scholarly journals Four years Follow-up of Patients with Irritable Bowel Syndrome

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.

Irritable bowel syndrome

2020 ◽  
pp. 2951-2959
Author(s):  
Adam D. Farmer ◽  
Qasim Aziz
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Recurrent Abdominal Pain ◽  
Bowel Habit ◽  
Western World ◽  
Older Individuals ◽  
Butyl Bromide ◽  
Rome Iii ◽  
Fermentable Carbohydrates ◽  
Irritable Bowel

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. The currently used terms are best viewed as an attempt to provide some clinically useful, rather than pathophysiologically accurate, categorization of patients and their symptoms based on disordered gut–brain interactions. Irritable bowel syndrome is defined according to the Rome III criteria as recurrent abdominal pain or discomfort associated with a change in bowel habit for at least 6 months, with symptoms experienced on at least 3 days of at least 3 months. Many subtypes are recognized. Routine haematological and biochemical screening is usually performed on the assumption that it will be normal. Features that raise the suspicion of organic disease and indicate a need for further investigation include the onset of symptoms in middle-aged or older individuals, weight loss, or blood in the stool. Management remains empirical: no single pharmacological agent or group of agents has ever been found to be consistently effective. The principal task of the physician is to provide explanation and reassurance (sometimes supplemented by psychological treatments), but particular symptoms are often treated as follows: (1) constipation—defecation may be eased by supplementary dietary fibre and poorly absorbed fermentable carbohydrates which increase faecal bulk and soften the stool; osmotic laxatives and enemas are used for the severely constipated patient, as well as more novel agents; (2) diarrhoea—attention to diet is often helpful, as are simple antidiarrhoeal agents; and (3) abdominal pain—antispasmodics (e.g. hyoscine butyl bromide) are frequently used, as are antidepressants.

scholarly journals Adherence and Effects Derived from FODMAP Diet on Irritable Bowel Syndrome: A Real Life Evaluation of a Large Follow-Up Observation

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 928 ◽  
Author(s):  
Antonietta Gerarda Gravina ◽  
Marcello Dallio ◽  
Mario Romeo ◽  
Antonietta Di Somma ◽  
Gaetano Cotticelli ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Symptom Control ◽  
Bowel Dysfunction ◽  
Positive Effects ◽  
Diet Regimen ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
The Impact

Introduction: Irritable bowel syndrome represents one of the most difficult gastroenterological diseases to treat, that usually induces the patients to follow different drug therapies, often not useful in symptom control. In this scenario low FODMAP diet could have positive effects in patients with irritable bowel syndrome, even because this type of diet regimen is characterized by a low gluten amount due to the exclusion of cereals. Methods: We enrolled 120 patients with irritable bowel syndrome, according to the Rome IV criteria, who were referred to Hepatogastroenterology Division of the University of Campania L. Vanvitelli from June to December 2018. They underwent a low FODMAP diet for six weeks, followed by a gradual weekly reintroduction of every category of food for three months. The patients had a follow-up evaluation for six months after the end of food reintroduction period. We measured abdominal pain with subjective numerical scale from 0 to 10. We evaluated other gastrointestinal symptoms with a questionnaire about symptoms of lower digestive tract, evaluating their frequency and intensity. We also evaluated the impact of irritable bowel syndrome on daily life with neurological bowel dysfunction score. Results: We obtained a good patient-adherence to diet and a statistically significant decrease of abdominal pain, bloating, flatulence, diarrhea, constipation, and neurological bowel dysfunction score (p < 0.001) at the end of the diet. These results remained constant in the follow-up period. Conclusions: We recommend the use of a low FODMAP diet regimen in patients with irritable bowel syndrome in order to control the symptoms and improve the quality of life.

Long-Term Follow-Up of Gut-Directed Hypnotherapy vs. Standard Care in Children With Functional Abdominal Pain or Irritable Bowel Syndrome

2012 ◽  
Vol 107 (4) ◽  
pp. 627-631 ◽  
Author(s):  
Arine M Vlieger ◽  
Juliette M T M Rutten ◽  
Anita M A P Govers ◽  
Carla Frankenhuis ◽  
Marc A Benninga
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Standard Care ◽  
Functional Abdominal Pain ◽  
Long Term Follow Up ◽  
Irritable Bowel

758 Long Term Follow-up of Gut-Directed Hypnotherapy Versus Standard Care in Children With Functional Abdominal Pain or Irritable Bowel Syndrome

2012 ◽  
Vol 142 (5) ◽  
pp. S-134 ◽  
Author(s):  
Arine M. Vlieger ◽  
Juliette M. Rutten ◽  
Anita M. Govers ◽  
Carla Frankenhuis ◽  
Marc A. Benninga
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Standard Care ◽  
Functional Abdominal Pain ◽  
Long Term Follow Up ◽  
Irritable Bowel

scholarly journals Irritable bowel syndrome after Clostridium difficile infection

2019 ◽  
Author(s):  
Teodora Iacob ◽  
Mihaela Sorina Lupșe ◽  
Dan Lucian Dumitrașcu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Severe Form ◽  
Control Group ◽  
Tertiary Center ◽  
Rome Iii ◽  
Stool Form ◽  
Irritable Bowel ◽  
Gastroenteritis Episode

Abstract Background and Aim Post-Infectious Irritable Bowel Syndrome (PI-IBS) is a common complication of Clostridium difficile infection (CDI). The objectives of this study were to asses the risk of PI-IBS following a CDI. We also evaluated if there is a correlation between the onset of PI-IBS and the severity of CDI. Methods The study group consisted of 69 patients consecutively admitted in a tertiary center with an acute gastroenteritis episode, suspected of having a Clostridium difficile infection. PCR for CDI from feces were performed to assess the infection. The subjects were divided into two groups. A group consisted of patients with CDI and the other group where the CDI was ruled out. The patients were evaluated for PI-IBS 6 months after the episode of CDI by Rome III IBS diagnostic questionnaire and the Bristol Stool Form Scale. Severity of CDI was stratified according to the need for hospitalization or not. The questionnaires were paper printed and directly filled in by the subjects. Results The response rate to the questionnaire was 100%. During the course of this study 31 patients died. Out of 38 patients, 37% (14 patients) were diagnosed with CDI. After CDI, 57% (8 patients) developed PI-IBS and 43% (6 patients) where without PI-IBS with a relative risk (RR) of 2.29 (95 % confidence interval CI 0.99 – 5.23), p=0.04. In the group of patients with a severe form of CDI, 90% (9 patients) developed PI-IBS with a RR of 2.72 (95% CI 0.80 – 9.24), p=0.04, compared to the group of patients with light and moderate forms CDI. Conclusion Our study shows that, 6 months after CDI, PI-IBS develops in 57% patients, higher than in the control group where CDI was ruled out by PCR (43%), statitstically significant (p=0.04). The severity of CDI was a risk factor for PI-IBS, 90% of patients with severe forms of CDI developed PI-IBS.

scholarly journals Randomized Clinical Trial: The Clinical Effects of Herb-Partitioned Moxibustion in Patients with Diarrhoea-Predominant Irritable Bowel Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Yu-xia Ma ◽  
Xiao Liu ◽  
Cun-zhi Liu ◽  
Lin-peng Wang ◽  
Gang Guo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Adverse Events ◽  
Abdominal Distension ◽  
Clinical Effects ◽  
End Of Treatment ◽  
Significant Difference ◽  
Irritable Bowel

Objective. To explore the efficacy of Herb-partitioned moxibustion in treating IBS-D patients.Method. 210 IBS-D patients were randomly assigned on a3:3:2basis to group HM, group FM, or group PB for 4-week treatment. The change of GSRS total score at weeks 4 and 8, the changes of GSRS specific scores, and adverse events were evaluated.Results. Patients in group HM and group FM had lower GSRS total score at week 4 (1.98±0.303,2.93±0.302versus3.73±0.449) and at week 8 (2.75±0.306,3.56±0.329versus4.39±2.48) as compared with patients’ score in group PB. However, there was no significant difference of GSRS total score between group HM and group FM. The effect of HM was significantly greater than that of orally taking PB in ameliorating the symptoms of rugitus (0.38 versus 0.59,P<0.05), abdominal pain (0.28 versus 0.57,P<0.01), abdominal distension (0.4 versus 0.7,P<0.01), and increased passage of stools (0.06 versus 0.25,P<0.01) at the end of treatment period. In the follow-up period, patients’ therapeutic effect in group HM remained greater than that in group FM (in abdominal pain, abdominal distension, and increased passage of stools) and that in group PB (in loose stools).Conclusions. HM appears to be a promising, efficacious, and well-tolerated treatment for patients with IBS-D.

scholarly journals Phenotypic features of patients with post-infectious irritable bowel syndrome

2019 ◽  
Author(s):  
Flaviu Viorel Rusu ◽  
Lorena Mocanu ◽  
Dan Lucian Dumitraşcu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Demographic Data ◽  
Female Gender ◽  
Sudden Onset ◽  
Published Data ◽  
Tertiary Center ◽  
Significant Difference ◽  
Irritable Bowel ◽  
Post Infectious

Background. Although there are many published data in the literature about irritable bowel syndrome, there are only few data on the long term evolution of patients with post infectious irritable bowel syndrome (PI-IBS) and associated conditions. Aims. The purpose of our research was to study the evolution of PI-IBS patients in a single tertiary center over a period of four years. Study Design. Our research was a longitudinal retrospective study. Methods. We carried out this study based on the survey of the patients records. We recruited two groups of patients: patients with classical IBS and patients with PI-IBS. The IBS diagnosis was established using ROME III criteria, which were used at that time. We compared the two groups of patients by analyzing the demographic data, comorbidities, treatment that was prescribed, and evolution after treatment for a period of 48 month on average. Results. From a total of 592 patients that were diagnosed with IBS between 2013-2016, we identified a subgroup of 64 patients with PI-IBS. These patients were also divided into two subgroups, depending on the main symptoms, 51 with PI-IBS – diarrhea and 13 of them with PI-IBS-constipation. IBS is the most commonly diagnosed among women, 45 patients were women and 15 were men. Regarding the frequency of occurrence of a certain subtype by gender, no significant differences were observed in both IBS and PI-IBS. We noticed a higher incidence of patients residents of an urban community in both groups. The main symptoms were: abdominal pain and bowel disorders (constipation, diarrhea). There was a significant difference between the two groups regarding the onset of the symptoms. From the total of 64 patients with PI-IBS, 88.3% presented a sudden onset of symptoms (mainly abdominal pain) unlike the other group where 81% of them presented a progressive onset, with an insidious progress and sporadic exacerbation. Most patients (65.63%) presented an improvement after the treatment, 25.56% oscillating periods but with a significant decrease of intensity of symptoms, and 7.8% did not show improvement after treatment. The most common associated diseases were depression and anxiety (34.37%). Conclusion IBS is generally present in approximately 11% of the population, with PI-IBS patients accounting for approximately 10% of them. Female gender is more common in both IBS and PI-IBS. Patients with PI-IBS are a burden in the health system in terms of the important economic resources used for diagnosis and treatment.

Understanding Functional Bowel Disorders

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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