Colonic dysmotility and morphological abnormality frequently detected in Japanese patients with irritable bowel syndrome

Mizukami, Takeshi; Sugimoto, Seiichiro; Masaoka, Tatsuhiro; Suzuki, Hidekazu; Kanai, Takanori

doi:10.5217/ir.2017.15.2.236

Cited by 9 publications

(6 citation statements)

References 29 publications

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“…Weak recommendation, evidence level B, 100% agreed. Comment: Colonoscopy offers diagnostic value to identify IBS patients and provide supportive evidence of pathophysiology compatible with IBS due to visceral hypersensitivity during colonoscopy as well as colonic dysmotility, with the additional benefit of excluding organic disease [ 63 , 64 ]. Diagnostic colonoscopy in 4178 undiagnosed IBS patients showed that there were no differences in regard to the prevalence of organic colonic diseases between patients who did and did not fulfill the Rome III criteria, suggesting that these criteria cannot exclude organic colonic lesions [ 65 ].…”

Section: Diagnosismentioning

confidence: 99%

Evidence-based clinical practice guidelines for irritable bowel syndrome 2020

et al. 2021

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Managing irritable bowel syndrome (IBS) has attracted international attention because single-agent therapy rarely relieves bothersome symptoms for all patients. The Japanese Society of Gastroenterology (JSGE) published the first edition of evidence-based clinical practice guidelines for IBS in 2015. Much more evidence has accumulated since then, and new pharmacological agents and non-pharmacological methods have been developed. Here, we report the second edition of the JSGE-IBS guidelines comprising 41 questions including 12 background questions on epidemiology, pathophysiology, and diagnostic criteria, 26 clinical questions on diagnosis and treatment, and 3 questions on future research. For each question, statements with or without recommendations and/or evidence level are given and updated diagnostic and therapeutic algorithms are provided based on new evidence. Algorithms for diagnosis are requisite for patients with chronic abdominal pain or associated symptoms and/or abnormal bowel movement. Colonoscopy is indicated for patients with one or more alarm symptoms/signs, risk factors, and/or abnormal routine examination results. The diagnosis is based on the Rome IV criteria. Step 1 therapy consists of diet therapy, behavioral modification, and gut-targeted pharmacotherapy for 4 weeks. For non-responders, management proceeds to step 2 therapy, which includes a combination of different mechanistic gut-targeted agents and/or psychopharmacological agents and basic psychotherapy for 4 weeks. Step 3 therapy is for non-responders to step 2 and comprises a combination of gut-targeted pharmacotherapy, psychopharmacological treatments, and/or specific psychotherapy. These updated JSGE-IBS guidelines present best practice strategies for IBS patients in Japan and we believe these core strategies can be useful for IBS diagnosis and treatment globally.

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Section: Diagnosismentioning

confidence: 99%

Evidence-based clinical practice guidelines for irritable bowel syndrome 2020

et al. 2021

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“…[2], bağırsak semptomları ile kolonik transit zamanı ve kolon uzunluğu arasındaki ilişkiyi araştırdıkları çalışmalarında, transit zamanı ile kolon döngü sayısı arasında doğrudan iliş- ki bulmuştur. Yapılan çalışmalarda morfolojik anomaliler, irritabl bağırsak sendromu olan hastalarda asemptomatik kontrol grubuna göre daha sık bulunmuştur [23,24].…”

Section: Discussionunclassified

“…Kolondaki redundansinin rutin klinik uygulamalarda önem kazandığı diğer bir hasta grubu, optik kolonokospi ile değerlendirilecek hastalardır. Kolon anomalileri optik kolonoskopiyi zorlaştırmakta ve süresini uzatmaktadır [23]. Özellikle kolondaki kıvrımlı yapı ("tortuosity") ve redundansi, çekumun görüntülenmesini zorlaştırıcı faktörlerdendir [11,27,28].…”

Section: Discussionunclassified

Longitudinal Evaluation of Gray Matter Atrophy in Mild Cognitive Impairment: A Voxel-Based Morphometric Study

Çavuşoğlu¹,

Ada²,

Savaş³

et al. 2019

Türk Radyoloji Derg

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Purpose: Our purpose was to investigate the frequency of the redundant sigmoid colon on computed tomography (CT) images by using Kantor's criteria and to compare the results with literature. We also aimed to emphasize the clinical importance of redundancy and to increase the awareness of radiologists for this condition. Material and Methods: This retrospective study was performed with 500 patients who underwent CT scan from August to October 2017. Axial views were evaluated to detect the presence of the redundant sigmoid colon. The thickness of rectus abdominis muscle, psoas muscle, subcutaneous fat, anteroposterior diameter of abdomen and thetransverse diameter between each anterior superior iliac spinae were measured. The presence of colonic diverticulae was also noted. Results: The redundant sigmoid colon was detected in 93 patients with a frequency of 18,6%. Age and sex were not significantly different between both groups. The transverse diameter between each anterior superior iliac spinae was significantly shorter in patients with redundant sigmoid colon. Conclusion: Kantor's criteria is a useful method for evaluation of the redundancy of the sigmoid colon on axial CT images. The frequency of the redundant sigmoid colon is nearly 20% and this condition is important since it is a major risc factor for volvulus, it causes incomplete optic colonoscopies and is associated with irritable bowel syndrome.

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“…1) In diarrhea-predominant IBS (IBS-D), which is one of the classifications, increased intestinal peristalsis has been reported. 2) Therefore, intestinal peristalsis inhibitors are used in the treatment of IBS-D. 1) Hyoscine butylbromide and other drugs are sometimes used to suppress peristalsis, but their use is limited owing to adverse events and insufficient effectiveness. 1,3,4) The use of Kampo medicines for the treatment of IBS has also been mentioned, and one Kampo medicine, keishikashakuyakuto, has been reported to significantly suppress abdominal pain in patients with IBS-D compared to placebo.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Glycicumarin and Isoliquiritigenin in Suppressing Colonic Peristalsis in Both an Animal Model and a Clinical Trial

Kobayashi,

Inoue,

Sugino

et al. 2024

Biological & Pharmaceutical Bulletin

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Patients with diarrhea-predominant irritable bowel syndrome (IBS-D) show excessive peristalsis, and antispasmodic agents may be useful therapeutic agents. There are few reports on the use of Kampo medicines for the treatment of IBS-D. Shakuyakukanzoto (SKT) is a Kampo medicine that is effective against abdominal pain. We examined the relationship between SKT and intestinal peristalsis in an animal model and a prospective study. In the animal model, SKT and its components were administered from the serosal side of the colon and colonic peristalsis was evaluated using intraluminal pressure and spatiotemporal mapping before and after the administration of SKT and its components. In this clinical trial, we used abdominal ultrasonography (US) to obtain long-axis images of the sigmoid colon of 11 patients. The frequency of intestinal peristalsis was measured using US in five patients with SKT and six patients without medication after the ingestion of a test meal. The primary outcome was the frequency of peristalsis. The Clinical Trial Registry Website (Trial No. UMIN-CTR; UMIN000051547). In the animal model, peony did not suppress peristalsis frequency, but SKT (p 0.005) and glycyrrhiza (p 0.001) significantly suppressed peristalsis frequency compared with saline and peony. Among the glycyrrhiza components, glycycoumarin and isoliquiritigenin suppressed the peristalsis frequency compared to dimethyl sulfoxide (control) (p 0.001, 0.01, respectively). In a clinical trial, peristalsis was significantly suppressed after oral administration in patients taking SKT (p 0.03). Administration of SKT was found to inhibit colonic peristalsis, with glycicumarin and isoliquiritigenin being particularly relevant among its components.

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Colonic dysmotility and morphological abnormality frequently detected in Japanese patients with irritable bowel syndrome

Cited by 9 publications

References 29 publications

Evidence-based clinical practice guidelines for irritable bowel syndrome 2020

Evidence-based clinical practice guidelines for irritable bowel syndrome 2020

Longitudinal Evaluation of Gray Matter Atrophy in Mild Cognitive Impairment: A Voxel-Based Morphometric Study

Efficacy of Glycicumarin and Isoliquiritigenin in Suppressing Colonic Peristalsis in Both an Animal Model and a Clinical Trial

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