Phenotypic features of patients with post-infectious irritable bowel syndrome

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.

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A Double Blind Randomized Clinical Trail: Comparing Lactobacillus plantarum 299v with Placebo in treating irritable bowel syndrome patients

10.21203/rs.2.23376/v1 ◽

2020 ◽

Author(s):

Moeen-ul- haq ◽

Fazl Ullah ◽

Muhammad Kamran Hassan ◽

Ahmad Nawaz Babar ◽

Anwar Ullah

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Lactobacillus Plantarum ◽

Clinical Symptoms ◽

Gastrointestinal Disease ◽

Treated Group ◽

Significant Difference ◽

Randomized Control ◽

Irritable Bowel ◽

Rectal Emptying

Abstract Irritable bowel syndrome (IBS) is a gastrointestinal disease of intestinal mobility. IBS present with variable clinical symptoms making the treatment difficult. IBS is quiet prevalent around the globe with different frequency. Differences in frequency and gender is due to diet habit. It is less frequent where diary product and vegetable are frequently consumed as compared to those who consumed meat. Lactobacillus plantarum 299v (L. plantarum 299v) is the most widely studied strain in the IBS patients. It is resistant to the actions of intestinal acids and bile, colonizes the human colonic mucosa and is non-pathogenic in nature. The efficacy of Lactobacillus plantarum 299v L is different in different study. The present study was designed to find the efficacy of Lactobacillus plantarum 299v in comparison to placebo in randomized control trial. MethodOne hundred and ninety patients were assessed for eligibility 46 among them were excluded from the study and twenty four declined to participate in the study. One hundred and twenty patient of IBS was grouped in two different groups. The one was treated with Lactobacillus plantarum 299v and the other was treated with placebo. Symptoms of IBS, like abdominal pain, bloating and complete rectal emptying was noted and interpreted among the groups. Results There was no statistically significant difference in relieving abdominal pain, bloating, rectal emptying in Lactobacillus plantarum 299v treated group and placebo treated group. Conclusion This randomized control trail of Lactobacillus plantarum 299v fail to show signicant efficacy in IBS treatment as compared to placebo.

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

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/605460 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 9

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.

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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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Frequency of Microscopic Colitis in Patients with Diarrhea predominant Irritable bowel syndrome in Egyptian Patients

QJM ◽

10.1093/qjmed/hcaa052.047 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

K H Abdelmageed ◽

G S Riad ◽

N I Mousa ◽

D B A Sharafeldin

Keyword(s):

Weight Loss ◽

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Microscopic Colitis ◽

Watery Diarrhea ◽

Unknown Etiology ◽

Hospital Inpatient ◽

Common Diagnosis ◽

Significant Difference ◽

Irritable Bowel

Abstract Background Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. Irritable bowel syndrome is considered a functional illiness wih no diagnostic biomarkers or pathologic findings. The most common diagnosis made in patients with chronic diarrhea is IBS. MC is a clinical syndrome of unknown etiology, characterized by chonic watery diarrhea in the absence of macroscopic changes in the large bowel, but with histological examination changes Objective The aim of this study is to determine the frequency of microscopic colitis in patients with IBS of diarrhea predominant sub type. Methods This prospective study had been conducted on 100 subjects, age range 19-65 year from National Hepatology and Tropical medicine reaserch Institute and Ain Shams University hospital inpatient and outpatient clinics. The study was carried on over 2 years (2016-2018) duration. The study subjects were fulfilling Rome criteria. The main complain of the selected patients was abdominal pain associated with chronic watery diarrhea. Results This study showed that patients with microscopic colitis can be misdiagnosed as IBS – diarrhea predominant due similar presentation and normal macroscopic picture in endoscopy. In this study we found that 14 (14%) had microscopic colitis. This study showed that there is a significant difference between patients with normal biopsy and others with microscopic colitis as regard age and sex. Conclusions Our study showed that MC is not uncommon in Upper Egypt patients with chronic watery diarrhea and normal colonoscopic findings. Biopsy of the normal colonic mucosa in patient with chronic watery diarrhea is emphasized to reach a definite diagnosis of MC. Abdominal pain, nocturnal diarrhea and weight loss were the most common clinical manifestations of MC. MC types, LC, and CC have almost similar clinical presentations and there is no diagnostic laboratory marker; thus, histopathologic diagnosis is the only reliable method for differentiation between these subtypes. Nocturnal diarrhea and slight weight loss can be helpful in distinguishing microscopic colitis from diarrhea predominant IBS. Collaboration between treating physicians, endoscopists and pathologists is crucial for diagnosing MC.

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Efficacy of adding Luvos® Healing Earth supplementation to mebeverine in improving symptoms and quality of life of patients with diarrhea-predominant irritable bowel syndrome: A randomized clinical trial

Biomedical Research and Therapy ◽

10.15419/bmrat.v5i10.493 ◽

2018 ◽

Vol 5 (10) ◽

pp. 2776-2783

Author(s):

Marjan Mokhtare ◽

Mohammadreza Asadipanah ◽

Mansour Bahardoust ◽

Arezoo Chaharmahali ◽

Masoomeh Khalighi Sikaroudi ◽

...

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Demographic Data ◽

Gastrointestinal Disorder ◽

Young Males ◽

Significant Difference ◽

Group A ◽

Irritable Bowel ◽

Group B

Introduction: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Treatment can improve symptoms and social functioning in the patients. This study was designed to assess the effect of adding Luvos supplementation to mebeverine on improving symptoms and quality of life (QOL) in patients with diarrhea-predominant irritable bowel syndrome. Methods: Eighty patients with diarrhea-predominant IB, ages 18-65, were diagnosed by the Rome IV criteria and randomly assigned to the study. Forty patients (group A) received mebeverine (135 mg) twice a day (bid) plus Luvos®Healing Earth (1 sachet, bid). The other 41 patients (group B) received mebeverine (135 mg) bid for 4 weeks. Basic demographic data, Bristol score, symptom severity score, and QOL questionnaire were recorded at the start and completion of treatment. The data were analyzed by SPSS version 22. Results: Seventy one of the patients (35 and 36 patients in groups A and B, respectively) completed the study. The majority of the patients were young males, unmarried and highly educated. Diarrhea and QOL were both significantly improved in group A when compared to group B (P=0.036 and P=0.028, respectively). We did not find a significant difference (improvement) in abdominal pain or overall symptom score between group A (mebeverine + Luvos) compared to group B (mebeverine alone) (P=0.096 and P=0.071, respectively). Mild and tolerable adverse effects were observed in 2.8% (2/71) of the patients. Conclusion: According to our results, Luvos supplementation is safe, effective and well-tolerated in diarrhea-predominant irritable bowel syndrome patients. Further study with a larger sample size is recommended to evaluate the efficacy of this natural clay-like medicine.

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Effect of Samryungbaekchul-san Combined with Otilonium Bromide on Diarrhea-Predominant Irritable Bowel Syndrome: A Pilot Randomized Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm8101558 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1558 ◽

Cited By ~ 1

Author(s):

Jin-Hyun Lee ◽

Joong Il Kim ◽

Myong Ki Baeg ◽

Yun-Young Sunwoo ◽

Kwangsun Do ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Primary Outcome ◽

Controlled Trial ◽

Multiple Logistic Regression Analysis ◽

Symptom Improvement ◽

Randomized Controlled ◽

Significant Difference ◽

Irritable Bowel

Conventional and herbal drugs are frequently used together to treat many disorders. Samryungbaekchul-san (SRS, a herbal formula) and otilonium bromide (OB, an antispasmodic agent) are widely used to treat diarrhea-predominant irritable bowel syndrome (D-IBS) in Eastern Asian countries. However, there have been no studies on the co-administration of SRS and OB. Therefore, we aimed to preliminarily assess the feasibility of SRS combined with OB for D-IBS treatment in a pilot double-blind, four-arm, parallel-group, randomized controlled trial (RCT), including 80 patients diagnosed with D-IBS according to the Rome III criteria. The patients were randomly assigned to four treatment groups and were administered drugs for eight weeks after a two-week preparatory period. Follow-up was conducted four weeks after the administration period. The primary outcome was evaluated by using a global D-IBS symptom improvement score; no statistically significant difference was observed between the groups. However, multiple logistic regression analysis of primary outcome scores shows that SRS significantly improved D-IBS symptoms (p < 0.05). For secondary outcomes, better results were observed in the SRS + OB group, in terms of symptoms, including abdominal pain, discomfort, frequency of abdominal pain, and stool form than in OB alone or placebo groups (p < 0.05). In conclusion, the co-administration of SRS and OB might be an effective and safe strategy for the treatment of D-IBS. Large-scale RCTs are warranted to further confirm and clarify these findings.

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Comparison between the Effects of Acupuncture Relative to Other Controls on Irritable Bowel Syndrome: A Meta-Analysis

Pain Research and Management ◽

10.1155/2019/2871505 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Haizhen Zheng ◽

Rixin Chen ◽

Xiaofeng Zhao ◽

Guanhui Li ◽

Yi Liang ◽

...

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Western Medicine ◽

Meta Analysis ◽

Sham Acupuncture ◽

Cochrane Library ◽

Significant Difference ◽

Irritable Bowel

Background. Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with recurrent abdominal pain and altered defecation habits. We here attempted to determine the effect of acupuncture on IBS. Methods. Randomized controlled trials (RCTs) published in CNKI, VIP, Wanfang, PubMed, Cochrane Library, EMBASE, Web of science, and ClinicalTrials.gov till July 17, 2019 were searched. Outcomes were total efficacy rates, overall IBS symptom scores, or global quality of life scores. Standardized mean difference (SMD) with 95% confidence intervals (CI) and risk ratio (RR) with 95% CI were calculated for meta-analysis. Results. We included 41 RCTs involving 3440 participants for analysis. 8 RCTs compared acupuncture with sham acupuncture, among which 3 trials confirmed the biological effects of acupuncture, especially in treating abdominal pain, discomfort, and stool frequency. No significant difference was found when acupuncture was compared with sham acupuncture, in terms of effects on IBS symptoms and quality of life (SMD = 0.18, 95% CI −0.26∼0.63, P=0.42; SMD = −0.10, 95% CI −0.31∼0.11, P=0.35), but the pooled efficacy rate data showed a better outcome for true acupuncture (RR = 1.22, 95% CI 1.01∼1.47, P=0.04), which was not supported by sensitivity analysis. Acupuncture was more effective relative to western medicine in alleviating IBS symptoms (RR = 1.17, 95% CI 1.12∼1.23, I2 = 0%, P<0.00001), whose effect might last 3 months. Besides, acupuncture as an adjunct to western medicine, Chinese medications, or tuina was superior over the single latter treatment (RR = 1.68, 95% CI 1.18 to 2.40, P=0.004; 1.19, 1.03 to 1.36, P=0.02; 1.36, 1.08 to 1.72, P=0.009, respectively), with high heterogeneities. Conclusions. Relative to sham controls, acupuncture showed no superiority for treating IBS, while the advantage over western medicine was significant. Acupuncture could be used as an adjunct in clinical settings to improve efficacy. Future high-quality and large-sample-size studies with adequate quantity-effect design need to be conducted.

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A Cross-Sectional Study of the Association between Overnight Call and Irritable Bowel Syndrome in Medical Students

Canadian Journal of Gastroenterology ◽

10.1155/2012/865915 ◽

2012 ◽

Vol 26 (5) ◽

pp. 281-284 ◽

Cited By ~ 8

Author(s):

Malcolm Wells ◽

Lee Roth ◽

Morgan McWilliam ◽

Kim Thompson ◽

Nilesh Chande

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Medical Students ◽

Demographic Data ◽

Paper Copy ◽

Gastrointestinal Symptoms ◽

Cross Sectional ◽

Significant Difference ◽

Irritable Bowel

BACKGROUND: Shift work has been associated with irritable bowel syndrome (IBS), which includes gastrointestinal symptoms such as abdominal pain, constipation and diarrhea. Overnight call shifts also lead to a disruption of the endogenous circadian rhythm.HYPOTHESIS: Medical students who perform intermittent overnight call shifts will demonstrate a higher prevalence of IBS symptoms when compared with medical students who perform no overnight call shifts.METHODS: First- and second-year (preclinical) medical students have no overnight call requirements, whereas third- and fourth-year medical (clerkship) students do have overnight call requirements. All medical students at the Schulich School of Medicine and Dentistry (London, Ontario) were invited to complete an anonymous, web-based survey or an identical paper copy that included demographic data, the Rome III questionnaire and the IBS-Quality of Life measure (IBS-QOL). The prevalence of IBS symptoms and quality of life secondary to those symptoms were determined.RESULTS: Data were available for 247 medical students (110 pre-clinical students, 118 clerkship students and 19 excluded surveys). There was no significant difference in the presence of IBS between preclinical and clerkship students (21 of 110 [19.1%] versus 26 of 118 [22.0%]; P=0.58). The were no significant differences in mean (± SD) IBS-QOL score of those with IBS between preclinical (43.5±8.3) and clerkship students (45.7±13.8) (P=0.53).CONCLUSIONS: Participation in overnight call was not associated with the development of IBS or a lower quality of life secondary to IBS in medical students.

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