PO compared to placebo (p<0.001. Conclusion: So far, evidence suggests that PO should be considered for IBS patients, especially in the presence of abdominal pain (Strength of recommendation B. However, more high methodological quality studies that evaluate long-term efficacy and security of PO are needed.

  8. Treatment of irritable bowel syndrome with probiotics: An etiopathogenic approach at last?

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    M. Bixquert Jiménez

    2009-08-01

    Full Text Available Irritable bowel syndrome (IBS is the most common functional digestive disorder, and may affect 11-20% of the adult population in industrialized countries. In accordance with Rome III criteria (2006 IBS involves abdominal pain and bowel habit disturbance, which are not explained by structural or biochemical abnormalities. Several hypotheses attempt to account for the pathophysiology of IBS, but the etiology still remains uncertain or obscure, perhaps multifactorial. Abnormalities in colonic microflora have recently been suggested in such patients, as has abnormal small-intestine bacterial overgrowth (SIBO, or in particular a significant reduction in the amount of intraluminal Bifidobacteria or Lactobacilli, with consequences like the production of colonic gas, and motility or sensitivity disturbances of the intestinal tract. The disorder is difficult to treat, and the wide spectrum of non-drug and drug treatments shows our ignorance about the cause of the condition. Newer drugs, both pro- and anti-serotonin, have failed to show long-term efficacy or have been withdrawn due to concerns about harmful effects. Recent research has provided increasing support for the idea that disturbances of intestinal microbiota occur in patients with IBS, and that such abnormalities may contribute to IBS symptoms. Studies in Scandinavian countries in the last ten years emphasize the role of probiotics in the modulation of intestinal microbiota, and as a consequence in the regulation of the motility and hypersensitivity of the digestive tract. Although results between studies are difficult to compare because of differences in study design, probiotic dose, strain, and duration of therapy, some studies show symptom improvement. Lactobacilli are found among the normal bacterial flora of the gastrointestinal tract, and Lactobacillus plantarum (Lp is one of the species frequently isolated from the human mucosa, which is capable of surviving the low pH of the stomach and

  9. Benefit of Aloe vera and Matricaria recutita mixture in rat irritable bowel syndrome: Combination of antioxidant and spasmolytic effects.

    Science.gov (United States)

    Asadi-Shahmirzadi, Azar; Mozaffari, Shilan; Sanei, Yara; Baeeri, Maryam; Hajiaghaee, Reza; Monsef-Esfahani, Hamid Reza; Abdollahi, Mohammad

    2012-12-21

    OBJECTIVE: To evaluate the beneficial effects of a mixture of Aloe vera (AV) and Matricaria recutita (German chamomile, GC) in an experimental model of irritable bowel syndrome (IBS). METHODS: IBS was induced by a 5-day restraint stress in rats including the groups of control (water), GC (300 mg/kg), loperamide (10 mg/kg), mixed AV and GC (50: 50 at doses of 150, 300 or 450 mg/kg assigned as Mix-150, Mix-300 and Mix-450, respectively) and the sham group which did not receive any restraint stress and was fed with saline. All medications were administered intragastrically by gavage for 7 days, 2 days as pre-treatment followed by 5 days during induction of IBS every day before restraining. RESULTS: The increased tumor necrosis factor alpha (TNF-α), myeloperoxidase (MPO) activity, and lipid peroxidation (LPO) in colonic cells in the control group were significantly decreased in the treatment groups. GC inhibited only small bowel transit while the AV/GC mixture delayed gastric emptying at the doses of 150 and 300 mg/kg. The AV/GC mixture also reduced colonic transit and small bowel transit at the dose of 150 mg/kg. CONCLUSIONS: The severity of stress-induced IBS was diminished by the AV/GC mixture at all doses used but not dose-dependently, via inhibiting colonic MPO activity and improving oxidative stress status. The effect of the mixture was more effective than GC alone. The present results support effectiveness of the AV and GC combination in IBS. PMID:23263994

  10. 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.

  11. 心理治疗提高肠易激综合征治疗效应的探讨%A study on the improvement of treatment effect to treat irritable bowel syndrome with psychological therapy

    Institute of Scientific and Technical Information of China (English)

    宫彦英; 温艳惠; 曲韬

    2002-01-01

    @@ Background:Irritable bowel syndrome(IBS) is one of the most common diseases of the digestic tract, from which the patients suffer greater pains and psychoburden. It affects life quality,studying and working of the patients badly. So it is an important factor affecting the patients' rehabilitation now to improve the therapeutic effect of these patients. Conventional therapy plus psychotherapy is effective in management of IBS patients recruital from Oct.1999 to Oct. 2001.

  12. Frequency of Celiac Disease in Irritable Bowel Syndrome Patients with Predominant Diarrhea Referred to Gastroenterology Clinics in Yazd, Iran

    Directory of Open Access Journals (Sweden)

    Rabei

    2011-12-01

    Full Text Available Introduction: Irritable Bowel Syndrome(IBS is a common clinical syndrome that presents with abdominal pain, diarrhea and constipation, and flatulence which may be intermittent. Also celiac disease, an enteropathy due to gluten sensitivity, presents with diarrhea resulting from mal-absorption, which should be considered as a differential diagnosis of IBS. If celiac is diagnosed in a patient suspicious to IBS, the treatment method will be changed completely. This study was designed to evaluate celiac disease in IBS patients. Methods: A cross-sectional study was conducted on 125 patients 15-50 years old suffering from IBS with diarrhea- predominant clinical picture, who were referred to Yazd gastroenterology clinics. The study data including age, gender and results of anti TTG measurement were collected and analyzed by SPSS 13. Duodenal biopsy was performed in patients that were positive for anti TTG for confirmation of diagnosis. Results: 125 patients suffering from IBS with diarrhea- predominant clinical picture entered the study. Their mean age was 29.85±9.22 years. 74 subjects (59.2% were males and 51 (40.8% were females. Four patients showed positive anti TTG (3 males and 1 female. Duodenal biopsy was performed and diagnosis of celiac disease was confirmed in all four patients (3 with March II and with March I grade. Totally the frequency of celiac disease was 3.2% in this study. There was no significant relationship between age, gender and anti TTG results, which can be explained by small sample size. Conclusion: According to the results of the study and the frequency of celiac, it is not an uncommon and rare disease, so it should be considered as one of the differential diagnoses of IBS.

  13. The effect of sex and irritable bowel syndrome on HPA axis response and peripheral glucocorticoid receptor expression

    Science.gov (United States)

    Videlock, Elizabeth J.; Shih, Wendy; Adeyemo, Mopelola; Mahurkar-Joshi, Swapna; Presson, Angela P.; Polytarchou, Christos; Alberto, Melissa; Iliopoulos, Dimitrios; Mayer, Emeran A.; Chang, Lin

    2016-01-01

    Background and aims Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been reported in irritable bowel syndrome (IBS). Enhanced HPA axis response has been associated with reduced glucocorticoid receptor (GR) mediated negative feedback inhibition. We aimed to study the effects of IBS status, sex, or presence of early adverse life events (EAL) on the cortisol response to corticotropin-releasing factor (CRF) and adrenocorticotropic hormone (ACTH), and on GR mRNA expression in peripheral blood mononuclear cells (PBMCs). Methods Rome III+ IBS patients and healthy controls underwent CRF (1 μg/kg ovine) and ACTH (250 μg) stimulation tests with serial plasma ACTH and cortisol levels measured (n = 116). GR mRNA levels were measured using quantitative PCR (n = 143). Area under the curve (AUC) and linear mixed effects models were used to compare ACTH and cortisol response measured across time between groups. Results There were divergent effects of IBS on the cortisol response to ACTH by sex. In men, IBS was associated with an increased AUC (p = 0.009), but in women AUC was blunted in IBS (p = 0.006). Men also had reduced GR mRNA expression (p = 0.007). Cumulative exposure to EALs was associated with an increased HPA response. Lower GR mRNA was associated with increased pituitary HPA response and increased severity of overall symptoms and abdominal pain in IBS. Conclusion This study highlights the importance of considering sex in studies of IBS and the stress response in general. Our findings also provide support for PBMC GR mRNA expression as a peripheral marker of central HPA response. PMID:27038676

  14. Functional brain imaging in irritable bowel syndrome with rectal balloon-distention by using fMRI

    Institute of Scientific and Technical Information of China (English)

    Yao-Zong Yuan; Ran-Jun Tao; Bin Xu; Jing Sun; Ke-Min Chen; Fei Miao; Zhong-Wei Zhang; Jia-Yu Xu

    2003-01-01

    AIM: Irritable bowel syndrome (IBS) is characterized by abdominal pain and changes in stool habits. Visceral hypersensitivity is a key factor in the pathophysiology of IBS. The aim of this study was to examine the effect of rectal balloon-distention stimulus by blood oxygenation leveldependent functional magnetic resonance imaging (BOLDfMRI) in visceral pain center and to compare the distribution,extent, and intensity of activated areas between IBS patients and normal controls. METHODS: Twenty-six patients with IBS and eleven normal controls were tested for rectal sensation, and the subjective pain intensity at 90 ml and 120 ml rectal balloon-distention was reported by using Visual Analogue Scale. Then, BOLDfMRI was performed at 30 ml, 60 ml, 90 ml, and 120 ml rectal balloon-distention in all subjects. RESULTS: Rectal distention stimulation increased the activity of anterior cingulate cortex (35/37), insular cortex (37/37),prefrontal cortex (37/37), and thalamus (35/37) in most cases.At 120 ml of rectal balloon-distention, the activation area and percentage change in MR signal intensity of the regions of interest (ROI) at IC, PFC, and THAL were significantly greater in patients with IBS than that in controls. Score of pain sensation at 90 ml and 120 ml rectal balloon-distention was significantly higher in patients with IBS than that in controls. CONCLUSION: Using fMRI, some patients with IBS can be detected having visceral hypersensitivity in response to painful rectal balloon-distention. fMRI is an objective brain imaging technique to measure the change in regional cerebral activation more precisely. In this study, IC and PFC of the IBS patients were the major loci of the CNS processing of visceral perception.

  15. Surgical techniques in short bowel syndrome.

    Science.gov (United States)

    Waag, K L; Heller, K

    1990-01-01

    An operation according to Bianchi in a 2-year-old girl is described and indications as well as technical procedure are discussed. The girl was born with a gastroschisis. There was a jejunal perforation 10 cm below the ligament of Treitz caused by a volvulus. Only 20 cm of the jejunum remained. Moreover, only the left part of the colon was present. Total parenteral nutrition for 2 years was necessary. The principle of the operation is based on a longitudinal division of the remaining bowel and a creation of two separate bowel tubes out of the divided bowel halves, thus effecting an isoperistaltic serial connection by means of two anastomoses. This is technically possible since each half of the bowel wall has its own blood supply. The vessels originating from the mesenterium branch off before they reach the bowel wall so that the mesenteric dissection line can be anastomosed longitudinally with the antimesenteric border. This results in doubling of the bowel length, narrowing of the preoperatively dilated bowel diameter, closer contact of bowel contents with the mucosa, prolonged transit time and a Bacteroides colonization which is reduced by more effective peristalsis. Indications, time of operation and our own experiences are discussed and three cases are described. All children are alive and show marked improvement in nutrition. PMID:2105523

  16. Understanding the Pathophysiology of IBS

    OpenAIRE

    Giovanni Barbara; Marco Dolci; Cesare Cremon; Maria Raffaella Barbaro; Lara Bellacosa; Anita Fucili; Vincenzo Stanghellini

    2013-01-01

    While irritable bowel syndrome (IBS) is still considered a ‘disorder of gut function’ and is diagnosed on the basis of symptoms, evidence is growing to indicate the existence of biochemical, molecular, immune, and microbiological abnormalities in large subsets of patients. According to the current view, luminal factors (e.g. derived from food, microbiota, and bile acids) permeate into the mucosa through a leaky epithelial barrier. These substances elicit abnormal responses, partly related to ...

  17. CLINICAL RESEARCH ON MOXIBUSTION TREATMENT OF DIARREHEA TYPE IRRITABLE BOWEL SYNDROME

    Institute of Scientific and Technical Information of China (English)

    倪莹莹; 陆建芹

    2001-01-01

    Objective: To observe the therapeutic effect of moxibustion in treatment of diarrhea type irritable bowel syndrome (IBS). Methods: 56 cases of IBS were divided into treatment group (n=30) and control group (n=26). Patients of the former group were treated with moxibustion of Guanyuan (CV 4) and Zusanli (ST 36) in combination with Xiajuxu (ST 39) for lowering abdominal pain and with Shangjuxu (ST 37) for left lower abdominal pain; whilethose of the later group were treated with oral administration of Nifedipinum (10 mg, 3 times a day) and Smecta (1 bag, 3 times daily). After 15 days' treatment, the therapeutic effect was evaluated. Results: After treatment, the effective rates for abdominal pain, abdominal distension, abnormal frequency, abnormal stool, dyspepsia in treatment group were 100.00%, 94.74%, 96.67%, 100.00% and 95.00% respectively, with a total improving rate of 79.30% ; and those in control group 95.65%, 82.35%, 92.31%, 96.15% and 75.00% separately, with the total improving rate being 63.98%. There were significant differences between two groups in the effective rate of dyspepsia and the total improving rate of symptoms (P<0.05,0.01 ). Conclusion: Moxibustion treatment is effective in treatment of IBS and superior to that of Western medicines

  18. Efficacy of tricyclic antidepressants in irritable bowel syndrome: A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Roja Rahimi; Shekoufeh Nikfar; Ali Rezaie; Mohammad Abdollahi

    2009-01-01

    We aimed to evaluate the efficacy of tricyclic antidepressants (TCAs) as a therapeutic option for irritable bowel syndrome (IBS) through meta-analysis of randomized controlled trials. For the years 1966 until September 2008, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched for double-blind, placebo-controlled trials investigating the efficacy of TCAs in the management of IBS. Seven randomized, placebo-controlled clinical trials met our criteria and were included in the metaanalysis. TCAs used in the treatment arm of these trials included amitriptyline, imipramine, desipramine, doxepin and trimipramine. The pooled relative risk for clinical improvement with TCA therapy was 1.93 (95% CI: 1.44 to 2.6, P<0.0001). Effect size of TCAs versus placebo for mean change in abdominal pain score among the two studies was -44.15 (95% CI: -53.27 to -35.04, P<0.0001). It is concluded that low dose TCAs exhibit clinically and statistically significant control of IBS symptoms.

  19. Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Philippe Ducrotté; Prabha Sawant; Venkataraman Jayanthi

    2012-01-01

    AIM:To assess the symptomatic efficacy of Lactobacillus plantarum 299v (L.plantarum 299v) (DSM 9843) for the relief of abdominal symptoms in a large subset of irritable bowel syndrome (IBS) patients fulfilling the Rome Ⅲ criteria.METHODS:In this double blind,placebo-controlled,parallel-designed study,subjects were randomized to daily receive either one capsule of L.plantarum 299v (DSM 9843) or placebo for 4 wk.Frequency and intensity of abdominal pain,bloating and feeling of incomplete rectal emptying were assessed weekly on a visual analogue scale while stool frequency was calculated.RESULTS:Two hundred and fourteen IBS patients were recruited.After 4 wk,both pain severity (0.68+ 0.53 vs 0.92 + 0.57,P < 0.05) and daily frequency (1.01 + 0.77 vs 1.71 + 0.93,P < 0.05) were lower with L.plantarum 299v (DSM 9843) than with placebo.Similar results were obtained for bloating.At week 4,78.1% of the patients scored the L.plantarum 299v (DSM 9843) symptomatic effect as excellent or good vs only 8.1% for placebo (P < 0.01).CONCLUSION:A 4-wk treatment with L.plantarum 299v (DSM 9843) provided effective symptom relief,particularly of abdominal pain and bloating,in IBS patients fulfilling the Rome Ⅲ criteria.

  20. Instability of the faecal microbiota in diarrhoea-predominant irritable bowel syndrome.

    Science.gov (United States)

    Durbán, Ana; Abellán, Juan J; Jiménez-Hernández, Nuria; Artacho, Alejandro; Garrigues, Vicente; Ortiz, Vicente; Ponce, Julio; Latorre, Amparo; Moya, Andrés

    2013-12-01

    The irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with a largely unknown aetiology and a wide range of symptoms. Most cross-sectional studies carried out so far suggest subtle alterations in the structure of the intestinal microbiota that are barely reproduced, partly because of the high inter-subject variation in the community composition and disorder-specific features. We performed a longitudinal study to explore the within-subject variation in the faecal microbiota in two patients with IBS classified into the diarrhoea subtype and the healthy spouse of one of them. Faecal communities were monitored over 6-8 weeks and analysed through metagenomic and metatranscriptomic approaches. We found a higher temporal instability in the fraction of active microbiota related to the IBS condition and fluctuating symptoms. Strong and quick shifts in the distribution of the active microbiota and changes in the global pattern of gene expression were detected in association with acute diarrhoea, whereas microbial composition and encoded functions were more stable. The specific alterations in the microbiota were barely reproduced within and between patients. Further research is needed to assess whether these changes are a consequence of the abnormal gut function in acute diarrhoeic episodes and the potential usefulness of tackling them. PMID:23889283

  1. Effect of 5-HT1 agonist (sumatriptan) on anorectal function in irritable bowel syndrome patients

    Institute of Scientific and Technical Information of China (English)

    Agata Mulak; Leszek Paradowski

    2006-01-01

    AIM: To evaluate the effect of sumatriptan, a selective 5-HT1 agonist, on anorectal function in irritable bowel syndrome (IBS) patients.METHODS: Twenty-two IB5 patients selected according to the Rome Ⅱ criteria (F 15, M 7; mean age 29.3±6.8,range 22-44 years) were examined. The study was blind,randomized and placebo-controlled with a crossover design. Anorectal manometry and rectal balloon distension test were performed before and after the administration of placebo and sumatriptan.RESULTS: The administration of sumatriptan caused a significant increase in the resting anal canal pressure from 9.2±2.0 kPa to 13.1±3.3 kPa (P<0.0001) connected with the increase in the anal sphincter length and high pressure zone. After sumatriptan injection a remarkable increase in the threshold for the first sensation from 27±9 mL to 34±12 mL (P<0.05) and urge sensation from 61±19 mL to 68±18 mL (P<0.01) was observed.Sumatriptan did not affect either the volume evoking the rectoanal inhibitory reflex or the results of the straining test.CONCLUSION: 5-HT1 receptors participate in the regulation of anorectal function. Elucidation of the role of 5-HT1 receptors in the pathophysiological mechanisms of IBS may have some therapeutic implications.

  2. General practitioners believe that hypnotherapy could be a useful treatment for irritable bowel syndrome in primary care

    Directory of Open Access Journals (Sweden)

    de Lusignan Simon

    2004-10-01

    Full Text Available Abstract Background Irritable bowel syndrome is a common condition in general practice. It occurs in 10 to 20% of the population, but less than half seek medical assistance with the complaint. Methods A questionnaire was sent to the 406 GPs listed on the West Sussex Health Authority Medical List to investigate their views of this condition and whether they felt hypnotherapy had a place in its management Results 38% of general practitioners responded. The achieved sample shared the characteristics of target sample. Nearly half thought that irritable bowel syndrome (IBS was a "nervous complaint" and used a combination of "the placebo effect of personal care," therapeutic, and dietary advice. There is considerable divergence in the perceived effectiveness of current approaches. Over 70% thought that hypnotherapy may have a role in the management of patients with IBS; though the majority (68% felt that this should not be offered by general practitioners. 84% felt that this should be offered by qualified hypnotherapist, with 40% feeling that this should be offered outside the health service. Conclusions General practitioners vary in their perceptions of what constitutes effective therapy in IBS. They are willing to consider referral to a qualified hypnotherapist.

  3. Long-term efficacy and safety of ramosetron in the treatment of diarrhea-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Chiba T

    2013-07-01

    Full Text Available Toshimi Chiba, Kazunari Yamamoto, Shoko Sato, Kazuyuki Suzuki Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan Abstract: Irritable bowel syndrome (IBS is a functional disease with persisting gastrointestinal symptoms that has been classified into four subtypes. Serotonin (5-hydroxytryptamine [5-HT] plays important physiological roles in the contraction and relaxation of smooth muscle. Intraluminal distension of the intestine is known to stimulate the release of endogenous 5-HT from enterochromaffin cells, activating 5-HT3 receptors located on primary afferent neurons and leading to increases in intestinal secretions and peristaltic activity. Ramosetron, a potent and selective 5-HT3-receptor antagonist, has been in development for use in patients suffering from diarrhea-predominant IBS. In a double-blind, placebo-controlled, parallel-group study of 418 patients with diarrhea-predominant IBS-D, once-daily 5 µg and 10 µg doses of ramosetron increased the monthly responder rates of IBS symptoms compared to placebo. In a 12-week randomized controlled trial of 539 patients, a positive response to treatment was reported by 47% of a once-daily 5 µg dose of ramosetron-treated individuals compared to 27% of patients receiving placebo (P<0.001. Furthermore, the responder rate was increased in the oral administration of 5 µg of ramosetron for at least 28 weeks (up to 52 weeks, and long-term efficacy for overall improvement of IBS symptoms was also demonstrated. The rate was further increased subsequently. Adverse events were reported by 7% in ramosetron treatment. No serious adverse events, eg, severe constipation or ischemic colitis, were reported for long-term treatment with ramosetron. In conclusion, further studies to evaluate the long-term efficacy and safety of ramosetron are warranted in the form of randomized controlled trials. Keywords: long

  4. Thinking and method of treatment based on syndrome types of IBS%肠易激综合征分型辨治的思路与方法

    Institute of Scientific and Technical Information of China (English)

    迟莉丽; 杨传华

    2012-01-01

    肠易激综合征(IBS)临床以腹泻型、便秘型、混合型最为常见.介绍了IBS分型论治的思路与方法,腹泻型采用抑肝扶脾化湿止泻法;便秘型采用疏肝解郁通腑导滞法,混合型采用寒热并用补虚泻实法.而疏肝健脾补骨法有助于抗IBS复发.%The diarrhea type,constipation type and mixed type are the most commonly seen types in irritable bowel syndrome (IBS). This article introduces the thinking and method of Chinese medicine treatment based on western medicine types of IBS:treating the diarrhea type by suppressing liver srengthen spleen and resolve dampness to stop diarrhea,treating the constipation type by dispersing liver-Qi to relieve stagnation and purging bowls, treating the mixed type by applying both cold and heat herbs simultaneously and tonifing the dificiency and reduce excessive method,and soothing the liver and strengthening the spleen and invigorating the kidney contribute to prevent recurrence of IBS.

  5. Effects of electroacupuncture at Zusanli (ST 36) on neurons in the colonic myenteric plexus in rats with irritable bowel syndrome with constipation

    Institute of Scientific and Technical Information of China (English)

    Liting Zhu; Zhonghan Li; Bin Xu; Chen Xia; Jie Cheng; Xiaoren Xiang; Yi Zhu

    2011-01-01

    We studied the effects of electroacupuncture at Zusanli (ST 36) on neurons in the colonic myenteric plexus and on defecation in rats with irritable bowel syndrome with constipation (IBS-C). We also used intragastric administration of pinaverium bromide as a positive control treatment to reveal the pathway mediating the onset of IBS-C. Both electroacupuncture and pinaverium bromide greatly improved defecation in rats with IBS-C. Immunohistochemical staining of the enteric nervous system neuronal marker protein gene product 9.5 in the colonic myenteric plexus showed that electroacupuncture by itself, or in combination with pinaverium bromide, increased the number of neurons and the staining intensity of protein gene product 9.5 in the colonic myenteric plexus. We conclude that visceral hypersensitivity is likely to be a primary cause of constipation in IBS-C rats.

  6. 电针“百会”“足三里”穴对 IBS 模型大鼠行为及肠道 NK1受体 mRNA 表达的影响%Electro-acupuncturing at “Baihui”point and “Zusanli”point on beha-vior and mRNA expression of intestinal NK1 receptor in rats with irrita-ble bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    赵雅芳; 郭孟玮; 王顺; 杨帅; 冯潇潇; 任晓暄

    2015-01-01

    目的:观察电针“百会”“足三里”穴对肠易激综合征(IBS)模型大鼠内脏敏感性和情绪心理行为的影响,探讨针刺对慢性内脏痛伴发情绪心理障碍是否具有双重调节作用。方法Wistar 幼鼠随机分为正常组、模型组及针刺组。以母子分离和醋酸灌肠法制备 IBS 大鼠模型。造模完成后,正常组及模型组不做任何处理,针刺组针刺百会穴及足三里穴,隔日1次,共5次。对大鼠进行内脏敏感性评估和旷场实验测试,用 RT-PCR 法检测大鼠肠道 NK1受体(neurokinin-1 receptor)mRNA的水平。结果针刺后模型大鼠内脏敏感性降低、水平活动和垂直活动减少、肠道 NK1 mRNA 表达降低。结论针刺对慢性内脏痛伴发情绪心理障碍具有双重调节作用。%Objective To observe the effects of electro-acupuncturing (EA)at “Baihui”(DU20)and“Zusanli”(ST36)on the visceral sensitivity and emotional and psychological behavior of the irritable bowel syndrome (IBS)model rats,and to explore the double adjustment of electro-acupuncture on chron-ic visceral pain with emotional and psychological dysfunction.Methods Wistar immature rats were ran-domly divided into normal group,model group and electro-acupuncture group.The IBS model was in-duced by mechanical colorectal irritation of acetic acid combined with maternal separation in the postnatal period.Rats of normal group and model group underwent no intervention while those of electro-acupunc-ture group were needled at “Baihui”and “Zusanli”every other day for ten days.The visceral sensitivity was evaluated and the open-filed test was used,and the mRNA of neurokinin-1(NK1)receptor was de-tected by using RT-PCR.Results The treatment of acupuncture reduced significanty the visceral sensi-tivity,crossing activity and vertical activity in open field test,and the mRNA expression of NK1.Con-clusion The double adjustment of electro-acupuncturing at

  7. Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects.

    Science.gov (United States)

    Boersma, Katja; Ljótsson, Brjánn; Edebol-Carlman, Hanna; Schrooten, Martien; Linton, Steven J; Brummer, Robert J

    2016-11-01

    Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.

  8. Title: The Comparison of Anxiety Sensitivity and Happiness in Irritable Bowel Syndrome Patients with Normal Matched Group in Shiraz

    Directory of Open Access Journals (Sweden)

    2012-09-01

    Full Text Available Background & Objective: The purpose of this study was the comparison of anxiety sensitivity and happiness between patients with Irritable Bowel Syndrome (IBS and normal matched group. Materials & Methods: The Subjects were 35 (21 females and 14 male IBS patients diagnosed by gastroenterologist and 35 (25 female and 10 males normal matched group all in 14– 63 old age. Anxiety Sensitivity Index (ASI-R, Oxford Happiness Questionnaire (OHQ, and a checklist applied as measures of anxiety sensitivity, happiness and demographic information. Results: Data analysis indicates that IBS patients significantly are higher than matched group in fear of publicly observable symptoms (P= 0.032, fear of cardiovascular symptoms (P= 0.01, fear of gastrointestinal symptoms (P= 0.001, fear of dissociative and neurological symptoms (P= 0.018, & general anxiety sensitivity (P= 0.003, and lower in joy (P= 0.005, control (P= 0.008, self- esteem (P= 0.001 calm (P= 0.006 and general happiness (P= 0.001. Although no significant differences were found in life satisfaction (P= 0.083 & efficacy (P= 0.09, fear of respiratory symptoms (P= 0.067, and fear of cognitive control deficiency (p= 0.097. Conclusion: As a psychological variable anxiety sensitivity can predict treatment seeking of IBS patient, and happiness negatively influenced by both anxiety sensitivity and IBS.

  9. Chronic functional bowel syndrome enhances gut-brain axis dysfunction, neuroinflammation, cognitive impairment, and vulnerability to dementia.

    Science.gov (United States)

    Daulatzai, Mak Adam

    2014-04-01

    The irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder world wide that lasts for decades. The human gut harbors a diverse population of microbial organisms which is symbiotic and important for well being. However, studies on conventional, germ-free, and obese animals have shown that alteration in normal commensal gut microbiota and an increase in pathogenic microbiota-termed "dysbiosis", impact gut function, homeostasis, and health. Diarrhea, constipation, visceral hypersensitivity, and abdominal pain arise in IBS from the gut-induced dysfunctional metabolic, immune, and neuro-immune communication. Dysbiosis in IBS is associated with gut inflammation. Gut-related inflammation is pivotal in promoting endotoxemia, systemic inflammation, and neuroinflammation. A significant proportion of IBS patients chronically consume alcohol, non-steroidal anti-inflammatories, and fatty diet; they may also suffer from co-morbid respiratory, neuromuscular, psychological, sleep, and neurological disorders. The above pathophysiological substrate is underpinned by dysbiosis, and dysfunctional bidirectional "Gut-Brain Axis" pathways. Pathogenic gut microbiota-related systemic inflammation (due to increased lipopolysaccharide and pro-inflammatory cytokines, and barrier dysfunction), may trigger neuroinflammation enhancing dysfunctional brain regions including hippocampus and cerebellum. These as well as dysfunctional vago-vagal gut-brain axis may promote cognitive impairment. Indeed, inflammation is characteristic of a broad spectrum of neurodegenerative diseases that manifest demntia. It is argued that an awareness of pathophysiological impact of IBS and implementation of appropriate therapeutic measures may prevent cognitive impairment and minimize vulnerability to dementia. PMID:24590859

  10. Increased Chromogranin A Cell Density in the Large Intestine of Patients with Irritable Bowel Syndrome after Receiving Dietary Guidance

    Directory of Open Access Journals (Sweden)

    Tarek Mazzawi

    2015-01-01

    Full Text Available The large intestine contains five types of endocrine cells that regulate its functions by sensing its luminal contents and releasing specific hormones. Chromogranin A (CgA is a common marker for the gastrointestinal endocrine cells, and it is abnormal in irritable bowel syndrome (IBS patients. Most IBS patients relate their symptoms to certain food elements. The present study investigated the effect of dietary guidance on the total endocrine cells of the large intestine as detected by CgA in 13 IBS patients. Thirteen control subjects were also included. Each patient received three sessions of dietary guidance. Colonoscopies were performed on controls and patients (at baseline and at 3–9 months after receiving guidance. Biopsy samples from the colon and rectum were immunostained for CgA and quantified by computerized image analysis. The densities of CgA cells in the total colon (mean ± SEM among the controls and the IBS patients before and after receiving dietary guidance were 83.3±10.1, 38.6±3.7, and 64.7±4.2 cells/mm2, respectively (P=0.0004, and were unchanged in the rectum. In conclusion, the increase in CgA cell density after receiving dietary guidance may reflect a change in the densities of the large intestinal endocrine cells causing an improvement in the IBS symptoms.

  11. 粪菌移植在肠易激综合征中的研究进展%Advances in fecal microbiota transplantation in irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    弓三东; 崔立红

    2015-01-01

    粪菌移植(fecal microbiota transplantation,FMT)可以纠正肠道微生态失衡,近年来已成功应用于部分肠道微生态相关疾病的治疗,但 FMT 在肠易激综合征(irritable bowel syndrome,IBS)中的研究仍较少。本文对肠道微生态与 IBS 的关系、FMT 在 IBS 中的临床应用、可能机制、安全性及应用前景等方面的最新进展进行综述。%Fecal microbiota transplantation (FMT) can correct intestinal dysbiosis, and it has been successfully used in the treatment of partial intestinal microflora related diseases in recent years, but still few researches are found on irritable bowel syndrome (IBS). In this article, the latest progresses of the relationship between gut microflora and IBS, clinical applications, possible mechanisms, safety and application prospects of FMT in IBS will be reviewed.

  12. Advances in fecal microbiota transplantation in irritable bowel syndrome%粪菌移植在肠易激综合征中的研究进展

    Institute of Scientific and Technical Information of China (English)

    弓三东; 崔立红

    2015-01-01

    Fecal microbiota transplantation (FMT) can correct intestinal dysbiosis, and it has been successfully used in the treatment of partial intestinal microflora related diseases in recent years, but still few researches are found on irritable bowel syndrome (IBS). In this article, the latest progresses of the relationship between gut microflora and IBS, clinical applications, possible mechanisms, safety and application prospects of FMT in IBS will be reviewed.%粪菌移植(fecal microbiota transplantation,FMT)可以纠正肠道微生态失衡,近年来已成功应用于部分肠道微生态相关疾病的治疗,但 FMT 在肠易激综合征(irritable bowel syndrome,IBS)中的研究仍较少。本文对肠道微生态与 IBS 的关系、FMT 在 IBS 中的临床应用、可能机制、安全性及应用前景等方面的最新进展进行综述。

  13. Modern treatment of adult short bowel syndrome patients

    DEFF Research Database (Denmark)

    Efsen, E; Jeppesen, P B

    2011-01-01

    By definition, intestinal failure prevails when oral compensation is no longer feasible and parenteral support is necessary to maintain nutritional equilibrium. In the past, conventional treatment has mainly focused on "making the most of what the short bowel syndrome patient still had" by optimi......By definition, intestinal failure prevails when oral compensation is no longer feasible and parenteral support is necessary to maintain nutritional equilibrium. In the past, conventional treatment has mainly focused on "making the most of what the short bowel syndrome patient still had...

  14. A Randomised, Cross-Over, Placebo-Controlled Study of Aloe vera in Patients with Irritable Bowel Syndrome: Effects on Patient Quality of Life

    OpenAIRE

    Hutchings, H. A.; Wareham, K; Baxter, J. N.; Atherton, P.; J. G. C. Kingham; Duane, P; Thomas, L.; Thomas, M.; C. L. Ch'ng; Williams, J G

    2011-01-01

    Background. Irritable bowel syndrome (IBS) is a chronic, difficult to treat condition. The efficacy of Aloe vera in treating IBS symptoms is not yet proven. The purpose of this study was to determine if Aloe vera is effective in improving quality of life. Methods. A multicentre, randomised, double-blind, cross-over placebo controlled study design. Patients were randomised to Aloe vera, wash-out, placebo or placebo, washout, Aloe vera. Each preparation (60 mL) was taken orally twice a day. Pat...

  15. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  16. Treatment patterns, symptom reduction, quality of life, and resource use associated with lubiprostone in irritable bowel syndrome constipation subtype.

    Science.gov (United States)

    Solem, Caitlyn T; Patel, Haridarshan; Mehta, Sonam; Mody, Reema; Macahilig, Cynthia; Gao, Xin

    2016-05-01

    Objectives Real-world patient outcomes data is scarce concerning the high disease burden of IBS-C. The aim of this study was to compare patient-reported symptom control, health-related quality of life (HRQoL), resource utilization, and treatment satisfaction of lubiprostone vs non-lubiprostone treatment for irritable bowel syndrome-constipation (IBS-C). Research design and methods An observational, retrospective US chart review and computer-assisted telephone patient survey was conducted March to August 2013 recruiting women over 18 years old with physician-confirmed IBS-C who had initiated new treatment from inadequate relief of previous treatments and who had been on the new treatment ≥3 months. Multiple IBS-C treatments were permitted. IBS-C severity, time since diagnosis, age, and race were controlled using inverse probability of treatment weighting. Weighted outcomes were compared using t-tests (continuous outcomes) and chi-squared tests (categorical outcomes). Main outcomes measures Instruments included Patient Assessment of Constipation Symptoms (PAC-SYM) and IBS quality of life (IBS-QoL). A single item assessed current treatment satisfaction. Results Of 162 patients (mean age 45.9 [SD 15.3] years old, 71% white, 61.1% with moderate IBS-C), 76 switched to lubiprostone and 86 to non-lubiprostone. Groups were similar in clinical and demographic characteristics and previous 30 day IBS-C treatment. After weighting, all PAC-SYM scores were lower for lubiprostone (P < 0.05). All IBS-QoL subscales were higher for lubiprostone including overall, dysphoria, social reaction, sexual, and relationship scores (P < 0.05.) More lubiprostone patients reported positive treatment satisfaction (92.3% vs 71.0%, P < 0.001). Conclusions In IBS-C patients with inadequate response to previous therapies, lubiprostone improved patient-reported symptom control, treatment satisfaction, and HRQoL. Key limitations include lack of measurement of patient-reported outcomes

  17. Low serum levels of short-chain fatty acids after lactulose ingestion may indicate impaired colonic fermentation in patients with irritable bowel syndrome

    OpenAIRE

    Undseth R; Jakobsdottir G; Nyman M; Berstad A; Valeur J

    2015-01-01

    Ragnhild Undseth,1 Greta Jakobsdottir,2 Margareta Nyman,2 Arnold Berstad,3 Jørgen Valeur3 1Department of Radiology, Lovisenberg Diaconal Hospital, Oslo, Norway; 2Food for Health Science Centre, Lund University, Lund, Sweden; 3Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway Background: Ingestion of low-digestible carbohydrates triggers symptoms in patients with irritable bowel syndrome (IBS). These carbohydrates become substrates for microbial fermentation in ...

  18. A Clinicopathologic Study of 24 Cases of Systemic Mastocytosis Involving the Gastrointestinal Tract and Assessment of Mucosal Mast Cell Density in Irritable Bowel Syndrome and Asymptomatic Patients

    OpenAIRE

    Doyle, Leona A.; Sepehr, Golrokh J.; Hamilton, Matthew J; Akin, Cem; Castells, Mariana C.; Hornick, Jason L.

    2014-01-01

    Counting mast cells in gastrointestinal (GI) mucosal biopsies is becoming an increasingly common practice. The primary reason for this exercise is to evaluate for possible involvement by systemic mastocytosis (SM). However, the features of mastocytosis in GI biopsies are not well described. In addition, recent studies have suggested that increased mast cells may be involved in the pathogenesis of some cases of diarrhea-predominant irritable bowel syndrome (IBS); the term “mastocytic enterocol...

  19. Treatment of Irritable Bowel Syndrome by Oral Administration of Chinese Medicines and Retention-Enema—— A Report of 50 Cases

    Institute of Scientific and Technical Information of China (English)

    段国玉

    2002-01-01

    @@ Irritable bowel syndrome (IBS), a common disease of intestinal dysfunction, is also called emotional enteritis, mucous enteritis, irritable colon and so on1. It is often lingering with a long disease course and is easy to recur. The author has in recent years treated 50 cases of the disease by oral administration of Chinese medicines and retention-enema, with satisfactory results reported as follows.

  20. Subjective lactose intolerance in apparently healthy adults in southern Iran: Is it related to irritable bowel syndrome?

    Directory of Open Access Journals (Sweden)

    Saberi-Firoozi M

    2007-11-01

    Full Text Available Background : The main symptoms of lactose intolerance are bloating, abdominal cramps, increased flatus and loose watery stools. These symptoms are similar to those of irritable bowel syndrome (IBS, which is a prevalent entity in the community. Objective : As there was no data available on the prevalence of LI and the correlated factors, this study aimed to determine these correlations and their relation to IBS symptoms in an apparently healthy population in Shiraz, southern Iran. Materials and Methods : A survey among 1,978 individuals older than 35 years was conducted in Shiraz, southern Iran, using a questionnaire that consisted of items regarding demographic data, life style, subjective gastrointestinal symptoms of LI and IBS symptoms according to ROME II criteria. Results : A total of 562 subjects reported LI (28.41%. The prevalence was significantly higher in females, in subjects taking NSAIDs or acetaminophen and in cases reporting IBS symptoms. Subjects with LI avoided certain foods and drinks; and in order to relieve their symptoms, they used OTC drugs, herbal medicine or visited a physician. On the other hand, no relation was found between LI and age, smoking or the number of meals per day. Conclusions : Although we found that individuals with IBS had significantly more subjective LI than those without IBS, in the absence of documented lactose malabsorption, it is hard to tell whether the reported symptoms indeed are those of LI or simply those of IBS. So, a period of dairy product avoidance and/ or requesting a test for lactose malabsorption may be beneficial in this area.

  1. Randomised controlled trial of brief intervention with biofeedback and hypnotherapy in patients with refractory irritable bowel syndrome.

    Science.gov (United States)

    Dobbin, A; Dobbin, J; Ross, S C; Graham, C; Ford, M J

    2013-01-01

    Irritable bowel syndrome (IBS) is a common disorder associated with profoundly impaired quality of life and emotional distress. The management of refractory IBS symptoms remains challenging and non-pharmacological therapeutic approaches have been shown to be effective. We compared brief interventions with biofeedback and hypnotherapy in women referred by their GP with refractory IBS symptoms. Patients were randomised to one of two treatment groups, biofeedback or hypnotherapy, delivered as three one-hour sessions over 12 weeks. Symptom assessments were undertaken using validated, self-administered questionnaires. Two of the 128 consecutive IBS patients suitable for the study declined to consider nonpharmacological therapy and 29 patients did not attend beyond the first session. Of the 97 patients randomised into the study, 21 failed to attend the therapy session; 15 of 76 patients who attended for therapy dropped out before week 12 post-therapy. The mean (SD) change in IBS symptom severity score 12 weeks post-treatment in the biofeedback group was -116.8 (99.3) and in the hypnotherapy group -58.0 (101.1), a statistically significant difference between groups (difference=-58.8, 95% confidence interval [CI] for difference [-111.6, -6.1], p=0.029). In 61 patients with refractory IBS, biofeedback and hypnotherapy were equally effective at improving IBS symptom severity scores, total non-gastrointestinal symptom scores and anxiety and depression ratings during 24 weeks follow-up. Biofeedback may prove to be the more cost-effective option as it requires less expertise. PMID:23516685

  2. Associations between Single-Nucleotide Polymorphisms in Corticotropin-Releasing Hormone-Related Genes and Irritable Bowel Syndrome.

    Directory of Open Access Journals (Sweden)

    Ayaka Sasaki

    Full Text Available Irritable bowel syndrome (IBS is a common functional disorder with distinct features of stress-related pathophysiology. A key mediator of the stress response is corticotropin-releasing hormone (CRH. Although some candidate genes have been identified in stress-related disorders, few studies have examined CRH-related gene polymorphisms. Therefore, we tested our hypothesis that single-nucleotide polymorphisms (SNPs in CRH-related genes influence the features of IBS.In total, 253 individuals (123 men and 130 women participated in this study. They comprised 111 IBS individuals and 142 healthy controls. The SNP genotypes in CRH (rs28364015 and rs6472258 and CRH-binding protein (CRH-BP (rs10474485 were determined by direct sequencing and real-time polymerase chain reaction. The emotional states of the subjects were evaluated using the State-Trait Anxiety Inventory, Perceived Stress Scale, and the Self-rating Depression Scale.Direct sequencing of the rs28364015 SNP of CRH revealed no genetic variation among the study subjects. There was no difference in the genotype distributions and allele frequencies of rs6472258 and rs10474485 between IBS individuals and controls. However, IBS subjects with diarrhea symptoms without the rs10474485 A allele showed a significantly higher emotional state score than carriers.These results suggest that the CRH and CRH-BP genes have no direct effect on IBS status. However, the CRH-BP SNP rs10474485 has some effect on IBS-related emotional abnormalities and resistance to psychosocial stress.

  3. Differentiating coeliac disease from irritable bowel syndrome by urinary volatile organic compound analysis--a pilot study.

    Directory of Open Access Journals (Sweden)

    Ramesh P Arasaradnam

    Full Text Available Coeliac disease (CD, a T-cell-mediated gluten sensitive enteropathy, affects ∼ 1% of the UK population and can present with wide ranging clinical features, often being mistaken for Irritable Bowel Syndrome (IBS. Heightened clinical awareness and serological screening identifies those with potential coeliac disease; the diagnosis is confirmed with duodenal biopsies, and symptom improvement with a gluten-free diet. Limitations to diagnosis are false negative serology and reluctance to undergo biopsy. The gut microbiome is altered in several gastrointestinal disorders, causing altered gut fermentation patterns recognisable by volatile organic compounds (VOC analysis in urine, breath and faeces. We aimed to determine if CD alters the urinary VOC pattern, distinguishing it from IBS. 47 patients were recruited, 27 with established CD, on gluten free diets, and 20 with diarrhoea-predominant IBS (D-IBS. Collected urine was stored frozen in 10 ml aliquots. For assay, the specimens were heated to 40 ± 0.1°C and the headspace analysed by Field Asymmetric Ion Mobility Spectrometry (FAIMS. Machine learning algorithms were used for statistical evaluation. Samples were also analysed using Gas chromatography and mass spectroscopy (GC-MS. Sparse logistic regression showed that FAIMS distinguishes VOCs in CD vs D-IBS with ROC curve AUC of 0.91 (0.83-0.99, sensitivity and specificity of 85% respectively. GCMS showed a unique peak at 4'67 found only in CD, not D-IBS, which correlated with the compound 1,3,5,7 cyclooctatetraene. This study suggests that FAIMS offers a novel, non-invasive approach to identify those with possible CD, and distinguishes from D-IBS. It offers the potential for monitoring compliance with a gluten-free diet at home. The presence of cyclooctatetraene in CD specimens will need further validation.

  4. Differentiating coeliac disease from irritable bowel syndrome by urinary volatile organic compound analysis--a pilot study.

    Science.gov (United States)

    Arasaradnam, Ramesh P; Westenbrink, Eric; McFarlane, Michael J; Harbord, Ruth; Chambers, Samantha; O'Connell, Nicola; Bailey, Catherine; Nwokolo, Chuka U; Bardhan, Karna D; Savage, Richard; Covington, James A

    2014-01-01

    Coeliac disease (CD), a T-cell-mediated gluten sensitive enteropathy, affects ∼ 1% of the UK population and can present with wide ranging clinical features, often being mistaken for Irritable Bowel Syndrome (IBS). Heightened clinical awareness and serological screening identifies those with potential coeliac disease; the diagnosis is confirmed with duodenal biopsies, and symptom improvement with a gluten-free diet. Limitations to diagnosis are false negative serology and reluctance to undergo biopsy. The gut microbiome is altered in several gastrointestinal disorders, causing altered gut fermentation patterns recognisable by volatile organic compounds (VOC) analysis in urine, breath and faeces. We aimed to determine if CD alters the urinary VOC pattern, distinguishing it from IBS. 47 patients were recruited, 27 with established CD, on gluten free diets, and 20 with diarrhoea-predominant IBS (D-IBS). Collected urine was stored frozen in 10 ml aliquots. For assay, the specimens were heated to 40 ± 0.1°C and the headspace analysed by Field Asymmetric Ion Mobility Spectrometry (FAIMS). Machine learning algorithms were used for statistical evaluation. Samples were also analysed using Gas chromatography and mass spectroscopy (GC-MS). Sparse logistic regression showed that FAIMS distinguishes VOCs in CD vs D-IBS with ROC curve AUC of 0.91 (0.83-0.99), sensitivity and specificity of 85% respectively. GCMS showed a unique peak at 4'67 found only in CD, not D-IBS, which correlated with the compound 1,3,5,7 cyclooctatetraene. This study suggests that FAIMS offers a novel, non-invasive approach to identify those with possible CD, and distinguishes from D-IBS. It offers the potential for monitoring compliance with a gluten-free diet at home. The presence of cyclooctatetraene in CD specimens will need further validation. PMID:25330367

  5. Endocannabinoid and cannabinoid-like fatty acid amide levels correlate with pain-related symptoms in patients with IBS-D and IBS-C: a pilot study.

    Directory of Open Access Journals (Sweden)

    Jakub Fichna

    Full Text Available AIMS: Irritable bowel syndrome (IBS is a functional gastrointestinal (GI disorder, associated with alterations of bowel function, abdominal pain and other symptoms related to the GI tract. Recently the endogenous cannabinoid system (ECS was shown to be involved in the physiological and pathophysiological control of the GI function. The aim of this pilot study was to investigate whether IBS defining symptoms correlate with changes in endocannabinoids or cannabinoid like fatty acid levels in IBS patients. METHODS: AEA, 2-AG, OEA and PEA plasma levels were determined in diarrhoea-predominant (IBS-D and constipation-predominant (IBS-C patients and were compared to healthy subjects, following the establishment of correlations between biolipid contents and disease symptoms. FAAH mRNA levels were evaluated in colonic biopsies from IBS-D and IBS-C patients and matched controls. RESULTS: Patients with IBS-D had higher levels of 2AG and lower levels of OEA and PEA. In contrast, patients with IBS-C had higher levels of OEA. Multivariate analysis found that lower PEA levels are associated with cramping abdominal pain. FAAH mRNA levels were lower in patients with IBS-C. CONCLUSION: IBS subtypes and their symptoms show distinct alterations of endocannabinoid and endocannabinoid-like fatty acid levels. These changes may partially result from reduced FAAH expression. The here reported changes support the notion that the ECS is involved in the pathophysiology of IBS and the development of IBS symptoms.

  6. Four-sample lactose hydrogen breath test for diagnosis of lactose malabsorption in irritable bowel syndrome patients with diarrhea

    OpenAIRE

    Yang, Jian-Feng; Fox, Mark; Chu, Hua; Zheng, Xia; Long, Yan-Qin; Pohl, Daniel; Fried, Michael; Dai, Ning

    2015-01-01

    AIM: To validate 4-sample lactose hydrogen breath testing (4SLHBT) compared to standard 13-sample LHBT in the clinical setting. METHODS: Irritable bowel syndrome patients with diarrhea (IBS-D) and healthy volunteers (HVs) were enrolled and received a 10 g, 20 g, or 40 g dose lactose hydrogen breath test (LHBT) in a randomized, double-blinded, controlled trial. The lactase gene promoter region was sequenced. Breath samples and symptoms were acquired at baseline and every 15 min for 3 h (13 ...

  7. Is there an association of microscopic colitis and irritable bowel syndrome-A subgroup analysis of placebo-controlled trials

    Institute of Scientific and Technical Information of China (English)

    Ahmed Madisch; Birgit Bethke; Manfred Stolte; Stephan Miehlke

    2005-01-01

    @@ TO THE EDITOR With great interest we read the recent retrospectice study by Barta et al (1) dealing with the clinical presentation of patients with microscopic colitis. They investigated in a cohort of 53 patients with microscopic colitis (46 with collagenous colitis, 7 with lymphocytic colitis)the relationship between microscopic colitis and both constipation and diarrhea. One of their mean finding was that abdominal pain, diarrhea and constipation was a common symptom complex of patients with microscopic colitis, thus the face of microcopic colitis resembles the subgroups of irritable bowel syndrome (IBS).

  8. [NEWS IN ETIOLOGY AND PATHOGENESIS OF IRRITATED BOWEL SYNDROME].

    Science.gov (United States)

    Sheptulin, A A; Vize-Khripunova, M A

    2016-01-01

    The concept of irritated bowel syndrome as a complex of functional disorders that can not be explained by organic changes and are totally due to intestinal motility and visceral sensitivity needs revision. The development of this syndrome also depends on a number of pathogenetic and etiological factors, such as inflammation of intestinal mucosa, changes of its permeability, previous infection, altered microflora, gene polymorphism, and food hypersensitivity. PMID:27459756

  9. Sindrom iritabilnega črevesa: Irritable bowel syndrome:

    OpenAIRE

    Dajčman, Davorin; Potočnik Dajčman, Nataša

    2005-01-01

    Irritable bowl syndrome is one of the most common medical condition diagnosed today. It is a chronic functional gastrointestinal disorder tha affects all aspects of the patient's daily life. It was recognized nearly two centuries ago, but it still remains widely misunderstood by both patients and physicians. Irritable bowel syndrome has been given a number of different names over the years, including nervous colitis, spastic colitis, mucous colitis, unstable colon and irritable colon. Today i...

  10. Epidemiology of functional diarrhea and comparison with diarrhea-predominant irritable bowel syndrome: a population-based survey in China.

    Directory of Open Access Journals (Sweden)

    Yan-Fang Zhao

    Full Text Available BACKGROUND: The epidemiology of functional diarrhea and its impacts on Chinese remain unclear, and there are no data on the comparative epidemiology of functional diarrhea and diarrhea-predominant irritable bowel syndrome (IBS-D. This study was to explore the epidemiology of functional diarrhea and its impacts, and to identify its distinction from IBS-D. METHODS AND FINDINGS: A cross-sectional survey was conducted in 16078 respondents, who were interviewed under a randomized stratified multi-stage sampling design in five cities of China. All respondents completed the modified Rome II questionnaire, and the 36-item Short Form health survey (SF-36 was used for assessing health-related quality of life in 20% of the sample. Overall, 248 respondents (1.54% had functional diarrhea and 277 (1.72% had IBS-D. Functional diarrhea was positively associated with increasing age and body mass index (trend test P<0.05. The three most common symptoms for at least 3 weeks in the past months were loose, mushy or watery stools (n = 203, 81.85%, more than three bowel movements a day (n = 100, 40.32% and having to rush to the toilet to have a bowel movement (n = 72, 29.03%. Meaningful impairment was observed in 5 of the 8 SF-36 domains in respondents with functional diarrhea. The demographics are mostly similar between the respondents with functional diarrhea and IBS-D; however, respondents with IBS-D had more frequent symptoms of diarrhea and even lower scores in SF-36 domains than those with functional diarrhea. CONCLUSIONS: The prevalence of functional diarrhea in China is substantially lower than that in Western countries and relatively higher than that in other Asian countries. It impaired health-related quality of life, and respondents with IBS-D have even worse quality of life. Further population-based studies are needed to investigate the epidemiology of functional diarrhea and the differences between functional diarrhea and IBS-D.

  11. Long term benefits of hypnotherapy for irritable bowel syndrome

    OpenAIRE

    Gonsalkorale, W M; Miller, V; Afzal, A.; Whorwell, P J

    2003-01-01

    Background and aims: There is now good evidence from several sources that hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question.

  12. Technologies in the evaluation of irritable bowel syndrome

    NARCIS (Netherlands)

    Smout, AJPM; Azpiroz, F; Brummer, RJ; Coremans, G; Dapoigny, M; Muller-Lissner, SA; Pace, F; Stockbrugger, RM; Vatn, M; Whorwell, PJ

    2004-01-01

    During a meeting in The Hague, The Netherlands, the IBiS Club evaluated the most important techniques that can be used in the investigation of irritable bowel syndrome, either in the context of scientific research or as a clinical diagnostic tool. In each of these, the relevance of findings made in

  13. 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.

  14. The fecal microbiome in pediatric patients with short bowel syndrome

    Science.gov (United States)

    Changes in the intestinal microbiome of patients with short bowel syndrome (SBS) are thought to significantly affect clinical outcome. These changes may not only delay enteral diet advancement but may also predispose patients to bacterial translocation, bacteremia, and liver disease. Patients with S...

  15. CLINICAL STUDY ON SPLEEN—STOMACH—REINFORCING MOXIBUSTION TREATMENT OF DIARRHEA—TYPE IRRITABLE BOWEL SYNDROME

    Institute of Scientific and Technical Information of China (English)

    吴焕淦; 赵琛; 等

    2002-01-01

    In the present paper,the therapeutic effect of spleen-stomach-reinforcing moxibustion for treatment of irritable bowel syndrome(IBS) is observed and its underlying mechanisms on immunity are analyzed.A total of 72 IBS patients are randomly divided into moxibustion group(n=46)and acupuncture goup(control group,n=26).Acupoints used are Zhongwan(CV12),Qihai(CV6) and Zusanli(ST36).etc.Serum IgG,IgA and IgM contents,blood T-lympocytes(T2+,T4+,T8+)counts,T4+/T8+,cancer embryonic antigen(CEA) content,serum Il-2 and sIL-2R contents are assayed for evaluating changes of the immunocompetence.After two courses of treatment(24 sessions),results show that in moxibustion group,25 cases(54.35%)are cured,17 experience improvement in clinical symptoms and 4 have no apparent changes,with an effective rate of 91.03%;in control group,8 cases(30.78%) are cured,12 experience improvement and 6 have no marked improvement ,with an effective rate of 76.92%.The therapeutic effect of moxibustion is significantly superior to that of acupuncture(P<0.01),In addition,moxibustion can effectively rectify abnormal immune function and stabilize human's immunity,This research provides a reliable experimental basis for clinical application of “principal prescription of moxibustion for reinforcing the spleen and stomach”。KEY WORDS:principal prescription of moxibustion for reinforcing the spleen and stomach Acupuncture therapy Diarrhea-type irritable bowel syndrome.

  16. Clinical Observation on Treatment of Irritable Bowel Syndrome with Diarrhea (IBS-D) by Regulating Liver and Spleen%调肝理脾法治疗腹泻型肠易激综合征症状疗效观察

    Institute of Scientific and Technical Information of China (English)

    汪正芳; 张声生

    2015-01-01

    Objective:To observe the clinical efficacy of the method of regulating liver and spleen on treating irritable bowel syn -drome of diarrhea pattern .Methods:A total of 97 IBS-D patients were randomly divided into two groups .One group received tradi-tional Chinese medicine treatment which has effect of regulating liver and spleen; and the other group received pinaverium bro-mide.Both groups received the treatment for 4 weeks.We followed up the patients for 3 months after treatment to observe the symptoms and the curative effect .Results: The symptoms of both groups showed obvious improvement than before the treatment when it was observed after 2 weeks and 4 weeks of treatment , and 1 month and 3 months after treatment .There were statistical differences ( P<0.05 ) .After 4 weeks of treatment , the symptom reduction value of regulating liver and spleen group was better than that of pinaverium bromide group with statistically significant difference ( P<0.05 );the total effectiveness of the regulating liver and spleen group was 92 .2%and pinaverium bromide group was 69 .6%, it indicated that regulating liver and spleen group was better than the pinaverium bromide group and the difference was statistically significant ( P<0.05 ) .In the respect of impro-ving the major symptoms such as the number of defecation and character of stool , the regulating liver and spleen group was superior than pinaverium bromide group , and the difference was statistically significant ( P<0.05 ) .Conclusion:The prescription of regu-lating liver and spleen has a good clinical curative effect on treating IBS-D.%目的:观察调肝理脾法治疗腹泻型肠易激综合征( IBS-D)的临床疗效。方法:97例IBS-D患者随机分为调肝理脾中药组和匹维溴铵西药组,分别给予调肝理脾方及匹维溴铵治疗。疗程均为4周,疗程结束后随访3个月,观察症状疗效。结果:治疗2周后、治疗4周后、治疗结束后第1个月及第3

  17. Linaclotide-a novel secretagogue in the treatment of irritable bowel syndrome with constipation and chronic idiopathic constipation.

    Science.gov (United States)

    Sharma, Shivani; Sharma, Tina; Dhingra, Richa; Tomar, Prince; Singh, Sukhminder; Malhotra, Manav; Bhardwaj, T R

    2013-10-01

    Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are highly prevalent gastrointestinal disorders. Traditional symptoms based therapies had somewhat limited success and efficacy in addressing the disorders. Recently, linaclotide emerged as novel peptide capable of improving abdominal symptoms in patients suffering from IBS-C and CIC. Guanylate cyclase C (GC-C) receptor a multi domain protein, found to be molecular target for linaclotide which acts by activating GC-C receptor on the apical surface of intestinal epithelial cells. Binding of linaclotide to GC-C receptor triggers the elevation of second messenger cGMP that elicits fluid secretion into intestinal cells which play a critical role in maintaining homeostasis through cystic fibrosis transmembrane conductance regulator (CFTR). Data from Phase II and III clinical trials demonstrated that linaclotide seems to produce a statistically significant increase in stool frequency, improved straining, decreased abdominal pain and discomfort. PMID:24001336

  18. Elevated Circulating hsa-miR-106b, hsa-miR-26a, and hsa-miR-29b in Type 2 Diabetes Mellitus with Diarrhea-Predominant Irritable Bowel Syndrome

    Science.gov (United States)

    Tao, Wenhua; Dong, Xiaoyun; Kong, Guimei; Fang, Penghua; Huang, Xiaoli

    2016-01-01

    Background and Aims. Although the differential expression of microRNA (miRNA) genes has been identified in many diseases, little information exists concerning the miRNA expression profile in type 2 diabetes mellitus (T2DM) with diarrhea-predominant irritable bowel syndrome (D-IBS). Therefore, the specific expression of miRNAs in diabetes with D-IBS is identified in the study. Materials and Methods. 201 patients with IBS and 220 matched healthy controls were included in the study. Microarray technology and real-time reverse transcriptase-polymerase chain reaction analysis (RT-PCR) were taken to examine the miRNA expression profiles of T2DM patients with diarrhea-predominant irritable bowel syndrome (D-IBS) compared with patients with T2DM, patients with D-IBS, and control subjects. Results. We have found that 35 miRNAs were differentially expressed in T2DM with D-IBS, in which three representative miRNAs, hsa-miR-106b, hsa-miR-26a, and hsa-miR-29b, were found to be significantly elevated in T2DM with D-IBS by RT-PCR. Conclusions. Our study has indicated that hsa-miR-106b, hsa-miR-26a, and hsa-miR-29b were elevated in T2DM with D-IBS, which may be the potential biomarkers of T2DM with D-IBS. To obtain a better understanding of the biological functions of these miRNAs in T2DM with D-IBS, functional annotation analysis suggested that the MAPK pathway may be responsible for T2DM with D-IBS.

  19. Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adults with a history of pediatric recurrent abdominal pain

    Institute of Scientific and Technical Information of China (English)

    Fabio Pace; Giovanna Zuin; Stefania Di Giacomo; Paola Molteni; Valentina Casini; Massimo Fontana; Gabriele Bianchi Porro

    2006-01-01

    AIM: To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain (RAP) or irritable bowel syndrome (IBS).METHODS: A group of 67 children with RAP referred to the department from January 1986 to December 1995was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview.We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history of IBS in comparison with adults with no persistent abdominal complaint.RESULTS: Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up (29%)whereas the majority (37 subjects) did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining (40.0% vs 16.0%), respectively (P < 0.05 at Student t test).Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances.CONCLUSION: The study confirms previous observations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms,possibly through the learning of a specific illness behavior.

  20. A HOLISTIC GROUP PSYCHOTHERAPEUTIC INTERVENTION FOR THE TREATMENT OF IRRITABLE BOWEL SYNDROME AND ITS COMORBID DEPRESSION AND ANXIETY

    Directory of Open Access Journals (Sweden)

    A. D. Stuart

    2011-11-01

    Full Text Available The aim of this study was to ascertain the effects of a holistic short-term group intervention in the treatment of Irritable Bowel Syndrome (/BS with comorbid depression and anxiety. The sample consisted of 24 South African women who had been diagnosed with severe IBS. Furthermore, each participant had to have associated moderate to severe depression and anxiety. The group design was a pre-test, post-test control group design where the experimental group (n = 12 received group intervention and the members of the control group (n = 12 received no intervention until after completion of the research. All the participants completed the Functional Bowel Disorder Severity Index and the Depression and Anxiety subscales of the Personality Assessment Inventory before commencement of group therapy for Group 1 and one month after completion of this intervention. The effect of the intervention was determined by utilising comparative statistics. The findings indicate that holistic short-term group therapy results in significant improvement in terms of depreSSion and anxiety scores, but that IBS symptom severity remains unchanged. It is recommended that further research be conducted to ascertain whether holistic group therapy of a longer duration has a greater impact on the IBS symptom severity.

  1. [Physicochemical and pharmacological characteristic and clinical efficacy of an anti-irritable bowel syndrome agent, polycarbophil calcium (Polyful)].

    Science.gov (United States)

    Iwanaga, Yuji

    2002-03-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain or discomfort and abnormal defecation. Polycarbophil calcium, a water-absorbing polymer, is expected to improve stool consistency. Polycarbophil calcium decalcified under the acidic condition and then absorbed 70 times its weight of water under the neutral condition. In in situ experiments using rat jejunum and colon, polycarbophil decreased water absorption by the intestine without affecting water secretion. Polycarbophil inhibited prostaglandin E2-, 5-hydroxy-L-tryptophan- and castor oil-induced diarrhea in mice or rats. Polycarbophil calcium also inhibited sennoside-induced diarrhea in dogs. Polycarbophil increased the weight of feces in naive or low-fiber diet feeding rats. In naive dogs, polycarbophil calcium increased stool frequency, stool weight and moisture. Polycarbophil was not absorbed from the gastrointestine, not metabolized and eliminated into feces in rats and dogs. Polycarbophil calcium did not affect the absorption of coadministered drugs in dogs. In the dose-finding clinical study for IBS, polycarbophil calcium was effective both in diarrhea and constipation. In the Phase III study, polycarbophil calcium was superior to trimebutine maleate in efficacy and equal in safety. Emesis/vomiting and thirst were observed, but episodes of diarrhea or constipation by excessive action were few. Polycarbophil calcium seems promising as an anti-IBS agent.

  2. Serological Screening for Celiac Disease in Adult Chinese Patients With Diarrhea Predominant Irritable Bowel Syndrome.

    Science.gov (United States)

    Wang, Hongling; Zhou, Guoying; Luo, Linjie; Crusius, J Bart A; Yuan, Anlong; Kou, Jiguang; Yang, Guifang; Wang, Min; Wu, Jing; von Blomberg, B Mary E; Morré, Servaas A; Peña, A Salvador; Xia, Bing

    2015-10-01

    Celiac disease (CD) is common in Caucasians, but thought to be rare in Asians. Our aim was to determine the prevalence of CD in Chinese patients with chronic diarrhea predominant irritable bowel syndrome (IBS-D).From July 2010 to August 2012, 395 adult patients with IBS-D and 363 age and sex-matched healthy controls were recruited in Zhongnan Hospital of Wuhan University and Xiaogan Central Hospital in Hubei province, central China. Patients with IBS-D were diagnosed according to the Rome III criteria. Serum Immunoglobulin (IgA/IgG) anti-human tissue transglutaminase (anti-htTG)-deamidated gliadin peptide (DGP) antibodies were measured in a single ELISA (QUANTA Lite h-tTG/DGP Screen). Upper endoscopy with duodenal biopsies and HLA-DQA1 and HLA-DQB1 genotyping were performed in seropositive subjects and a gluten-free diet was prescribed.Seven IBS-D patients (7/395, 1.77%) and 2 healthy controls (2/363, 0.55%), were positive for anti-htTG/DGP antibodies. Of these 9 cases, 1 was lost to follow-up, 3 were suspected to have CD and 5 were eventually diagnosed as CD with intestinal histological lesions classified as Marsh Type II in 2 and Type III in 3. Of these 5 diagnosed CD patients, 4 (4/395, 1.01%) were from the IBS-D group and 1 (1/363, 0.28%) from the healthy control had asymptomatic CD. Two Type III CD patients with relatively high titers in the serologic assay were homozygous and heterozygous for haplotype HLA-DQA1*03-DQB1*03:03 (HLA-DQ9.3), respectively.In the present study, CD was present in 1.01% of patients with IBS-D and in 0.28% of the control group. We like to suggest that the haplotype HLA-DQA1*03-DQB1*03:03 (HLA-DQ9.3), which is common in Chinese, is a new susceptibility factor for CD in China. Larger screening and genetic studies are needed in the Chinese population of different regions. PMID:26496305

  3. The risk of ischaemic colitis in irritable bowel syndrome patients treated with serotonergic therapies.

    Science.gov (United States)

    Lewis, James H

    2011-07-01

    Ischaemic colitis (IC) is the most common form of ischaemic injury to the gastrointestinal (GI) tract. IC typically presents with the sudden onset of lower abdominal pain, cramping and rectal bleeding, and is usually self-limited with low morbidity, although it may cause gangrenous or fulminant colitis, especially when the right colon is involved. Multiple medical conditions, as well as several pharmacological agents, are associated with IC, including irritable bowel syndrome (IBS) and drugs used for its treatment that act on gut serotonin 5-HT receptors. These include the selective 5-HT(3) receptor antagonist alosetron, currently approved for the treatment of severe diarrhoea-predominant IBS in women who fail to respond to conventional treatment, and cilansetron, another 5-HT(3) receptor antagonist that is no longer in clinical development. In addition, the 5-HT(4) receptor partial agonist tegaserod, which was approved for the treatment of constipation-predominant IBS in women, was associated with IC in the postmarketing setting, as was renzapride, a 5-HT(4) agonist/5-HT(3) antagonist. Although several hypotheses have been proposed, the pathophysiological basis for development of IC with 5-HT(3) receptor antagonists or 5-HT(4) receptor agonists remains unknown. Of interest, several population-based studies demonstrated that a diagnosis of IBS (independent of serotonergic therapies) increases the risk of developing IC 2- to 4-fold. As a result, IBS patients with the acute onset of abdominal pain, tenderness, diarrhoea or lower intestinal bleeding, especially those with predisposing conditions or medications, should be evaluated promptly for IC. The management of IC remains supportive; most cases of non-gangrenous IC, as seen in the alosetron and tegaserod databases, have been transient and have resolved spontaneously without complications or death. Despite the small number of deaths associated with alosetron in patients with complications of constipation and

  4. Short bowel syndrome: A review of management options

    Directory of Open Access Journals (Sweden)

    Prasad Seetharam

    2011-01-01

    Full Text Available Extensive resection of the intestinal tract frequently results in inadequate digestion and/or absorption of nutrients, a condition known as short bowel syndrome (SBS. This challenging condition demands a dedicated multidisciplinary team effort to overcome the morbidity and mortality in these patients. With advances in critical care management, more and more patients survive the immediate morbidity of massive intestinal resection to present with SBS. Several therapies, including parenteral nutrition (PN, bowel rehabilitation and surgical procedures to reconstruct bowel have been used in these patients. Novel dietary approaches, pharmacotherapy and timely surgical interventions have all added to the improved outcome in these patients. However, these treatments only partially correct the underlying problem of reduced bowel function and have limited success resulting in 30% to 50% mortality rates. However, increasing experience and encouraging results of intestinal transplantation has added a new dimension to the management of SBS. Literature available on SBS is exhaustive but inconclusive. We conducted a review of scientific literature and electronic media with search terms ′short bowel syndrome, advances in SBS and SBS′ and attempted to give a comprehensive account on this topic with emphasis on the recent advances in its management.

  5. Low serum levels of short-chain fatty acids after lactulose ingestion may indicate impaired colonic fermentation in patients with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Undseth R

    2015-11-01

    Full Text Available Ragnhild Undseth,1 Greta Jakobsdottir,2 Margareta Nyman,2 Arnold Berstad,3 Jørgen Valeur3 1Department of Radiology, Lovisenberg Diaconal Hospital, Oslo, Norway; 2Food for Health Science Centre, Lund University, Lund, Sweden; 3Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway Background: Ingestion of low-digestible carbohydrates triggers symptoms in patients with irritable bowel syndrome (IBS. These carbohydrates become substrates for microbial fermentation in the colon, yielding short-chain fatty acids (SCFAs that are readily absorbed. Aiming to compare colonic fermentation in patients with IBS and healthy controls, we analyzed the concentrations of SCFA in serum at fasting and 90 minutes following ingestion of an unabsorbable, but fermentable carbohydrate, lactulose. Methods: Patients with IBS according to Rome III criteria (n=22 and healthy controls (n=20 ingested 10 g lactulose dissolved in water. Symptoms were graded by questionnaires and SCFA were analyzed using hollow fiber-supported liquid membrane extraction coupled with gas chromatography. Results: Lactulose induced more symptoms in patients with IBS than in healthy controls (P=0.0001. Fasting serum levels of SCFA did not differ between patients with IBS and controls. However, the postprandial levels of total SCFA (P=0.0002, acetic acid (P=0.005, propionic acid (P=0.0001, and butyric acid (P=0.01 were significantly lower in patients with IBS compared with healthy controls. There was no correlation between the levels of serum SCFA and symptom severity. Conclusion: Low-serum levels of SCFA after lactulose ingestion may indicate impaired colonic fermentation in patients with IBS. Conceivably, this disturbance is related to symptom generation, but the mechanism is not clear. Keywords: fermentation, FODMAP, irritable bowel syndrome, microbiota, short-chain fatty acids 

  6. Effect of experimental stress on the small bowel and colon in healthy humans

    OpenAIRE

    Pritchard, SE; Garsed, KC; Hoad, CL; Lingaya, M; Banwait, R; Thongborisute, W; Roberts, E; Costigan, C; Marciani, L.; Gowland, PA; Spiller, RC

    2015-01-01

    Background Symptoms of irritable bowel syndrome (IBS) are frequently reported to be exacerbated by stress. Animal studies suggest that corticotrophin releasing hormone (CRH) mediates the effect of stress on the bowel. We have shown that stressed IBS patients with diarrhea have constricted small bowels. We hypothesized that we could mimic this effect by applying experimental stress in the form of either hand immersion in ice water or CRH injection in healthy volunteers (HV). Methods The postpr...

  7. [SHORT BOWEL SYNDROME AND NUTRITIONAL ENTERAL].

    Science.gov (United States)

    Ariadel Cobo, Diana; Pereira Cunill, José Luis; Socas Macías, María; Serrano Aguayo, Pilar; Gómez Liébana, Eulalia; Morales Conde, Salvador; García Luna, Pedro Pablo

    2015-12-01

    The particularity of this case is the nutritional management that has managed to avoid the use of prolonged parenteral nutrition and possible complications by placing jejunal tube at the distal end in patients with short bowel. It is a 34-year-old colecistectomizado complicated with postoperative peritonitis and dehiscence; two years he studied with small bowel obstruction, he was made de-volvulus and was complicated with two leak at different times after the second escape took place jejunostomy side double barreled shotgun level dehiscence, presented high debits by afferent loop of the terminal jejunostomy; during admission, polyurethane probe enteral feeding was inserted by the efferent loop jejunostomy. He received jejunal tube feeding laundry in the efferent loop terminal with decreased weight gain and subsequent reconstruction of intestinal transit debit proximal jejunostomy.

  8. Cost-effectiveness of internet-based cognitive behavior therapy for irritable bowel syndrome: results from a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Paxling Björn

    2011-04-01

    Full Text Available Abstract Background Irritable Bowel Syndrome (IBS is highly prevalent and is associated with a substantial economic burden. Cognitive behavior therapy (CBT has been shown to be effective in treating IBS. The aim of this study was to evaluate the cost-effectiveness of a new treatment alternative, internet-delivered CBT based on exposure and mindfulness exercises. Methods Participants (N = 85 with IBS were recruited through self-referral and were assessed via a telephone interview and self-report measures on the internet. Participants were randomized to internet-delivered CBT or to a discussion forum. Economic data was assessed at pre-, post- and at 3-month and 1 year follow-up. Results Significant cost reductions were found for the treatment group at $16,806 per successfully treated case. The cost reductions were mainly driven by reduced work loss in the treatment group. Results were sustained at 3-month and 1 year follow-up. Conclusions Internet-delivered CBT appears to generate health gains in IBS treatment and is associated with cost-savings from a societal perspective.

  9. Inter ventional Mechanism of Tongxieyao Formula on Irritable Bowel Syndrome due to Liver Depression and Spleen Deifciency

    Institute of Scientific and Technical Information of China (English)

    Qian Feng; Bo Ping

    2013-01-01

    Objective:To investigate the efficacy and interventional mechanism of Tongxieyao Formula (TXYF) on rat model with irritable bowel syndrome (IBS) due to liver depression and spleen deifciency. Methods:75 newborn SD rats were randomly divided into groups A, B, C, D and E. Except group A, the rats in other groups were treated with senna and strained stress to establish IBS models due to liver depression and spleen deifciency. Groups A and B were fed with intra-gastric normal saline, group C pinaverium bromide, groups D and E TXYF. After treatment, animals were sacriifced to excise colons, and modiifed toluidine blue staining was applied to observe the changes of colonic mucosal mast cell (MC) count and de-granulation conditions in rats. Then the levels of 5-hydroxytryptamine (5-HT), P substance (SP), calcitonin gene-related peptide (CGRP) in blood samples were detected. Results:The counts of colonic mucosal MC and de-granulation increased signiifcantly in model control group. The levels of 5-HT, SP signiifcantly decreased while CGRP increased in C, D and group Es. Conclusion:TXYF can play its role of improving gastrointestinal mobility and reduce visceral sensitivity so as to treat IBS through reducing the counts of colonic mucosal MC and de-granulation as well as the levels of serum 5-HT and plasma SP, and increasing the level of CGRP in IBS model rats.

  10. Irritable bowel syndrome: The incidence of concurrent psychopathology

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    Anita D Stuart

    1999-01-01

    Full Text Available The goal of this study was to improve understanding of the association between physiology and psychology in Functional Gastrointestinal disorders by considering the co-morbidity of lrritable Bowel Syndrome and psychopathology in a sector of the South African population. A comparison was made between the incidence of concurrent psychopathology in a sample of 48 white female patients, aged 25 to 55 years and diagnosed with lrritable Bowel Syndrome and the incidence of psychopathology in a control group that consisted of 39 white women, aged 25 to 55 years, who did not meet the criteria for lrritable Bowel Syndrome.

    The Personality Assessment Inventory was used to determine the incidence of psychopathological personality traits and symptoms in the lrritable Bowel Syndrome group and the control group. This is a selfadministered, objective measuring instrument of adult personality that was developed to provide information about 18 critical clinical variables. The instrument was developed and standardised for use in the clinical assessment of individuals aged 18 years and older. Earlier studies showed a high incidence of associated psychiatric disorder in patients with lrritable Bowel Syndrome. This study confirmed this trend and it seems as if age and level of education has no influence on the incidence of psychopathology in patients with lrritable Bowel Syndrome.

    Opsomming
    Dit was die doel van die studie om 'n verbeterde begrip van die assosiasie tussen fisiologie en sielkunde in Funksionele Maagderm Versteurings te bewerkstellig deur die komorbiditeit van Prikkelbare Dermsindroom en psigopatalogie binne 'n sektor van die Suid Afrikaanse populasie te oorweeg. 'n Vergelyking is getref tussen die voorkoms van konkurrente psigopatalogie in 'n steekproef van 48 wit, vroulike pasiente wat wissel in ouderdomme van 25 tot 55 jaar en gediagnoseer is met Prikkelbare Dermsindroom, en die voorkoms van psigopatalogie in 'n kontrolegroep wat bestaan het

  11. A randomized controlled trial of imipramine in patients with irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Heitham Abdul-Baki; Ihab I El Hajj; Lara ElZahabi; Cecilio Azar; Elie Aoun; Assaad Skoury; Hani Chaar; Ala I Sharara

    2009-01-01

    AIM: To study the efficacy of low-dose imipramine in relieving symptoms associated with the irritable bowel syndrome (IBS). METHODS: A randomized, double-blind trial of 25 mg imipramine vs matched placebo for 12 wk was performed. Doubling the dose was allowed once at week 2 in case of an unsatisfactory early response. Primary efficacy variables were subjective global symptom relief and quality of life (QoL) using SF-36 at week 12. RESULTS: One hundred and seven patients were enrolled by advertisement or referral by general practitioners and 56 (31 imipramine: 25 placebo) completed the 16-wk study. Baseline characteristics were comparable. A high overall dropout rate was noted in the imipramine and placebo arms (47.5% vs 47.9%, P > 0.05), a mean of 25.0 and 37.4 d from enrollment, respectively ( P 0.05). CONCLUSION: Imipramine may be effective in the treatment of IBS patients and is associated with improved QoL. Careful patient selection, initiation of a low dose with gradual escalation and monitoring for side effects may result in an improved therapeutic response.

  12. CLINICAL STUDY ON SPLEEN-STOMACH-REINFORCING MOXIBUSTION TREATMENT OF DIARRHEA-TYPE IRRITABLE BOWEL SYNDROME

    Institute of Scientific and Technical Information of China (English)

    WU Huangan; ZHAO Chen; SHI Zheng; CHEN Hanping; LIU Yan; LIU Shimin

    2002-01-01

    In the present paper, the therapeutic effect of spleen- stomach- reinforcing moxibustion for treatment of irritable bowel syndrome (IBS) is observed and its underlying mechanisms on immunity are analyzed. A total of 72IBS patients are randomly divided into moxibustion group (n = 46) and acupuncture group (control group, n = 26). Acupoints used are Zhongwan (CV 12), Qihai (CV 6) and Zusanli (ST 36), etc. Serum IgG, IgA and IgM contents, blood T-lympocytes (T+3, T+4, T+8) counts, T+4/T+8, cancer embryonic antigen (CEA) content, serum IL-2 and sIL-2R contents are assayed for evaluating changes of the immunocompetence. After two courses of treatment (24 sessions), results show that in moxibustion group, 25 cases (54.35%) are cured, 17 experience improvement in clinical symptoms and 4 have no apparent changes, with an effective rate of 91.30%; in control group, 8 cases (30.78%) are cured,12 experience improvement and 6 have no marked improvement, with an effective rate of 76.92 %. The therapeutic effect of moxibustion is significantly superior to that of acupuncture (P < 0.01). In addition, moxibustion can effectively rectify abnormal immune function and stabilize human's immunity. This research provides a reliable experimental basis for clinical application of "principal prescription of moxibustion for reinforcing the spleen and stomach".

  13. Isolation and whole genome sequencing of a Ruminococcus-like bacterium, associated with irritable bowel syndrome.

    Science.gov (United States)

    Hynönen, Ulla; Rasinkangas, Pia; Satokari, Reetta; Paulin, Lars; de Vos, Willem M; Pietilä, Taija E; Kant, Ravi; Palva, Airi

    2016-06-01

    In our previous studies on the intestinal microbiota in irritable bowel syndrome (IBS), we identified a bacterial phylotype with higher abundance in patients suffering from diarrhea than in healthy controls. In the present work, we have isolated in pure culture strain RT94, belonging to this phylotype, determined its whole genome sequence and performed an extensive genomic analysis and phenotypical testing. This revealed strain RT94 to be a strict anaerobe apparently belonging to a novel species with only 94% similarity in the 16S rRNA gene sequence to the closest relatives Ruminococcus torques and Ruminococcus lactaris. The G + C content of strain RT94 is 45.2 mol% and the major long-chain cellular fatty acids are C16:0, C18:0 and C14:0. The isolate is metabolically versatile but not a mucus or cellulose utilizer. It produces acetate, ethanol, succinate, lactate and formate, but very little butyrate, as end products of glucose metabolism. The mechanisms underlying the association of strain RT94 with diarrhea-type IBS are discussed. PMID:26946362

  14. Non-Celiac Gluten Sensitivity Has Narrowed the Spectrum of Irritable Bowel Syndrome: A Double-Blind Randomized Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Bijan Shahbazkhani

    2015-06-01

    Full Text Available Several studies have shown that a large number of patients who are fulfilling the criteria for irritable bowel syndrome (IBS are sensitive to gluten. The aim of this study was to evaluate the effect of a gluten-free diet on gastrointestinal symptoms in patients with IBS. In this double-blind randomized, placebo-controlled trial, 148 IBS patients fulfilling the Rome III criteria were enrolled between 2011 and 2013. However, only 72 out of the 148 commenced on a gluten-free diet for up to six weeks and completed the study; clinical symptoms were recorded biweekly using a standard visual analogue scale (VAS. In the second stage after six weeks, patients whose symptoms improved to an acceptable level were randomly divided into two groups; patients either received packages containing powdered gluten (35 cases or patients received placebo (gluten free powder (37 cases. Overall, the symptomatic improvement was statistically different in the gluten-containing group compared with placebo group in 9 (25.7%, and 31 (83.8% patients respectively (p < 0.001. A large number of patients labelled as irritable bowel syndrome are sensitive to gluten. Using the term of IBS can therefore be misleading and may deviate and postpone the application of an effective and well-targeted treatment strategy in gluten sensitive patients.

  15. Clinical Study on Acupuncture in Treating Diarrhea-predominant Irritable Bowel Syndrome

    Institute of Scientific and Technical Information of China (English)

    刘慧荣; 杨允; 吴焕淦; 肖元春

    2008-01-01

    Objective: To observe the changes of 5-hydroxytryptamine (5-HT) in colonic membrane of diarrhea-predominant irritable bowel syndrome (IBS-D) and the clinical efficacy of herbal cake-partitioned moxibustion in treating it, and to explore the action mechanisms. Methods: Seventy-three subjects were randomized into two groups: moxibustion group in which 37 cases were treated by herbal cake-partitioned moxibustion and needling group in which 36 cases were treated by needling. The clinical efficacy and 5-HT expression in colonic membrane were observed. Results: The cure rate was 43.2% in the moxibustion group and 36.1% in the needling group, with no significant difference between the two groups (P>0.05). Herbal cake-partitioned moxibustion could reduce 5-HT expression in colonic membrane. Conclusion: Herbal cake-partitioned moxibustion might improve the clinical symptoms of IBS-D by reducing 5-HT expression.%目的:观察腹泻型肠易激综合征(irritable bowel syndrome,IBS)患者结肠粘膜5-HT趸化及隔药灸治疗的临床疗效,初步探讨其作用机理.方法:临床收集腹泻型IBS患者73例,随机分为隔药灸组(37例)和针刺组(36例)进行治疗,观察临床疗效,并观察隔药灸治疗对典型患者结肠粘膜5一HT表达的影响.结果:隔药灸组痊愈率为43.2%,针刺组痊愈率为36.1%,两组间无统计学差异(P>O.05);隔药灸治疗能够改善患者结肠粘膜5-HT异常增高的表达.结论:隔药灸能够改善腹泻型IBs临床症状,可能是通过调节5-HT表达发挥治疗作用.

  16. Treatment of the irritable bowel syndrome.

    Science.gov (United States)

    Friedman, G

    1991-06-01

    Individualization of treatment for patients with IBS is predicated on a thorough analysis of the patient's symptoms, consideration of the reasons for seeking health care, evaluation of symptom-precipitating factors, elimination of confounding features, and the absolute knowledge of the absence of organic illness. Collecting and codifying appropriate historical data allow the physician to educate the patient with respect to the origin of his symptoms, and to enlist the patient as a partner in his future health care. There is no single, universally accepted therapeutic agent available for the treatment of the IBS patient. As a result, treatment is directed at reducing the frequency and intensity of triggering factors as well as ameliorating the symptoms when they arise. Symptoms evoked by psychologic factors may be effectively reduced by psychotherapy or hypnotherapy. Situational anxiety may be treated for brief periods by using antianxiety agents such as diazepam, chlordiazepoxide, buspirone, or similar agents. Depressive reactions may be reduced with suitable doses of antidepressant agents such as amitriptyline. Smooth muscle hyperreactivity may be dulled with small amounts of selected anticholinergics, which are usually most effective in reducing meal-induced discomfort. Peppermint oil may be of additional benefit. Gas-related symptoms require elimination of contributory dietary factors, such as lactose-containing foods, sorbitol, or fructose, as well as certain oligosaccharides. Simethecone, charcoal, or beanase may be helpful. Functional constipation is best treated with graded doses of insoluble or soluble fiber. Diarrheal episodes may be reduced with either loperamide or diphenoxylate. Careful, continued follow-up assessment of therapeutic endeavors, a sincere interest in the patient's concerns, and surveillance for intercurrent organic illness are the cornerstones of complete ongoing care. PMID:2066156

  17. Irritable bowel syndrome: a mild disorder; purely symptomatic treatment.

    Science.gov (United States)

    2009-04-01

    (1) Patients frequently complain of occasional bowel movement disorders, associated with abdominal pain or discomfort, but they are rarely due to an underlying organ involvement. Even when patients have recurrent symptoms, serious disorders are no more frequent in these patients than in the general population, unless other manifestations, anaemia, or an inflammatory syndrome is also present; (2) There is currently no way of radically modifying the natural course of recurrent irritable bowel syndrome; (3) The effects of antispasmodics on abdominal pain have been tested in about 20 randomised controlled trials. Pinaverium and peppermint essential oil have the best-documented efficacy and only moderate adverse effects. Antispasmodics with marked atropinic effects do not have a favourable risk-benefit balance; (4) Tricylic antidepressants seem to have only modest analgesic effects in this setting. In contrast, their adverse effects are frequent and they have somewhat negative risk-benefit balances. Nor has the efficacy of selective serotonin reuptake inhibitor antidepressants (SSRIs) been demonstrated; (5) Alosetron and tegaserod carry a risk of potentially life-threatening adverse effects and therefore have negative risk-benefit balances; (6) Seeds of plants such as psyllium and ispaghul, as well as raw apples and pears, have a limited impact on constipation and pain. Osmotic laxatives are effective on constipation. Symptomatic treatments for constipation can sometimes aggravate abdominal discomfort; (7) Loperamide has been poorly assessed in patients with recurrent irritable bowel syndrome with diarrhoea. It modestly slows bowel movement but does not relieve pain or abdominal discomfort; (8) Dietary measures have not been tested in comparative trials. Some patients are convinced that certain foods provoke a recurrence of irritable bowel syndrome, but restrictive diets carry a risk of nutritional deficiencies; (9) Various techniques intended to control emotional and

  18. The management of patients with the short bowel syndrome

    OpenAIRE

    Platell, Cameron F. E.; Coster, Jane; McCauley, Rosalie D.; Hall, John C

    2002-01-01

    The surgeon is invariably the primary specialist involved in managing patients with short bowel syndrome. Because of this they will play an important role in co-ordinating the management of these patients. The principal aims at the initial surgery are to preserve life, then to preserve gut length, and maintain its continuity. In the immediate postoperative period, there needs to be a balance between keeping the patient alive through the use of TPN and antisecretory agents and promoting gut ad...

  19. Overview of short bowel syndrome and intestinal transplantation.

    OpenAIRE

    Debora Duro; Daniel Kamin

    2009-01-01

    Short bowel syndrome is at once a surgical, medical, and a disorder, with potential for life-threatening complications as well as eventual independence from artificial nutrition. Navigating through the diagnostic and therapeutic decisions is ideally accomplished by a multidisciplinary team comprised of nutrition, pharmacy, social work, medicine, and surgery. Early identification of patients at risk for long-term PN-dependency is the first step towards avoiding severe complications. Close mon...

  20. Short Bowel Syndrome, a Case of Intestinal Rehabilitation

    OpenAIRE

    Dianna Ramírez Prada; Gabriel del Castillo Calderón

    2015-01-01

    Case: The objective is to present the successful experience of multidisciplinary management of a patient with short bowel syndrome and intestinal failure with progression to intestinal adaptation. This is a newly born premature with intestinal atresia type IV with multiple intestinal atresia who evolved to intestinal failure and required managed with prolonged parenteral nutritional support, multiple antibiotic schemes, prebiotics, multivitamins, enteral nutrition with elemental formula to ac...