Anorectal manometry in irritable bowel syndrome: differences between diarrhoea and constipation predominant subjects.

Prior, Alison; Maxton, D. G.; Whorwell, Peter J.

doi:10.1136/gut.31.4.458

Cited by 194 publications

(135 citation statements)

References 17 publications

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“…Maximal basal anal pressures in IBS as a whole and in diarrhea-predominant IBS were within the same range as in healthy controls [36, 37]. The incidence of distension-induced repetitive rectal contractions was also similar in diarrhea-predominant IBS as in healthy subjects [36].…”

Section: Anorectal Motility In Diarrhea-predominant and Constipation-mentioning

confidence: 85%

The Rectum: A Window to Irritable Bowel Syndrome?

Coremans

Azpiroz²,

Collins³

et al. 2002

Digestion

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This report summarizes current concepts and information gathered to date about the rectum in the irritable bowel syndrome (IBS) that were presented at the 10th meeting of IBiS Club held in Leuven, Belgium. A working group of experts in the field of IBS discussed whether the rectum or the whole colon is the better site to test in IBS patients and provided suggestions for a number of areas where further advances are required.

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Section: Anorectal Motility In Diarrhea-predominant and Constipation-mentioning

confidence: 85%

The Rectum: A Window to Irritable Bowel Syndrome?

Coremans

Azpiroz²,

Collins³

et al. 2002

Digestion

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“…Our hypotheses were based on the clinical presentation of patients with carcinoid diarrhea and on previous data from patients with diarrhea caused by ulcerative colitis, irritable bowel syndrome, or sequelae of radiation therapy. [18][19][20]31 Excessive production of 5-HT escaping hepatic first-pass metabolism is considered the main reason for the carcinoid syndrome. 5 As seen in most patients included in the present study, very high levels of 5-HT can be reached in the systemic circulation of patients with NET.…”

Section: Discussionmentioning

confidence: 99%

Rectal Mechano-sensory Function in Patients with Carcinoid Diarrhea

Gregersen

Brock

Haase

et al. 2016

J Neurogastroenterol Motil

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Background/AimsIn patients with neuroendocrine tumors, excessive production of serotonin and other amines may cause the carcinoid syndrome, which is mainly characterized by diarrhea and flushing. Little is known about the pathophysiology of carcinoid diarrhea. In several other groups of patients, diarrhea may be associated with rectal hypersensitivity and increased rectal tone. Therefore, the aim of the present study was to compare rectal sensitivity and compliance in patients with carcinoid diarrhea and in healthy subjects. MethodsTwelve patients (6 males, aged 54-78 years, median 65 years), with carcinoid diarrhea and 19 healthy subjects (7 males, aged 50-78 years, median 61 years) were included. Rectal mechanical and heat stimulation was used for assessment of rectal mechano-sensory properties. ResultsOverall, 5.3% higher temperatures were needed to elicit sensory responses in patients with carcinoid diarrhea than in healthy subjects (P = 0.015). Posthoc analyses revealed that the sensory threshold to heat was 48.1 ± 3.1 o C in patients vs 44.7 ± 4.7 o C in healthy subjects (P = 0.041). In contrast, patients and healthy subjects showed no overall differences in rectal sensory response to mechanical distension (P = 0.731) or rectal compliance (P = 0.990). ConclusionsPatients with carcinoid diarrhea have higher sensory thresholds to heat stimulation in comparison to healthy subjects, but normal rectal sensation to mechanical distension and normal compliance. Therefore, treatment of carcinoid diarrhea should aim at prolonging gastrointestinal transit and decreasing secretion, rather than modifying rectal mechano-sensory function.

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“…The pathophysiology of IBS is uncertain, and it is unlikely that a single unifying mechanism explains the condition, but abnormal GI motor function, [7] , between 1961 and 1963). IBS was defined as the presence of abdominal pain associated with either disturbed defecation or abdominal distension, and the absence of organic bowel disease.…”

Section: Aetiology/ Risk Factorsmentioning

confidence: 99%

Irritable Bowel Syndrome

Ford

Martin

Talley

2010

Evidence‐Based Gastroenterology and Hepatology

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INTRODUCTION: The prevalence of irritable bowel syndrome (IBS) varies depending on the criteria used to diagnose it, but it ranges from about 5% to 20%. IBS is associated with abnormal gastrointestinal motor function and enhanced visceral perception, as well as psychosocial and genetic factors. People with IBS often have other bodily and psychiatric symptoms, and have an increased likelihood of having unnecessary surgery compared with people without IBS. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments in people with IBS? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: 5HT 3 receptor antagonists (alosetron and ramosetron), 5HT 4 receptor agonists (tegaserod), antidepressants (tricyclic antidepressants and selective serotonin reuptake inhibitors [SSRIs]), antispasmodics (including peppermint oil), cognitive behavioural therapy (CBT), hypnotherapy, loperamide, and soluble and insoluble fibre supplementation. QUESTIONS To be covered in future updates Probiotics Key points• The key features of irritable bowel syndrome (IBS) are chronic, recurrent abdominal pain or discomfort, associated with disturbed bowel habit, in the absence of any structural abnormality to account for these symptoms.The prevalence of IBS varies depending on the criteria used to diagnose it, but it ranges from about 5% to 20%.IBS is associated with abnormal GI motor function, enhanced visceral perception, abnormalities in central pain processing, and altered gut flora, as well as psychosocial and genetic factors.People with IBS often have other bodily and psychiatric symptoms, and have an increased likelihood of having unnecessary surgery compared with people without IBS.A positive symptom-based diagnosis and a graded general treatment approach are cornerstones in the management of people with IBS.• Antidepressants (tricyclic antidepressants and SSRIs) may reduce global symptoms of IBS and abdominal pain compared with placebo.• Antispasmodics (including peppermint oil) may reduce global symptoms of IBS and abdominal pain compared with placebo.• We don't know whether soluble fibre supplementation (ispaghula) is more effective than placebo at improving global symptoms or abdominal pain in IBS as the data are contradictory.• Insoluble fibre supplementation does not reduce global symptoms o...

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Anorectal manometry in irritable bowel syndrome: differences between diarrhoea and constipation predominant subjects.

Cited by 194 publications

References 17 publications

The Rectum: A Window to Irritable Bowel Syndrome?

The Rectum: A Window to Irritable Bowel Syndrome?

Rectal Mechano-sensory Function in Patients with Carcinoid Diarrhea

Irritable Bowel Syndrome

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