AGA technical review on irritable bowel syndrome

Drossman, Douglas A.; Camilleri, Michael; Mayer, Emeran A.

doi:10.1053/gast.2002.37095

Cited by 1,205 publications

(1,089 citation statements)

References 250 publications

Supporting

Mentioning

1,037

Contrasting

Unclassified

Order By: Relevance

“…1,22 Guidelines for the management of IBS from national organizations encourage physicians to make a positive diagnosis of IBS, using these symptom-based diagnostic criteria, and to avoid extensive investigation. [23][24][25] Accurate diagnostic criteria for IBS are of paramount importance, as they allow physicians to make the diagnosis with confidence, hence reducing the costs of managing the condition to the health service, and reassure patients that their physician's opinion is correct. However, a recent systematic review and meta-analysis identified very few validation studies of existing symptom-based diagnostic criteria.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Rome III Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care

et al. 2013

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Validation of the Rome III Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care

et al. 2013

View full text Add to dashboard Cite

“…IBS affects around 10% of adults in Western countries (Clarke et al 2009), and is 2-3 times more common in females (Drossman et al 2002). Symptoms of IBS are chronic and in some cases debilitating, considerably reducing the quality of life of IBS sufferers (Wilson et al 2004) and accounting for a significant proportion of work absenteeism and presenteeism (Spiegel, 2009).…”

Section: Introductionmentioning

confidence: 99%

A sustained hypothalamic–pituitary–adrenal axis response to acute psychosocial stress in irritable bowel syndrome

et al. 2014

View full text Add to dashboard Cite

Background. Despite stress being considered a key factor in the pathophysiology of the functional gastrointestinal (GI) disorder irritable bowel syndrome (IBS), there is a paucity of information regarding the ability of IBS patients to respond to acute experimental stress. Insights into the stress response in IBS could open the way to novel therapeutic interventions. To this end, we assessed the response of a range of physiological and psychological parameters to the Trier Social Stress Test (TSST) in IBS.Method. Thirteen female patients with IBS and 15 healthy female age-matched control participants underwent a single exposure to the TSST. Salivary cortisol, salivary C-reactive protein (CRP), skin conductance level (SCL), GI symptoms, mood and self-reported stress were measured pre-and post-exposure to the TSST.Results. The hypothalamic-pituitary-adrenal (HPA) axis response to the TSST was sustained in IBS, as shown by a greater total cortisol output throughout (p = 0.035) and higher cortisol levels measured by an area under the curve with respect to ground (AUC G ) analysis (p = 0.044). In IBS patients, GI symptoms increased significantly during the recovery period following exposure to the TSST (p = 0.045). Salivary CRP and SCL activity showed significant changes in relation to stress but with no differential effect between experimental groups.Conclusions. Patients with IBS exhibit sustained HPA axis activity, and an increase in problematic GI symptoms in response to acute experimental psychosocial stress. These data pave the way for future interventional studies aimed at identifying novel therapeutic approaches to modulate the HPA axis and GI symptom response to acute psychosocial stress in IBS.

show abstract

“…Irritable bowel syndrome (IBS) has a very high global incidence nowadays [1,2] . Though it is not fatal, it exerts a strong inf luence on the quality of human life [3] .…”

Section: Introductionmentioning

confidence: 99%

Decreased expression of serotonin in the jejunum and increased numbers of mast cells in the terminal ileum in patients with irritable bowel syndrome

Wang¹

2007

WJG

View full text Add to dashboard Cite

AIM:To investigate if there are changes in serotonin (5-HT) levels, enterochromaffin (EC) cells and mast cells in small intestinal mucosa of patients with irritable bowel syndrome (IBS). n = 20), or constipation-predominant (IBS-C, n = 18) IBS patients and healthy controls (n = 20) underwent colonoscopy and peroral small intestinal endoscopy, and mucosal samples were obtained at the descending part of the duodenum, proximal end of jejunum and terminal ileum. High-performance liquid chromatographyelectrochemistry and immunohistochemical methods were used to detect 5-HT content, EC cells and mast cells. METHODS: RESULTS:(1) There were no differences in the number and distribution of EC cells between IBS patients and the normal group. (2) The mucosal 5-HT contents at the duodenum, jejunum and ileum in IBS-C patients were 182 ± 90, 122 ± 54, 61 ± 35 ng/mg protein, respectively, which were all lower than those in the normal group (256 ± 84, 188 ± 91, and 93 ± 45 ng/ mg protein, respectively), with a significant difference at the jejunum (P < 0.05). There were no differences in the small intestinal mucosal 5-HT contents between IBS-D patients and the normal group. The mucosal 5-HT contents at the duodenum were significantly higher than those at the ileum in the three groups (P < 0.001). (3) The numbers of mast cells in patients with IBS-C and IBS-D at the ileum were 38.7 ± 9.4 and 35.8 ± 5.5/high www.wjgnet.com power field (hpf), respectively, which were significantly more than that in the normal group (29.8 ± 4.4/hpf) (P < 0.001). There was no significant difference in the numbers of mast cells at the other two parts between IBS patients and the normal group. The numbers of mast cells in IBS-C, IBS-D, and normal groups were all significantly higher at the ileum (38.7 ± 9.4, 35.8 ± 5.5, 29.8 ± 4.4/hpf, respectively) than at the duodenum (19.6 ± 4.7, 18.5 ± 6.3, 19.2 ± 3.3/hpf, respectively, P < 0.001). CONCLUSION:The changes in the 5-HT signaling pathway at the jejunum of IBS-C patients and the increase in mast cells in patients with IBS at the terminal ileum may offer evidence to explain the pathogenesis of IBS.

show abstract

AGA technical review on irritable bowel syndrome

Cited by 1,205 publications

References 250 publications

Validation of the Rome III Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care

Validation of the Rome III Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care

A sustained hypothalamic–pituitary–adrenal axis response to acute psychosocial stress in irritable bowel syndrome

Decreased expression of serotonin in the jejunum and increased numbers of mast cells in the terminal ileum in patients with irritable bowel syndrome

Contact Info

Product

Resources

About