scholarly journals Irritable bowel syndrome and biliary tract pathology. Clinical analysis

2020 ◽  
pp. 28-38
Author(s):  
T. E. Polunina

Irritable bowel syndrome (IBS) – a recurrent functional disorder of the gastrointestinal tract (GIT), the main symptom of which is abdominal pain necessarily associated with a change in intestinal function. IBS is a functional intestinal disorder in which recurrent abdominal pain is associated with a defecation act and a change in the frequency or shape of the stool. The diagnosis of IBS remains exclusively clinical. The difficulty in studying IBS, especially from the perspective of its epidemiology, is that there is still no universal and specific biological marker. Very often patients complain about symptoms typical for several functional disorders, in particular, biliary tract pathology and IBS. The article discusses the multi-component causes and mechanisms of IBS formation, which are also present in other functional gastrointestinal tract diseases. Patients with IBS often have functional disorders of the biliary tract (FDBT) that are not associated with organic pathology. There are no reliable differences in the frequency and nature of FDBT in patients with IBS, depending on its current variant - with constipation or diarrhea prevalence. As a result, the treatment of patients with IBS remains a challenge, and the recurrence of the disease depends on the state of psycho-emotional health, the presence of overlap syndrome in most cases. The article presents the main international criteria for diagnostics of IBS. The main approaches to the treatment of IBS are considered. Good results in the treatment of IBS are observed when using drugs that affect the complex of pathophysiological mechanisms of the disease. This is confirmed in the article by a clinical case study. The prescription of the Sparex drug for pain relief in a patient with IBS and FDBT is justified by the fact that it not only eliminates pain, but also improves the rheological properties of bile, typical for overlap “IBS-FDBT” syndrome.

2015 ◽  
Author(s):  
Loni Tang ◽  
Brooks D. Cash

Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain or discomfort that has occurred at least 3 days per month in the 3 months prior to diagnosis. One of the subtypes of this disorder is IBS with constipation (IBS-C), where individuals experience hard or lumpy stools at least 25% of the time and loose or watery stools less than 25% of the time with defecation. This review addresses IBS-C, detailing the epidemiology, etiology, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, and prognosis. A figure shows the Bristol stool form scale. Tables list IBS subtypes, components of digital rectal examination, differential diagnoses for IBS and IBS-C, alarm features, and the American College of Gastroenterology Recommendations. This review contains 1 highly rendered figure, 6 tables, and 71 references. 


Author(s):  
T. V. Zhestkova

Aim. Assessment of the quality of life and physical activity level in students with and without symptoms of functional dyspepsia (FD) and irritable bowel syndrome (IBS) according to questionnaire “7×7” (7 symptoms per 7 days).Materials and methods. Symptoms of FD and IBS were surveyed using the “7×7” questionnaire. Level of physical activity was evaluated according to the short IPAQ, and quality of life — to WAM questionnaires.Results. The study surveyed 92 students aged 20.7 ± 0.2 years (56 men and 36 women). We report borderline manifestations of functional disorders of the gastrointestinal tract (GIT) in 51.1 %, and FD and/or IBS symptoms of mild to moderate severity in 23.9 % of respondents. Symptoms of FD and/or IBS were equally common in men and women. Severity of FD and/or IBS symptoms was rated 4 [[3; 7] in men and 4 [[4; 11] in women (p = 0.25). Physical activity of 57.6 % in students corresponded to a moderate level. Healthy students were more likely to exhibit higher physical activity than individuals with FD and/or IBS symptoms, 56.5 and 31.9 %, respectively (p = 0.04). The level of wellbeing and severity of FD and/or IBS symptoms correlated negatively (r = –0.28, p = 0.01). Wellbeing and mood correlated directly with physical activity, r = 0.33, p = 0.001 and r = 0.27, respectively (p = 0.01).Conclusions. 1. Symptoms of FD and/or IBS occur widely among students and equally in men and women. Functional disorders of the gastrointestinal tract of mild to moderate severity occur in 23.9 % of students, with borderline symptoms registered with every second individual. 2. Healthy students significantly more often exhibited higher physical activity compared to individuals with FD and/or IBS symptoms of varying severity in the ratios of 56.5 and 31.9 % (p = 0.04). 3. Severity of FD and/or IBS in students negatively correlates with the wellbeing component of quality of life (r = –0.28, p = 0.01).


2020 ◽  
pp. 2951-2959
Author(s):  
Adam D. Farmer ◽  
Qasim Aziz

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.


2003 ◽  
Vol 8 (3) ◽  
pp. 81-89 ◽  
Author(s):  
Monica Jarrett ◽  
Margaret Heitkemper ◽  
Danita I. Czyzewski ◽  
Robert Shulman

2012 ◽  
Vol 17 (3) ◽  
pp. 56-59
Author(s):  
M. S. Grigorovich

The significance of the problem of acute intestinal infections (AII) to date is associated with both their prevalence and high rate of adverse effects in the outcome of the disease. In modern literature there is enough information about the frequent occurrence in AII patients microbiota disorders, immune system imbalances, identifying signs of reactive changes ofpancreatic tissue and functional disorders of biliary tract, lactase deficiency, long-term disorders of functional activity of the digestive system. The data about AII as one of the factors of forming the gastrointestinal tract pathology, including irritable bowel syndrome have been accumulated.


2020 ◽  
Vol 33 (2) ◽  
pp. 235-243 ◽  
Author(s):  
Chloé Melchior ◽  
Véronique Douard ◽  
Moïse Coëffier ◽  
Guillaume Gourcerol

AbstractIrritable bowel syndrome (IBS) is a chronic disorder characterised by recurrent abdominal pain or discomfort and transit disturbances with heterogeneous pathophysiological mechanisms. The link between food and gastrointestinal (GI) symptoms is often reported by patients with IBS and the role of fructose has recently been highlighted. Fructose malabsorption can easily be assessed by hydrogen and/or methane breath test in response to 25 g fructose; and its prevalence is about 22 % in patients with IBS. The mechanism of fructose-related symptoms is incompletely understood. Osmotic load, fermentation and visceral hypersensitivity are likely to participate in GI symptoms in the IBS population and may be triggered or worsened by fructose. A low-fructose diet could be integrated in the overall treatment strategy, but its role and implication in the improvement of IBS symptoms should be evaluated. In the present review, we discuss fructose malabsorption in adult patients with IBS and the interest of a low-fructose diet in order to underline the important role of fructose in IBS.


1998 ◽  
Vol 26 (2) ◽  
pp. 76-81 ◽  
Author(s):  
AW Mangel ◽  
BA Hahn ◽  
AT Heath ◽  
AR Northcutt ◽  
S Kong ◽  
...  

Irritable bowel syndrome is characterized by recurrent abdominal pain and altered bowel function. In designing studies to evaluate new treatments for this disease, however, it is difficult to select appropriate endpoints to reflect improvement in the range of symptoms of the syndrome. In the present study we evaluated the parameter of adequate relief of abdominal pain and discomfort, as perceived by the patients, as a key endpoint for efficacy in the treatment of patients with irritable bowel syndrome. Abdominal pain and bowel function data were collected daily from 370 patients with the disease during treatment with placebo or a novel potent 5HT3 receptor antagonist. Once every 7 days adequate relief of pain and discomfort was assessed. Quality-of-life data were collected using self-administered questionnaires. The endpoint of adequate relief was significantly ( P < 0.05) correlated with improvement in pain severity scores, percentage of pain-free days, percentage of days with urgency, improvement in stool frequency and consistency, and quality-of-life parameters. Adequate relief of pain and discomfort is significantly correlated with changes in multiple parameters associated with irritable bowel syndrome and can be used as an endpoint for assessing response to therapy in these patients.


1999 ◽  
Vol 40 (4) ◽  
pp. 277-285 ◽  
Author(s):  
Patrick Burke ◽  
Melanie Elliott ◽  
Rachel Fleissner

Author(s):  
Aswathy M ◽  
Jithesh M

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by varying bowel habits and recurrent abdominal pain. An observational study conducted on 25 patients of IBS who attended the Kayachikitsa O.P.D, V.P.S.V Ayurveda college, Kottakkal noticed Muhurbadha muhurdrava varchas (Increased frequency of loose stools after meals)- 88%, Saruja malapravrithi (abdominal pain during defaecation)- 60%, Daha (burning sensation)- 60% and Sleshmasamsrishta mala (mucus in stools)- 52% as the common presentations. On assessing the symptoms, Grahani dushti, Agnimandya, Arsas and Tridosha involvement can be found predominating in the pathophysiology. Kaidaryadi kashayam is a well known traditional decoction formulation from the text Chikitsa manjari- Mahodara chikitsa. This yoga having Tridoshahara, Kleda soshana, Pachana deepana, Vatanulomana and Grahani balya property is found to be effective in reducing the symptoms of IBS, when administered along with suitable formulations. Kaidaryadi kashayam contain 4 drugs i.e., Zingiber officinale, Murraya koeinigii, Terminalia chebula and Tricosanthes dioica. The action of Kaidaryadi kashayam is evaluated for its action on IBS based on available clinical and research data here in this paper. The ingredients inhibits proton pump, thereby reducing the gastric secretion, helps in the protection of gastric mucosa, reduces the acidity of gastric juice and acts as a strong cytoprotective. So based on the available data we can say Kaidaryadi kashayam is an effective formulation in the management of Lower GIT pathology of IBS.


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