Symptomatic overlap in patients with diarrhea predominant irritable bowel syndrome and microscopic colitis in a sub group of Bangladeshi population

Microscopic Colitis (MC) and diarrhea predominant irritable bowel syndrome (IBS-D) has almost similar clinical feature but MC is diagnosed by histologic criteria and IBS is diagnosed by symptombased criteria. There is ongoing debate about the importance of biopsies from endoscopically normal colonic mucosa in the investigation of patients with IBS-D. Aim of this study was to assess the prevalence of MC in patient with IBS-D and to determine the distribution of MC in the colon. This observational study was conducted in department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2008 to December 2009. Patients were evaluated thoroughly & who meet RomeII criteria with normal routine laboratory tests, were included in the study. Colonoscopy was done and biopsies were taken from the caecum, transverse colon, descending colon, and rectum. Out of total 60 patients, 22 had Lymphocytic Colitis (LC), 28 had nonspecific microscopic colitis (NSMC) and 10 had irritable bowel syndrome noninflamed (IBSNI). The distribution of LC was restricted to proximal colon in 15 patients, in the left colon in 2 patients and diffuses throughout the colon in 5 patients. There is considerable symptom overlap between the patients of IBS-D and patients with microscopic colitis. Without colonoscopic biopsy from multiple sites, possibility of MC cannot be excluded in patients with IBS-D and it can be said that clinical symptom based criteria for irritable bowel syndrome are not sufficient enough to rule out the diagnosis of microscopic colitis. DOI: http://dx.doi.org/10.3329/bmrcb.v38i1.10450 Bangladesh Med Res Counc Bull 2012; 38: 33-38

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Microscopic colitis: a missed diagnosis among patients with moderate to severe irritable bowel syndrome

Scandinavian Journal of Gastroenterology ◽

10.1080/00365521.2016.1242025 ◽

2016 ◽

Vol 52 (2) ◽

pp. 173-177 ◽

Cited By ~ 3

Author(s):

Frank Hilpüsch ◽

Peter Holger Johnsen ◽

Rasmus Goll ◽

Per Christian Valle ◽

Sveinung Wergeland Sørbye ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Microscopic Colitis ◽

Missed Diagnosis ◽

Irritable Bowel

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Effect of Moderate Physical Exercise on Autonomic Balance in Irritable Bowel Syndrome

Journal of Bangladesh Society of Physiologist ◽

10.3329/jbsp.v10i1.24610 ◽

2015 ◽

Vol 10 (1) ◽

pp. 6-10

Author(s):

Karma Tenzin ◽

Noorzahan Begum ◽

Sultana Ferdousi

Keyword(s):

Irritable Bowel Syndrome ◽

Physical Exercise ◽

T Test ◽

Brisk Walking ◽

Autonomic Balance ◽

Post Exercise ◽

Mean Values ◽

Irritable Bowel ◽

Medical University ◽

Regular Physical Exercise

Background: Altered autonomic balance has been noted in Irritable bowel syndrome Regular physical exercise may cause restoration of autonomic balance in health and disease.Objective: To assess the effect of brisk walking on the autonomic balance by analysis of heart rate variability in patients with Irritable bowel syndrome (IBS).Methods: This prospective study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) in 2013.Seventy seven male IBS patients aged 20-50 years, were enrolled from Gastroenterology OPD, BSMMU, Dhaka. Twenty eight healthy sedentary male with similar age were control. HRV measures were recorded once prior to exercise and then after 3 months of brisk walking. For assessing autonomic balance, LF/HF ratio and Max/Min RR was evaluated by Polyrite D machine and software. ANOVA, Independent sample t-test and paired t-test were used for statistical analysis.Results: The pre-exercise mean values of LF/HF ratio were significantly higher (p<0.001) in all IBS patients compared to those of control. The post exercise LF/HF ratio were significantly lower (p<0.05) in all IBS patients compared to their pre-exercise values.Conclusion: This study concluded that the sympathovagal balance was towards sympathetic predominance in IBS and regular moderate physical exercise may shift the balance towards parasympathetic predominance in them.Bangladesh Soc Physiol. 2015, June; 10(1): 6-10

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Is there an association of microscopic colitis and irritable bowel syndrome-A subgroup analysis of placebo-controlled trials

World Journal of Gastroenterology ◽

10.3748/wjg.v11.i41.6409 ◽

2005 ◽

Vol 11 (41) ◽

pp. 6409 ◽

Cited By ~ 18

Author(s):

Ahmed Madisch

Keyword(s):

Irritable Bowel Syndrome ◽

Subgroup Analysis ◽

Microscopic Colitis ◽

Controlled Trials ◽

Irritable Bowel

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Increased Chromogranin A Cell Density in the Large Intestine of Patients with Irritable Bowel Syndrome after Receiving Dietary Guidance

Gastroenterology Research and Practice ◽

10.1155/2015/823897 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Tarek Mazzawi ◽

Doris Gundersen ◽

Trygve Hausken ◽

Magdy El-Salhy

Keyword(s):

Irritable Bowel Syndrome ◽

Cell Density ◽

Large Intestine ◽

Chromogranin A ◽

Endocrine Cells ◽

Common Marker ◽

Before And After ◽

A Cell ◽

Colon And Rectum ◽

Irritable Bowel

The large intestine contains five types of endocrine cells that regulate its functions by sensing its luminal contents and releasing specific hormones. Chromogranin A (CgA) is a common marker for the gastrointestinal endocrine cells, and it is abnormal in irritable bowel syndrome (IBS) patients. Most IBS patients relate their symptoms to certain food elements. The present study investigated the effect of dietary guidance on the total endocrine cells of the large intestine as detected by CgA in 13 IBS patients. Thirteen control subjects were also included. Each patient received three sessions of dietary guidance. Colonoscopies were performed on controls and patients (at baseline and at 3–9 months after receiving guidance). Biopsy samples from the colon and rectum were immunostained for CgA and quantified by computerized image analysis. The densities of CgA cells in the total colon (mean ± SEM) among the controls and the IBS patients before and after receiving dietary guidance were83.3±10.1,38.6±3.7, and64.7±4.2cells/mm2, respectively (P=0.0004), and were unchanged in the rectum. In conclusion, the increase in CgA cell density after receiving dietary guidance may reflect a change in the densities of the large intestinal endocrine cells causing an improvement in the IBS symptoms.

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