Functional bowel disorders and irritable bowel syndrome in Europe

Case History—A 42 yr old woman presenting with increased bowel frequency, loose stools and urgency after treatment of Campylobacter sp.. Symptoms suggestive of disturbed lower gastrointestinal function without adequate explanation are very common in adults in the Western world, up to 15% of whom experience such symptoms at any one time, although most do not seek medical advice. It is not clear whether the symptoms of those individuals who do seek medical help have a different pathophysiological basis from those who do not, and whether the seeking of medical advice is more an indication of a worried individual than of disturbed gut function....

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Understanding Functional Bowel Disorders

Adult Nursing Practice ◽

10.1093/oso/9780199697410.003.0020 ◽

2012 ◽

Author(s):

Jenny Gordon

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Disorders ◽

Functional Bowel Disorders ◽

Abdominal Symptoms ◽

Bowel Disorders ◽

Health Nursing ◽

Functional Bloating ◽

Irritable Bowel

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with the group of conditions often described as functional bowel disorders (FBD)—see definitions below—in an evidence-based and person-centred way. The chapter will provide an overview of the causes and impact of FBDs, before exploring best practice to deliver care, as well as to prevent or to minimize further ill-health. Nursing assessments and priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with FBDs can be found in Chapters 16, 23, 24, and 25, respectively. This chapter discusses the group of conditions often described as functional bowel disorders (FBDs). The term ‘functional gastrointestinal disorders’ is also used in the literature, but, for the purpose of this book, the term FBDs will be adopted. This refers to a group of disorders that are characterized by chronic gastrointestinal symptoms that currently have an unknown structural or biochemical cause that could explain those symptoms. Rome III is an internationally agreed set of diagnostic criteria and related information on functional gastrointestinal disorders (Longstreth et al., 2006). It includes six major domains for adults: oesophageal; gastro/duodenal; bowel; functional abdominal pain syndrome; biliary; and anorectal. This chapter will cover the FBDs that specifically relate to chronic abdominal symptoms. General abdominal symptoms include functional dyspepsia, non-cardiac chest pain, which may mimic functional abdominal symptoms, chronic abdominal pain, functional constipation, functional diarrhoea, functional bloating, and irritable bowel syndrome (IBS). The chapter will concentrate on irritable bowel syndrome. Coeliac disease and Crohn’s disease are included: to give an understanding of these disorders, and to differentiate between inflammatory and non-inflammatory conditions; to highlight the impact of the symptoms on the people who suffer from them; and to give an insight into the contribution that effective nursing makes. The amount of research and the number of publications concerning FBDs has risen considerably since the mid 1990s, and has contributed to the increasing legitimacy of these conditions as disorders in their own right and not simply by virtue of exclusion of all other possibilities.

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Prebiotics in irritable bowel syndrome and other functional bowel disorders in adults: a systematic review and meta-analysis of randomized controlled trials

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy376 ◽

2019 ◽

Vol 109 (4) ◽

pp. 1098-1111 ◽

Cited By ~ 23

Author(s):

Bridgette Wilson ◽

Megan Rossi ◽

Eirini Dimidi ◽

Kevin Whelan

Keyword(s):

Systematic Review ◽

Irritable Bowel Syndrome ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Controlled Trials ◽

Functional Bowel Disorders ◽

Randomized Controlled ◽

Bowel Disorders ◽

Mean Differences ◽

Irritable Bowel

ABSTRACT Background Irritable bowel syndrome (IBS) and other functional bowel disorders (FBDs) are prevalent disorders with altered microbiota. Prebiotics positively augment gut microbiota and may offer therapeutic potential. Objectives The aim of this study was to investigate the effect of prebiotics compared with placebo on global response, gastrointestinal symptoms, quality of life (QoL), and gut microbiota, via systematic review and meta-analysis of randomized controlled trials (RCTs) in adults with IBS and other FBDs. Methods Studies were identified using electronic databases, back-searching reference lists, and hand-searching abstracts. RCTs that compared prebiotics to placebo in adults with IBS or other FBDs were included. Two reviewers independently performed screening, data extraction, and bias assessment. Outcome data were synthesized as ORs, weighted mean differences (WMDs) or standardized mean differences (SMDs) with the use of a random-effects model. Subanalyses were performed for type of FBD and dose, type, and duration of prebiotic. Results Searches identified 2332 records, and 11 RCTs were eligible (729 patients). The numbers responding were 52/97 (54%) for prebiotic and 59/94 (63%) for placebo, with no difference between groups (OR: 0.62; 95% CI: 0.07, 5.69; P = 0.67). Similarly, no differences were found for severity of abdominal pain, bloating and flatulence, and QoL score between prebiotics and placebo. However, flatulence severity was improved by prebiotics at doses ≤6 g/d (SMD: –0.35; 95% CI: –0.71, 0.00; P = 0.05) and by non-inulin-type fructan prebiotics (SMD: –0.34; 95% CI: –0.66, –0.01; P = 0.04), while inulin-type fructans worsened flatulence (SMD: 0.85; 95% CI: 0.23, 1.47; P = 0.007). Prebiotics increased absolute abundance of bifidobacteria (WMD: 1.16 log10 copies of the 16S ribosomal RNA gene; 95% CI: 0.06, 2.26; P = 0.04). No studies were at low risk of bias across all bias categories. Conclusions Prebiotics do not improve gastrointestinal symptoms or QoL in patients with IBS or other FBDs, but they do increase bifidobacteria. Variations in prebiotic type and dose impacted symptom improvement or exacerbation. This review was registered at PROSPERO as CRD42017074072.

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Pharmacology of Antispasmodic Drugs Used in Management of Irritable Bowel Syndrome

Doctor Ru ◽

10.31550/1727-2378-2021-20-4-46-54 ◽

2021 ◽

Vol 20 (4) ◽

pp. 46-54

Author(s):

Е.N. Kareva ◽

◽

Keyword(s):

Irritable Bowel Syndrome ◽

Russian Federation ◽

Molecular Mechanisms ◽

Cell Voltage ◽

Neural Systems ◽

Pharmacokinetic Parameters ◽

Bowel Disorders ◽

Intestinal Motility Disorders ◽

The Russian Federation ◽

Irritable Bowel

Objective of the Review: To describe and compare some pharmacodynamic and pharmacokinetic parameters of antispasmodic drugs used in complex management of irritable bowel syndrome (IBS) in the Russian Federation. Key Points. IBS is a chronic recurrent disease associated with abdominal pain and bowel disorders. The key factors of IBS pathogenesis include intestinal motility disorders and visceral hypersensitivity. Both processes are controlled by endocrine and neural systems. In a target cell, voltage-operated calcium channels mediate neuronal signals for unstriped muscles to contract and for glands to start secreting. Antispasmodic drugs are a group of products that have been used for IBS management for decades. The review describes contemporary idea of molecular mechanisms to control contraction of GIT muscle cells and a comparison of antispasmodic drugs used in complex therapy of IBS in the Russian Federation. Their key pharmacodynamic and pharmacokinetic characteristics are discussed. Conclusion. The fundamental difference of mebeverine (Duspatalin) is its ability to normalise bowel motility in patients with IBS without the need in complete motility suppression. Also, its inability to block muscarinic receptors and stimulate opioid receptors is another advantage in improving the quality of life of patients. Keywords: pharmacodynamics, pharmacokinetics, antispasmodic drugs, therapy of irritable bowel syndrome, mebeverine.

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Whorwell et al's “Physiological Effects of Emotion: Assessment Via Hypnosis”

The British Journal of Psychiatry ◽

10.1192/bjp.164.2.241 ◽

1994 ◽

Vol 164 (2) ◽

pp. 241-243 ◽

Cited By ~ 1

Author(s):

T. D. Rogers ◽

David Waxman

Keyword(s):

Colonic Motility ◽

Physiological Effects ◽

Emotional States ◽

Functional Bowel Disorders ◽

Motility Index ◽

Beneficial Effects ◽

Bowel Disorders ◽

Irritable Bowel ◽

Emotion Assessment ◽

Considerable Intensity

“Assessment of the physiological effects of physical and emotional stress has been hampered by a lack of suitable laboratory techniques. Since hypnosis can be used safely to induce specific emotional states of considerable intensity, we studied the effect on distal colonic motility of three hypnotically induced emotions (excitement, anger, and happiness) in 18 patients aged 20–48 years with irritable bowel syndrome. Colonic motility index was reduced by hypnosis on its own (mean change 19.1; 95% CI 0.8, 37.3; P < 0.05) and this change was accompanied by decreases in both pulse (12; 8, 15) and respiration (6; 4, 8) rates (P < 0.001 for both). Anger and excitement increased the colonic motility index (50.8; 29.4, 72.2; and 30.4; 8.9, 51.9, respectively; P < 0.01 for both), pulse rate (26; 22, 30; and 28; 24, 32; P < 0.001 for both), and respiration rate (14; 12, 16; and 12; 10, 14; P < 0.001 for both). Happiness further reduced colonic motility although not significantly from that observed during hypnosis alone. Changes in motility were mainly due to alterations in rate than in amplitude of contractions. Our results indicate that hypnosis may help in the investigation of the effects of emotion on physiological functions; this approach could be useful outside the gastrointestinal system. Our observation that hypnosis strikingly reduces fasting colonic motility may partly explain the beneficial effects of this form of therapy in functional bowel disorders.”

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Four years Follow-up of Patients with Irritable Bowel Syndrome

Romanian Journal Of Internal Medicine ◽

10.1515/rjim-2015-0009 ◽

2015 ◽

Vol 53 (1) ◽

pp. 65-74

Author(s):

F. Rusu ◽

Dan L. Dumitraşcu

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Combined Therapy ◽

Hemorrhoidal Disease ◽

Associated Diseases ◽

Tertiary Center ◽

Rome Iii ◽

Bowel Disorders ◽

Irritable Bowel

Abstract There is little data on the long term evolution of patients with irritable bowel syndrome (IBS) and of associated conditions. We therefore studied the evolution of IBS patients in a single tertiary center during a long interval of time. Methods. We carried out a retrospective study based on the survey of patients records. We analyzed the records of symptoms, therapy, associated diseases, as consigned at follow-up visits for an interval of 4 years in average (2008-2011). Results. A cohort of 114 patients with IBS diagnosed based on Rome III criteria were included (29 men and 85 women), age 19-85 years (mean age: 43.45 years). Urban patients were predominant. The main three symptoms were: abdominal pain, bowel disorders (constipation, diarrhea) and bloating. IBS - constipation (IBS - C) is associated with a favorable course of symptoms (increasing the number of stools, decrease intensity of abdominal pain and bloating) after treatment and IBS - diarrhea (IBS - D) is associated with variable symptoms after treatment (p = 0.031). Using trimebutin or mebeverin in association with other drugs for one month correlates with a favorable evolution of symptoms after treatment and monotherapy is associated with fluctuating symptoms ( p< 0.001). Favorable symptoms are associated with the use of probiotics in combination, but not in monotherapy (p< 0.001). Favorable evolution of symptoms is also associated with the use of anxiolytics in combination. Persistence of symptoms after treatment was correlated with the presence or absence of depression. The absence of depression was correlated with a favorable evolution of symptoms (p = 0.005). IBS-C is associated at limit (marginal significance) with hemorrhoidal disease (p = 0.56). 33 patients (29%) - received monotherapy (trimebutin or mebeverin or probiotics); 81 patients (71%) - received combined therapy: (trimebutin or mebeverin or probiotics) + anxiolytics or proton pump inhibitors (PPI) or nonsteroidal anti-inflammatory (NSAI) or spasmolitics. The most common associated diseases observed in patients with IBS were: depression (27.19%), dyslipidemia (25.43%), hemorrhoidal disease (22.80%) and fibromyalgia (21%). Conclusions. The highest response rate was obtained with trimebutin or mebeverin + anxiolitics + probiotics. The most frequent disease associated with IBS was depression. Other diseases with a high incidence: dyslipidemia, hemorrhoidal disease and fibromyalgia. Further studies are needed to analyze the link between IBS and some associated diseases.

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Obesity and functional bowel disorders in children

Pediatrician (St Petersburg) ◽

10.17816/ped12159-69 ◽

2021 ◽

Vol 12 (1) ◽

pp. 59-69

Author(s):

Anna V. Pogodina ◽

Anastasia I. Romanitsa ◽

Lyubov V. Rychkova

Keyword(s):

Psychological Factors ◽

Eating Habits ◽

Low Grade ◽

Functional Bowel Disorders ◽

Associated Conditions ◽

Bowel Disorders ◽

Common Risk Factors ◽

Irritable Bowel ◽

Low Grade Inflammation ◽

The Relationship

Obesity and functional bowel disorders (FBDs) are often observed in children and share common risk factors. However, the possible relationship between these conditions has begun to be studied recently and the results obtained are ambiguous. Therefore, it is important to summarize the literature on the relationship between obesity and FBDs in children and to discuss the possible pathophysiological mechanisms mediating this. The literature suggests that obesity and FBDs are likely associated conditions. A significant link between obesity and irritable bowel syndrome in children has been confirmed by all studies on this problem. There is also a many evidence that obesity in the pediatric cohort is associated with constipation. However, it should also be noted that there are few studies of this issue, they are heterogeneous in the composition of participants and the diagnostic criteria used, in most cases they are unadjusted for potential confounders. The link between obesity and FBDs may be mediated by diet, eating habits, and psychological factors. But the most promising direction in studying the association between these conditions may be studies of the gut microbiota, changes in which can contribute to impaired intestinal immune function, the development of chronic low-grade inflammation, increased intestinal permeability, impaired motility and visceral hypersensitivity. To date, there is insufficient data to confidently confirm the existence and nature of the relationship between obesity and FBDs in children, but research in this direction can provide important information for the development of approaches to treatment, prevention and early diagnosis of both groups of diseases.

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