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Latest & greatest articles for irritable bowel syndrome
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the patient and helps detect possible organic causes. • A general examination is carried out for signs of systemic disease. • Abdominal examination: — Inspection — Palpation — Auscultation • Examination of the perianal region: — Digital rectal examination 3.4 IBS diagnostic algorithm Fig. 1 Algorithm for diagnosing irritablebowelsyndrome (IBS). IBS symptoms + no alarm features + age under 50 ? ? ? ? No diarrhea Low prevalence of intestinal parasitosis Low prevalence of celiac disease High prevalence (...) be experienced occasionally by almost every individual. To distinguish IBS from transient gut symptoms, experts have underscored the chronic and relapsing nature of IBS and have proposed diagnostic criteria based on the occurrence rate of symptoms and their duration. Definition. Irritablebowelsyndrome (IBS) is a functional boweldisorder in which abdominal pain or discomfort is associated with defecation and/or a change in bowel habit. Sensations of discomfort (bloating), distension, and disordered
. Eluxadoline (Mu Delta) for irritablebowelsyndrome (diarrhoea-predominant) – first line. Birmingham: NIHR Horizon Scanning Centre (NIHR HSC). Horizon Scanning Review. 2014 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Diarrhea; Gastrointestinal Agentss; IrritableBowelSyndrome; Receptors, Opioid, delta; Receptors, Opioid, mu Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence NIHR (...) Eluxadoline (Mu Delta) for irritablebowelsyndrome (diarrhoea-predominant) ? first line Eluxadoline (Mu Delta) for irritablebowelsyndrome (diarrhoea-predominant) – first line Eluxadoline (Mu Delta) for irritablebowelsyndrome (diarrhoea-predominant) – first line NIHR HSC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation NIHR HSC
A Randomized, Controlled, Crossover Study of Sacral Nerve Stimulation for IrritableBowelSyndrome To investigate whether sacral nerve stimulation reduces irritablebowelsyndrome (IBS)-specific symptoms by a randomized, controlled, crossover study.IBS affects 3% to 22% of the population worldwide, but most patients continue to have symptoms despite treatment.Patients included from our tertiary center had diarrhea-predominant or mixed IBS, with a minimum baseline IBS symptom score (...) (GastrointestinalSyndrome Rating Scale-IBS questionnaire) of 40 points reduced by a minimum of 30% during the percutaneous nerve evaluation before permanent implantation. Patients were randomized (1:1) to have the stimulator ON or OFF for 1 month and then the opposite for another month. Investigators and patients were not informed of the setting. IBS-specific symptoms and quality of life were assessed through bowel diaries and validated questionnaires. Primary endpoint was the IBS-specific symptom score.Twenty
A randomised trial of ondansetron for the treatment of irritablebowelsyndrome with diarrhoea Irritablebowelsyndrome with diarrhoea (IBS-D) is particularly debilitating due to urgency and episodic incontinence. Some 5-hydroxytryptamine 3 (5-HT3) receptor antagonists (5-HT3RAs) have proven effective but have serious side effects. Ondansetron, also a 5-HT3RA, has been widely used as an antiemetic with an excellent safety record for over two decades. Our aim was to assess its effectiveness
This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation CADTH. Probiotics for antibiotic-associated diarrhea, clostridium difficile infection and irritablebowelsyndrome: a review of clinical evidence and safety. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response - Summary with Critical Appraisal. 2013 Authors' conclusions A large body (...) Probiotics for antibiotic-associated diarrhea, clostridium difficile infection and irritablebowelsyndrome: a review of clinical evidence and safety Probiotics for antibiotic-associated diarrhea, clostridium difficile infection and irritablebowelsyndrome: a review of clinical evidence and safety Probiotics for antibiotic-associated diarrhea, clostridium difficile infection and irritablebowelsyndrome: a review of clinical evidence and safety CADTH Record Status
Pharmacological Management of IrritableBowelSyndrome AGA SECTION American Gastroenterological Association Institute Guideline on the Pharmacological Management of IrritableBowelSyndrome David S. Weinberg, 1 Walter Smalley, 2 Joel J. Heidelbaugh, 3 and Shahnaz Sultan 4,5 1 Fox Chase Cancer Center, Philadelphia, Pennsylvania; 2 VA Tennessee Valley Healthcare System, Vanderbilt University, Nashville, Tennessee; 3 University of Michigan Ann Arbor, Michigan; 4 Department of Veterans Affairs (...) Medical Center, Gastroenterology Section, North Florida/South Georgia Veterans Health System, Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, Florida; and 5 Minneapolis Veterans Affairs Health System, University of Minnesota, Minneapolis, Minnesota T his documentpresentstheof?cialrecommendations of the American Gastroenterological Association (AGA)ontheuseofpharmacologicalagentsforthetreatment of irritablebowelsyndrome (IBS) in adults. The guideline
hypersensitivity and/or gastrointestinal motility abnormalities. Although lactose intolerance may be associated with IBS, fructose malabsorption, where some ingested fructose reaches the colon, is a physiological occurrence. Indication Patients diagnosed with IBS. Diagnosis of IBS IBS is defined by the Rome III criteria as recurrent abdominal pain or discomfort for at least 3 days each month in the last 3 months in the absence of a pathologically based disorder. Pain and discomfort must be associated (...) Low-FODMAP diets : irritablebowelsyndrome (IBS) RACGP - Low-FODMAP diets for irritablebowelsyndrome (IBS) Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP
Long-Term Success of GUT-Directed Group Hypnosis for Patients With Refractory IrritableBowelSyndrome: A Randomized Controlled Trial Gut-directed hypnotherapy (GHT) in individual sessions is highly effective in the treatment of irritablebowelsyndrome (IBS). This study aimed to assess the long-term effect of GHT in group sessions for refractory IBS.A total of 164 patients with IBS (Rome-III-criteria) were screened, and 100 refractory to usual treatment were randomized 1:1 either to supportive (...) total of 90 patients received allocated intervention. After treatment, 28 (60.8%) out of 46 GHT patients and 18 (40.9%) out of 44 SMTs improved (absolute difference 20.0%; 95% confidence interval (CI): 0-40.2%; P=0.046); over 15 months, 54.3% of GHT patients and 25.0% of controls improved (absolute difference 29.4%; 95% CI 10.1-48.6%; P=0.004). GHT with SMT improved physical and psychological well being significantly more than SMT alone (P<0.001). Gender, age, disease duration and IBS type did
A 12-Week, Randomized, Controlled Trial With a 4-Week Randomized Withdrawal Period to Evaluate the Efficacy and Safety of Linaclotide in IrritableBowelSyndrome With Constipation Linaclotide is a minimally absorbed guanylate cyclase-C agonist. The objective of this trial was to determine the efficacy and safety of linaclotide in patients with irritablebowelsyndrome with constipation (IBS-C).This phase 3, double-blind, parallel-group, placebo-controlled trial randomized IBS-C patients (...) to placebo or 290 μ g oral linaclotide once daily in a 12-week treatment period, followed by a 4-week randomized withdrawal (RW) period. There were four primary end points, the Food and Drug Administration ’ s (FDA ’ s) primary end point for IBS-C (responder: improvement of ≥ 30 % in average daily worst abdominal pain score and increase by ≥ 1 complete spontaneous bowel movement (CSBM) from baseline (same week) for at least 50 % of weeks assessed) and three other primary end points, based on improvements
Linaclotide for IrritableBowelSyndrome With Constipation: A 26-Week, Randomized, Double-blind, Placebo-Controlled Trial to Evaluate Efficacy and Safety Linaclotide is a minimally absorbed peptide guanylate cyclase-C agonist. The objective of this trial was to determine the efficacy and safety of linaclotide treatment in patients with irritablebowelsyndrome with constipation (IBS-C) over 26 weeks.This phase 3, double-blind, parallel-group, placebo-controlled trial randomized IBS-C patients (...) to placebo or 290 μg of oral linaclotide once daily for a 26-week treatment period. The primary and the secondary efficacy assessments were evaluated over the first 12 weeks of treatment. Primary end points included the Food and Drug Administration's (FDA's) end point for IBS-C (responder: a patient who reported (i) improvement of ≥ 30 % from baseline in average daily worst abdominal pain score and (ii) increase of ≥ 1 complete spontaneous bowel movement (CSBM) from baseline, both in the same week
Mindfulness meditation for women with irritablebowelsyndrome--evidence of benefit from a randomised controlled trial. 22531145 2012 09 24 2012 07 06 1468-9618 15 3 2012 Jul Evidence-based nursing Evid Based Nurs Mindfulness meditation for women with irritablebowelsyndrome--evidence of benefit from a randomised controlled trial. 80-1 10.1136/ebnurs-2012-100488 Kearney David J DJ Department of Medicine, VA Puget Sound Health Care System, Seattle, Washington 98108, USA. kearney
obtaining breath samples before and at timed intervals after ingesting a carbohydrate substrate and analyzing these samples for hydrogen (H2) content. Intestinal bacteria ferment the carbohydrate, producing the only source of bodily H2, which is expelled in the breath. The pattern and degree of expelled H2 may indicate the presence of particular gastrointestinal (GI) disorders. Irritablebowelsyndrome (IBS) is a chronic GIdisorder that is diagnosed only by symptoms but shares symptoms with other GI (...) conditions. In patients with IBS, the HBT is performed to identify GIconditions that may be responsible for symptoms and may be treatable, potentially providing symptom relief. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Breath Tests; Hydrogen; IrritableBowelSyndromes Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc., 157 S
in the United States. Gastroenterology. 2002;122(5):1500-1511. 3. Galatola G, Grosso M, Barlotta A, et al. [Diagnosis of bacterial contamination of the small intestine using the 1 g [14C] xylose breath test in various gastrointestinaldiseases]. Minerva gastroenterol dietol. 1991;37(3):169-175. 4. Pimentel M, Chow EJ, Lin HC. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritablebowelsyndrome. Am J Gastroenterol. 2000;95(12):3503-3506. 5. Pimentel M, Chow EJ, Lin HC (...) and gastroenterologists. The workup is often extensive and rules out many etiologies. After discovering no metabolic, inflammatory, or anatomic pathology, physicians use the Rome III criteria to diagnose irritablebowelsyndrome (IBS). IBS is a functional boweldisorder that is diagnosed by symptoms of recurrent abdominal pain or discomfort for at least 3 days per month in the last 3 months and associated with 2 or more of the following: 1) improvement with defecation, 2) onset associated with a change in frequency
Linaclotide improves abdominal pain and bowel habits in a phase IIb study of patients with irritablebowelsyndrome with constipation Linaclotide, a minimally absorbed, 14-amino acid peptide agonist of guanylate cyclase-C, has shown benefit in a proof-of-concept study for the treatment of patients with irritablebowelsyndrome (IBS) with constipation (IBS-C). We assessed the efficacy and safety of linaclotide at a daily dose range of 75-600 μg in IBS-C.We performed a randomized, double-blind (...) , multicenter, placebo-controlled study of 420 patients with IBS-C given oral linaclotide at doses of 75, 150, 300, or 600 μg or placebo once daily for 12 weeks. End points included change from baseline in daily bowel habits, daily abdominal symptoms, and weekly global assessments, in addition to responder criteria.All doses of linaclotide significantly improved bowel habits, including frequency of spontaneous bowel movements and complete spontaneous bowel movements (primary end point), severity
Rifaximin therapy for patients with irritablebowelsyndrome without constipation. Evidence suggests that gut flora may play an important role in the pathophysiology of the irritablebowelsyndrome (IBS). We evaluated rifaximin, a minimally absorbed antibiotic, as treatment for IBS.In two identically designed, phase 3, double-blind, placebo-controlled trials (TARGET 1 and TARGET 2), patients who had IBS without constipation were randomly assigned to either rifaximin at a dose of 550 mg (...) a response to treatment as assessed by daily self-ratings of global IBS symptoms and individual symptoms of bloating, abdominal pain, and stool consistency during the 4 weeks after treatment and during the entire 3 months of the study.Significantly more patients in the rifaximin group than in the placebo group had adequate relief of global IBS symptoms during the first 4 weeks after treatment (40.8% vs. 31.2%, P=0.01, in TARGET 1; 40.6% vs. 32.2%, P=0.03, in TARGET 2; 40.7% vs. 31.7%, P<0.001, in the two
Chenodeoxycholate in females with irritablebowelsyndrome-constipation: a pharmacodynamic and pharmacogenetic analysis Sodium chenodeoxycholate (CDC) accelerates colonic transit in health. Our aim was to examine pharmacodynamics (colonic transit, bowel function) and pharmacogenetics of CDC in constipation-predominant irritablebowelsyndrome (IBS-C).In a double-blind placebo-controlled study, 36 female patients with IBS-C were randomized to treatment with delayed-release oral formulations (...) of placebo, 500 mg CDC, or 1000 mg CDC for 4 days. We assessed gastrointestinal and colonic transit, stool characteristics, and associations of transit with fasting serum 7αC4 (surrogate of bile acid synthesis) and FGF19 (negative regulator of bile acid synthesis) levels. Candidate genetic polymorphisms involved in regulation of bile acid synthesis were analyzed in the 36 patients with IBS-C and 57 healthy volunteers to assess genetic influence on effects of CDC on transit.Overall colonic transit
A randomized, double-blind, placebo-controlled trial of St John`s wort for treating irritablebowelsyndrome St John's wort (SJW) is known to effectively treat patients with mild-to-moderate depression. Antidepressants are frequently used to treat irritablebowelsyndrome (IBS). To date, no study that examines the efficacy of SJW in IBS has been carried out. The aim of this study was to evaluate the efficacy of SJW in IBS after 12 weeks.In this randomized, double-blind, placebo-controlled trial (...) , 70 participants with an established diagnosis of IBS were randomized and assigned by concealed allocation to either SJW or placebo. Both treatment arms were balanced on symptom subtype. The primary end point was self-reported overall bowel symptom score (BSS) at 12 weeks. Secondary end points were individual BSS for diarrhea (D-BSS), constipation (C-BSS), pain or discomfort, and bloating; adequate relief (AR) of IBS on at least 50% of the last 4 weeks of therapy; and IBS quality-of-life score
Comprehensive self-management for irritablebowelsyndrome: randomized trial of in-person vs. combined in-person and telephone sessions Psychological and behavioral therapies are being increasingly used for symptom management in patients with irritablebowelsyndrome (IBS). The aims of this study were to compare two delivery modes for a comprehensive self-management (CSM) intervention, primarily by telephone vs. entirely in person, and to compare each with usual care (UC).Adults with IBS were (...) recruited through community advertisement. Subjects (N=188) were randomly assigned to three groups: one in which all nine weekly CSM sessions were delivered in person, one in which six of the nine sessions were conducted over telephone, and one in which subjects received UC. Primary outcome measures were a gastrointestinal (GI) symptom score based on six symptoms from a daily diary and disease-specific quality of life (QOL). These and other outcomes were assessed at baseline and at 3, 6, and 12 months