scholarly journals Functional constipation masked as irritable bowel syndrome

2020 ◽  
Author(s):  
Monica Tosto ◽  
Paola D’Andrea ◽  
Ignazio Salamone ◽  
Salvatore Pellegrino ◽  
Stefano Costa ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Gastrointestinal Disorders ◽  
Number Of Patients ◽  
Erroneous Diagnosis ◽  
Irritable Bowel ◽  
Mixed Pattern ◽  
Rome Iv

Abstract Background Rome IV criteria for functional gastrointestinal disorders state that children suspected of having Irritable Bowel Syndrome (IBS) with Constipation (IBS-C) should be preliminarily treated for constipation. We aimed at verifying if functional constipation may indeed lead to an erroneous diagnosis of IBS with diarrhea (IBS-D) or IBS with mixed pattern of diarrhea and constipation (IBS-M).Methods We prospectively enrolled in an unblinded fashion 10 and 16 consecutive children referred to our center who met Rome IV criteria for a diagnosis of IBS-D and IBS-M, respectively. Patients who fulfilled criteria for suspect “occult constipation” were then given a bowel cleaning regimen with PEG 3350, re-evaluated at 2 months and followed up for at least 6 months. Sixteen additional patients with IBS with Constipation (IBS-C) referred in the same period served as control. The endpoints were: 1) a decrease of more than 50% in abdominal pain intensity and frequency scores; and 2) for patients with IBS-D and IBS-M: resolution of diarrhea.Results The endpoints were met by 8 (80%) and 14 (87%) of the patients with IBS-D and IBS-M, respectively, with decrease of abdominal pain and resolution of “diarrhea”. The response was not significantly different from that observed in 15 (93%) of the IBS-C control group.Conclusion acknowledging the limitations of the small number of patients and of the uncontrolled nature of the study, we suggest that a possibly large number of patients labeled as IBS-D or IBS-M may actually simply present functional constipation and should be managed as such.

scholarly journals Functional constipation masked as irritable bowel syndrome

2020 ◽  
Author(s):  
Monica Tosto ◽  
Paola D’Andrea ◽  
Ignazio Salamone ◽  
Salvatore Pellegrino ◽  
Stefano Costa ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Control Group ◽  
Number Of Patients ◽  
Erroneous Diagnosis ◽  
Irritable Bowel ◽  
Mixed Pattern ◽  
Rome Iv

Abstract Background: Rome IV criteria for functional gastrointestinal disorders state that children suspected of having Irritable Bowel Syndrome (IBS) with Constipation (IBS-C) should be preliminarily treated for constipation. We aimed at verifying if functional constipation may indeed lead to an erroneous diagnosis of IBS with diarrhea (IBS-D) or IBS with mixed pattern of diarrhea and constipation (IBS-M). Methods: We prospectively enrolled in an unblinded fashion 10 and 16 consecutive children referred to our center who met Rome IV criteria for a diagnosis of IBS-D and IBS-M, respectively. Patients who fulfilled criteria for suspect “occult constipation” were then given a bowel cleaning regimen with Polyethylene glycol 3350, re-evaluated at 2 months and followed up for at least 6 months. Sixteen additional patients with IBS with Constipation (IBS-C) referred in the same period served as control. The endpoints were: 1) a decrease of more than 50% in abdominal pain intensity and frequency scores; and 2) for patients with IBS-D and IBS-M: resolution of diarrhea. Results: The endpoints were met by 8 (80%) and 14 (87%) of the patients with IBS-D and IBS-M, respectively, with decrease of abdominal pain and resolution of “diarrhea”. The response was not significantly different from that observed in 15 (93%) of the IBS-C control group. Conclusion: Acknowledging the limitations of the small number of patients and of the uncontrolled nature of the study, we suggest that a possibly large number of patients labeled as IBS-D or IBS-M may actually simply present functional constipation and should be managed as such.

scholarly journals Functional gastrointestinal disorders in children: agreement between Rome III and Rome IV diagnoses

2021 ◽  
Author(s):  
Desiree F. Baaleman ◽  
Carlos A. Velasco-Benítez ◽  
Laura M. Méndez-Guzmán ◽  
Marc A. Benninga ◽  
Miguel Saps
Keyword(s):  
Diagnostic Criteria ◽  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
Functional Constipation ◽  
Final Analysis ◽  
Gastrointestinal Disorders ◽  
Rome Iii ◽  
Sample Characteristics ◽  
Irritable Bowel ◽  
Rome Iv

AbstractTo evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known:• The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs).• Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New:• We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia.• The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.

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

2015 ◽  
Vol 6 (2) ◽  
pp. 209-217 ◽  
Author(s):  
S. Guandalini ◽  
E. Cernat ◽  
D. Moscoso
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Trials ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Intestinal Microbiota ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Disorders ◽  
Controlled Trials ◽  
Inflammatory Bowel ◽  
Irritable Bowel

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, randomized clinical trials must be performed.

scholarly journals Gastrointestinal Symptoms in Diabetes Occur Long Before Diabetic Complications

2021 ◽  
Author(s):  
Hwanseok Jung ◽  
Eun-Jung Rhee ◽  
Mi Yeon Lee ◽  
Jung Ho Park ◽  
Dong Il Park ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Functional Dyspepsia ◽  
Diabetes Complications ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Functional Constipation ◽  
Gastrointestinal Disorders ◽  
Gi Symptoms ◽  
Irritable Bowel ◽  
Diabetes Patients

Abstract Background: Gastrointestinal (GI) manifestations are common in patients with diabetes complications such as autonomic neuropathy. However, the prevalence of GI symptoms before the development of diabetes complications remains unclear.Method: We performed an interview survey of functional gastrointestinal disorders in diabetes patients who visited the endocrinology clinic of a general hospital using the ROME III criteria. The investigation consisted of various questions on functional dyspepsia, irritable bowel syndrome, and functional constipation including functional defecation disorder.Results: A total of 509 patients were included in this analysis. The patients were analyzed in three groups, prediabetes patients (n = 115), diabetes patients without neuropathy (n = 275), and diabetes patients with neuropathy (n = 119). The prevalence of gastrointestinal symptoms in prediabetes patients, diabetes patients without neuropathy, and diabetes patients with neuropathy was estimated at 16.52%, 27.27%, and 23.53% for functional dyspepsia; 8.7%, 11.68%, and 16.81% for irritable bowel syndrome; and 8.85%, 11.85%, and 15.25% for functional constipation. In the subgroup analysis, postprandial distress syndrome symptoms such as postprandial fullness and early satiation were more prevalent than epigastric pain symptoms. In the constipation group, pelvic outlet obstruction symptoms such as the sensation of anorectal obstruction or blockage and manual maneuvers to facilitate defecation were more frequently observed than slow transit constipation symptomsConclusions: The prevalence of functional gastrointestinal disorders increased with diabetes severity. Diabetes-related GI symptoms appeared long before the diabetes complications

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.

scholarly journals Subthreshold Psychiatric Psychopathology in Functional Gastrointestinal Disorders: Can It Be the Bridge between Gastroenterology and Psychiatry?

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Cristina Stasi ◽  
Cristiana Nisita ◽  
Sonia Cortopassi ◽  
Giorgio Corretti ◽  
Dario Gambaccini ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Functional Constipation ◽  
Psychiatric Evaluation ◽  
Gastrointestinal Disorders ◽  
Axis I ◽  
Spectrum Disorders ◽  
Irritable Bowel

Background and Aims. Functional gastrointestinal disorders (FGDs) are multifactorial disorders of the gut-brain interaction. This study investigated the prevalence of Axis I and spectrum disorders in patients with FGD and established the link between FGDs and psychopathological dimensions.Methods. A total of 135 consecutive patients with FGD were enrolled. The symptoms’ severity was evaluated using questionnaires, while the psychiatric evaluation by clinical interviews established the presence/absence of mental (Diagnostic and Statistical Manual—4th edition, Axis I Diagnosis) or spectrum disorders.Results. Of the 135 patients, 42 (32.3%) had functional dyspepsia, 52 (40.0%) had irritable bowel syndrome, 21 (16.2%) had functional bloating, and 20 (15.4%) had functional constipation. At least one psychiatric disorder was present in 46.9% of the patients, while a suprathreshold panic spectrum was present in 26.2%. Functional constipation was associated with depressive disorders (p<0.05), while functional dyspepsia was related to the current major depressive episode (p<0.05). Obsessive-compulsive spectrum was correlated with the presence of functional constipation and irritable bowel syndrome (p<0.05).Conclusion. The high prevalence of subthreshold psychiatric symptomatology in patients with FGD, which is likely to influence the expression of gastrointestinal symptoms, suggested the usefulness of psychological evaluation in patients with FGDs.

scholarly journals Systematic Review of Pediatric Functional Gastrointestinal Disorders (Rome IV Criteria)

2021 ◽  
Vol 10 (21) ◽  
pp. 5087
Author(s):  
Angharad Vernon-Roberts ◽  
India Alexander ◽  
Andrew S Day
Keyword(s):  
Systematic Review ◽  
Functional Gastrointestinal Disorders ◽  
Symptom Burden ◽  
Functional Constipation ◽  
Final Analysis ◽  
Gastrointestinal Disorders ◽  
Prevalence Data ◽  
Irritable Bowel ◽  
Significant Symptom ◽  
Rome Iv

Functional gastrointestinal disorders (FGID) are common among children and may cause a significant symptom burden. The Rome criteria are symptom-based guidelines for the assessment of FGID among children and adults. The aim of this systematic review was to estimate the prevalence of FGID utilizing the revised Rome IV criteria. Nine health databases were searched. The inclusion criteria were: prospective FGID prevalence data using the Rome IV criteria for children up to 18 years, and the exclusion criteria were: cohorts with known gastrointestinal or organic conditions. The data were presented as a percentage of children experiencing at least one FGID, as well as in individual categories. The searches identified 376 papers, with 20 included in the final analysis, providing a pooled cohort of 18,935 children. The median prevalence of FGID for children aged up to four years was 22.2% (range 5.8–40%), and aged four–eighteen years was 21.8% (range 19–40%). The most common FGID for children aged 0–12 months was infant regurgitation, the most common FGID for those aged 13–48 months were functional constipation and cyclic vomiting, and, for those aged over four years, functional constipation, functional dyspepsia, and irritable bowel syndrome. This reported overall incidence of FGID may be used as a benchmark of normative data among the general population and comparative data for those with comorbid disease.

A systematic review of the association between fibromyalgia and functional gastrointestinal disorders

2020 ◽  
Author(s):  
Sharon Erdrich
Keyword(s):  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Health Care Systems ◽  
Strong Association ◽  
Functional Gastrointestinal Disorders ◽  
Future Research ◽  
Gastrointestinal Disorders ◽  
Irritable Bowel ◽  
Mixed Pattern ◽  
The Relationship

Abstract Background Fibromyalgia and functional gastrointestinal disorders are frequently encountered in clinical settings. Common to both is significant burden on individuals and health care systems, an elusive aetiology and several comorbid conditions. While a relationship between irritable bowel syndrome and fibromyalgia has been demonstrated, a broader review of the relationship between fibromyalgia and other functional gut disorders has not been undertaken. Objectives This paper reports a systematic review of the published literature, identifying the comorbidity of functional gastrointestinal disorders in people with fibromyalgia. We discuss the clinical implications, limitations of current research, and areas of interest for future research Methods A systematic review of the databases Medline, Embase, CINAHL and Web of Science was undertaken in June 2019. Results were screened for original articles meeting strict criteria for identification of functional gastrointestinal disorders in adult subjects with fibromyalgia. ResultsFourteen articles were included investigating 1340 subjects with fibromyalgia, 363 healthy controls and 441 subjects with other pathologies. Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating/gas, irritable bowel of mixed-pattern and constipation-types were more prevalent that diarrhoea-predominant irritable bowel in adults with fibromyalgia. One study reported the range of functional gastrointestinal disorders. Conclusion Existing research has focused on the relationship between irritable bowel syndrome and fibromyalgia, but sub-typing of irritable bowel syndrome is generally overlooked. A strong association with a range of functional gastrointestinal disorders is suggested. Further investigation is needed to determine the prevalence and relevance of the range of functional gastrointestinal disorders in patients with fibromyalgia.

scholarly journals Modern paradigm of functional diseases of gastrointestinal tract: focus on functional dyspepsia, sphincter of Oddi dysfunction and irritable bowel syndrome

2019 ◽  
Vol 3 (20) ◽  
pp. 24-29
Author(s):  
Yu. P. Uspensky ◽  
A. A. Gnutov ◽  
Yu. A. Fominykh ◽  
O. S. Mirzoev
Keyword(s):  
Irritable Bowel Syndrome ◽  
Gastrointestinal Tract ◽  
Functional Dyspepsia ◽  
Functional Gastrointestinal Disorders ◽  
Sphincter Of Oddi ◽  
Gastrointestinal Disorders ◽  
Sphincter Of Oddi Dysfunction ◽  
Oddi Dysfunction ◽  
Irritable Bowel ◽  
Rome Iv

The article presents data on changes in the perception of functional gastrointestinal disorders introduced by the Rome IV criteria. Particular attention is paid to the functional dyspepsia, gallbladder and sphincter of Oddi disorders, the Rome IV criteria.

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