124 – Irritable Bowel Syndrome: The Pathophysiologic Links to More Effective Future Therapy
Several investigators as well as an NIH consensus conference on the “irritable bowel syndrome” (IBS) have stressed the importance of the biopsychosocial model in the etiopathogenesis (origin and development) of this syndrome. In this short article, the pathophysiologic (disease process) links between big brain, little brain, motility and sensation are explored based on currently available data. These data suggest that investigators and clinicians need to be dissuaded from approaching IBS as though it was a single disorder in all patients, or as though only one mechanism is responsible for development of symptoms. In essence, this is a plea for the importance of integrated rather than reductionist approaches to research, diagnosis, and management of IBS. Revised and updated 2009.
121 – Gut Motility: In Health and Irritable Bowel Syndrome
What are normal movements (motility) of the digestive tract? How may altered motility lead to symptoms? Disorders affecting the motility of the digestive tract may be self-limiting, occurring only for a brief period as in acute infection of the digestive tract causing diarrhea. They can also be more longstanding and persistent as in irritable bowel syndrome (IBS). IBS is associated with a variety of symptoms, particularly abdominal pain and an irregular bowel habit.
178- Sleep and IBS
Sleep complaints are quite common in patients with irritable bowel syndrome, as well as other gastrointestinal disorders including gastroesophageal reflux disease. Estimates of the incidence of sleep complaints in IBS patients range from approximately 30-70%. Lethargy and daytime fatigue, which are common side effects of sleep disturbances, seem to also be common complaints in IBS patients. In fact, there have been several studies which have attempted to relate gastrointestinal symptoms in IBS patients to sleep disturbances and vice versa.
163 – Current Approach to the Diagnosis of Irritable Bowel Syndrome
In the past two decades, medical opinion has changed regarding how to diagnose IBS. The older view emphasized that IBS should be regarded primarily as a “diagnosis of exclusion;” that is, diagnosed only after diagnostic testing excludes many disorders that could possibly cause the symptoms. Fortunately, physicians can now diagnose IBS in most patients by recognizing certain symptom details, performing a physical examination, and undertaking limited diagnostic testing. This simpler approach is grounded on recent knowledge…and it leads to a reliable diagnosis in most cases. Revised and updated 2009.
168-Current Treatments for Irritable Bowel Syndrome
Pharmacologic treatments for IBS are usually aimed at improving the predominant IBS symptoms such as diarrhea, constipation, and abdominal pain. The most common classes of drugs currently used are laxatives, antidiarrheals, antispasmodics, antidepressants, and 5-HT modulators. A review of indications, methods of action, and side effects associated with commonly available agents used to treat IBS.
191 – Coping with IBS from the Inside Out: Relaxation Techniques to Manage Symptoms
Dealing with a chronic gastrointestinal disorder such as IBS can be distressing. You may have days where you don’t want to leave the house. You may feel you are sensitive to certain foods and/or have made significant restrictions to your diet. You may feel abdominal cramping one minute and bloating the next. You may walk into a room and check to see where the nearest restroom is, and may even avoid social situations more than you would like. Your bowel symptoms may feel unpredictable and you wish there was something more you could do to regain a sense of control of your life.
251a – Dietary Triggers for IBS Symptoms: The Low FODMAP Diet Approach
A wide range of therapies have been used to control IBS symptoms including various medications, bulking agents and laxatives, and a myriad of lifestyle changes. Most individuals with IBS believe that their symptoms are related to the consumption of certain foods, but advice in this area has been conflicting and confusing and offered little relief for IBS sufferers. Our research team has developed a new dietary management approach – the Low FODMAP diet – to control symptoms associated with IBS. In Australia, the low FODMAP diet is increasingly being accepted as the primary management strategy for IBS, recently adopted by their National Therapeutic Guidelines.
171 – Hypnosis Treatment of Irritable Bowel Syndrome
The standard medical methods currently used to treat irritable bowel syndrome (IBS) are of some help to the majority of people with the disorder. However, up to half of IBS sufferers are dissatisfied with the results of standard medical management, and many continue to have frequent symptoms after seeing doctors about them. In recent years, other alternatives have been sought to help these individuals. There has been growing interest in the possibility of using the mind to soothe the symptoms of IBS. This article includes a description of hypnosis for IBS and how to select a hypnotherapist.
123 – Gynecological Aspects of Irritable Bowel Syndrome
Over a decade ago, investigators noted that approximately half of the women attending a gynecology clinic had symptoms (e.g., abdominal pain, change in bowel pattern) compatible with a diagnosis of irritable bowel syndrome (IBS). Since that study, a number of other studies have demonstrated a higher prevalence of gynecologic disorders, such as pain associated with menstruation (dysmenorrhea) and premenstrual distress syndrome in women with IBS as compared to those without IBS.
149 – Fibromyalgia and Irritable Bowel Syndrome
Although fibromyalgia and irritable bowel syndrome (IBS) are two very different disorders, they often overlap, and they share a number of commonalities that bear closer scrutiny. Like irritable bowel syndrome, fibromyalgia is a disorder that is diagnosed based on clinical (symptom based) criteria as opposed to laboratory and imaging studies.
207 – Is the Association of IBS with Fibromyalgia and Other Non-Gastrointestinal Functional Disorders Important and Why?
Patients usually go to doctors with symptoms, not with the names of diseases or conditions. The doctor’s task is to make sense of the patient’s complaints within the framework of medical diagnoses and recognized diseases. But many patients have symptoms that remain unexplained after the diagnostic process is exhausted. This is the case because modern medicine focuses on diseases that have a basis in the structure or anatomy of the body systems rather than functional disorders that have a basis in how the systems work. In effect, symptoms remain “unexplained” not because they cannot be explained but because some doctors do not know how to explain them. Revised and updated 2009.
209 – Gut Bacteria and Irritable Bowel Syndrome
Does bacteria play a role in IBS? If so, is it helpful or harmful? What about antibiotics, or probiotics? Bacteria are present in the normal gut (intestines) and in large numbers the lower parts of the intestine. These “normal” bacteria have important functions in life. A variety of factors may disturb the mutually beneficial relationship between the gut bacteria and its host – and disease may result. The possibility that gut bacteria could have a role in irritable bowel syndrome (IBS) may surprise some; there is indeed, now quite substantial evidence to support the idea that disturbances in the bacteria that populate the intestine may have a role in at least some patients with IBS. This article looks at recent findings about possible influences of bacteria in IBS, which may be either negative or positive, and at various treatment approaches.