Topic: Irritable Bowel Syndrome (IBS)
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.
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.
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.
Fact Sheet: Visceral Sensations and Brain-Gut Mechanisms127
Over the past several years, different mechanisms located within the gut, or gut wall have been implicated as possible pathophysiologic mechanisms underlying the characteristic IBS symptoms of abdominal pain and discomfort. The list ranges from altered transit of intestinal gas, alterations in the colonic flora, immune cell activation in the gut mucosa, and alterations in serotonin containing enterochromaffin cells lining the gut. For those investigators with a good memory, these novel mechanisms can be added to an older list of proposed pathomechanisms, including altered gut motility ("spastic colitis") and alterations in mucus secretion.Topics: Brain-Gut, Constipation, difficult to pass stools, Diarrhea, loose stools, Irritable Bowel Syndrome (IBS), Lower Abdominal Pain, Pelvic Pain
Fact Sheet: Functional Abdominal Bloating128
By: David Maxton, MD
Bloating is a common symptom in irritable bowel syndrome (IBS), particularly in women, although mostly it is a nuisance rather than the most severe aspect of the disease. However, bloating may be the only symptom for some people. A discussion of bloating and tips on managing the condition.Topics: Constipation, difficult to pass stools, Gas, Bloating, Belching, Irritable Bowel Syndrome (IBS)
Symptoms related to this sensitive area can be very troubling, yet many people are reluctant to discuss them. Itching (pruritis ani), painful defecation, stained underwear, spotting of blood, and offensive odor add up to embarrassment, distress, social handicap and anguish. These complaints of anal discomfort are very common. Symptoms may coexist with the irritable bowel syndrome or other functional bowel disease. Diarrhea and constipation may aggravate them. Anal symptoms are not part of these conditions as they may occur independently. They may be due to or associated with many local diseases. Whatever the association, perianal irritation can be treated. Find out how to get help and what to do about it. Reviewed and updated 2009.Topics: Anal, Rectal Disorders, Bowel urgency, Constipation, difficult to pass stools, Diarrhea, loose stools, Incontinence, Irritable Bowel Syndrome (IBS)
Fact Sheet: Understanding and Managing Chronic Pain140
Most of the time pain serves as a critical part of our sensory system, and is therefore a necessary though unpleasant function of a healthy body. However, it is becoming increasingly clear that chronic pain may be more like a disease or pathology of the nervous system associated with abnormal responses in the brain and spinal cord. Chronic pain has an impact on every facet of patients' lives. If you have chronic pain it is important to develop a pain management plan that works for you.Topics: CAM, Complementary & Alternative Treatments, Irritable Bowel Syndrome (IBS), Lower Abdominal Pain, Pelvic Pain, Pain Management
Fact Sheet: Diet and Functional Bowel Disease143
The exact nature of the connection between what people eat and how their intestines behave is controversial, but there is certainly a connection. The effects of foods on the gut are reviewed.Topics: Diarrhea, loose stools, Diet, Foods, Food intolerance, Malabsorption, Gas, Bloating, Belching, Irritable Bowel Syndrome (IBS)
By: Paul Enck, PhD
Most of us have experienced some of the ways that the central nervous system (CNS) affects the gut in our everyday lives. The affect may be direct, like an urgent need to evacuate the bowels when life gets exciting. It may be indirect, like the decision to suppress the urge to go to the bathroom when social circumstances, work, or sanitary conditions do not allow it. In this article, we will examine four methods of brain-gut interaction and their influence on irritable bowel syndrome (IBS).
Fact Sheet: Fibromyalgia and Irritable Bowel Syndrome149
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.
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