Irritable Bowel Syndrome with Constipation

Differential Diagnosis ◽

Abdominal Pain ◽

Digital Rectal Examination ◽

Differential Diagnoses ◽

Rectal Examination ◽

Stool Form ◽

Alarm Features ◽

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.

Scientific evidence for the treatment of children with irritable bowel syndrome

Current Pediatric Reviews ◽

10.2174/1573396317666210127123330 ◽

2021 ◽

Vol 17 ◽

Author(s):

Paolo Quitadamo ◽

Sara Isoldi ◽

Saverio Mallardo ◽

Letizia Zenzeri ◽

Giovanni Di Nardo

Keyword(s):

Abdominal Pain ◽

Pediatric Patients ◽

Scientific Evidence ◽

Dietary Interventions ◽

Physiological Mechanisms ◽

Stool Form ◽

Irritable Bowel ◽

Biochemical Abnormalities

: Irritable bowel syndrome (IBS) is the commonest cause of recurrent abdominal pain in children in both more developed and developing parts of the world. It is characterized by abdominal pain that is improved by defecation and whose onset is associated with a change in stool form and/or frequency and is not explained by structural or biochemical abnormalities. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. Likewise, no optimal treatment has ever been found neither for adult nor for pediatric patients. Current therapeutic options include drugs, dietary interventions and biopsychosocial therapies. The present review aims at evaluating the scientific evidence supporting the efficacy of these treatments for children with IBS.

Irritable Bowel Syndrome with Diarrhea

10.2310/gastro.5445 ◽

2018 ◽

Author(s):

Judy Nee ◽

Jacqueline L. Wolf

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Treatment Options ◽

Clinical Manifestations ◽

Signs And Symptoms ◽

Treatment Modalities ◽

Dietary Advice ◽

Emerging Therapies ◽

Irritable bowel syndrome (IBS) is a complex, functional gastrointestinal condition characterized by abdominal pain and alteration in bowel habits without an organic cause. One of the subcategories of this disorder is IBS with diarrhea (IBS-D). Clinically, patients who present with more than 3 months of abdominal pain or discomfort associated with an increase in stool frequency and/or loose stool form are defined as having IBS-D. This review addresses IBS-D, detailing the epidemiology, etiology and genetics, pathophysiology and pathogenesis, diagnosis, clinical manifestations and physical examination findings, differential diagnosis, treatment, emerging therapies, complications, and prognosis. Figures show potential mechanisms and pathophysiology of IBS, IBS-D suspected by clinical assessment and Rome III criteria, pharmacologic and nonpharmacologic treatment options, potential mechanisms of action of probiotics, and potential treatment modalities. Tables list the Rome criteria for IBS, alarm signs and symptoms suggestive of alternative diagnoses, IBS criteria, differential diagnosis of IBS-D, dietary advice options for IBS-D, and alternative and emerging therapies in IBS-D. This review contains 5 figures, 6 tables and 42 references KEYWORDS: IBS-D, eluxadoline, rifaximin, probiotics, bloating, antidepressants, bile acid malabsorption, microscopic colitis, celiac

Irritable bowel syndrome

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0308 ◽

2020 ◽

pp. 2951-2959

Author(s):

Adam D. Farmer ◽

Qasim Aziz

Keyword(s):

Abdominal Pain ◽

Bowel Habit ◽

Western World ◽

Older Individuals ◽

Butyl Bromide ◽

Rome Iii ◽

Fermentable Carbohydrates ◽

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.

Recurrent Abdominal Pain in Children: Forerunner to Adult Irritable Bowel Syndrome?

Journal for Specialists in Pediatric Nursing ◽

10.1111/j.1088-145x.2003.00081.x ◽

2003 ◽

Vol 8 (3) ◽

pp. 81-89 ◽

Cited By ~ 19

Author(s):

Monica Jarrett ◽

Margaret Heitkemper ◽

Danita I. Czyzewski ◽

Robert Shulman

Keyword(s):

Abdominal Pain ◽

Irritable bowel syndrome and biliary tract pathology. Clinical analysis

Medical Council ◽

10.21518/2079-701x-2020-15-28-38 ◽

2020 ◽

pp. 28-38

Author(s):

T. E. Polunina

Keyword(s):

Abdominal Pain ◽

Gastrointestinal Tract ◽

Biliary Tract ◽

Emotional Health ◽

Biological Marker ◽

Clinical Analysis ◽

Functional Disorders ◽

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.

Fructose and irritable bowel syndrome

Nutrition Research Reviews ◽

10.1017/s0954422420000025 ◽

2020 ◽

Vol 33 (2) ◽

pp. 235-243 ◽

Cited By ~ 1

Author(s):

Chloé Melchior ◽

Véronique Douard ◽

Moïse Coëffier ◽

Guillaume Gourcerol

Keyword(s):

Abdominal Pain ◽

Breath Test ◽

Fructose Malabsorption ◽

Chronic Disorder ◽

Gi Symptoms ◽

Irritable Bowel ◽

Osmotic Load

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.

Adequate Relief as an Endpoint in Clinical Trials in Irritable Bowel Syndrome

Journal of International Medical Research ◽

10.1177/030006059802600203 ◽

1998 ◽

Vol 26 (2) ◽

pp. 76-81 ◽

Cited By ~ 68

Author(s):

AW Mangel ◽

BA Hahn ◽

AT Heath ◽

AR Northcutt ◽

S Kong ◽

...

Keyword(s):

Quality Of Life ◽

Abdominal Pain ◽

Bowel Function ◽

Response To Therapy ◽

Multiple Parameters ◽

Severity Scores ◽

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.