Organic colonic lesions in patients with irritable bowel syndrome (IBS)

Akhtar, Abbasi J.; Shaheen, Magda; Zha, Junli

doi:10.1111/j.1572-0241.2000.02754.x

Cited by 17 publications

(40 citation statements)

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“…[ 12 ] In a recent retrospective colonoscopic analysis, it was shown that 12.1% of 642 patients without symptoms of irritable bowel syndrome, and 11.9% of those with irritable bowel syndrome had colonic angiodysplasia. [ 13 ] Certainly, in this case the preexisting NMVH was exacerbated by the use of NSAIDs, causing hemorrhage due to diffuse ulceration of the mucosa covering hamartomatous lesion. NMVH remains a controversial entity, as most authors consider it a remnant of chronic “burnt-out” Crohn [ 9 ] caused by chronic use of NSAIDs.…”

Section: Discussionmentioning

confidence: 96%

Small bowel capsule endoscopy revealing neuromuscular and vascular hamartoma of the jejunum

et al. 2018

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Rationale:Digestive hemorrhage is a life-threatening and represents for both clinicians and patient a challenger problematic condition with the urgencies to discover the origin for correct the cause and safe the life of patient.Patient concerns:We report the case of a 58 -year-old man with extremely rare hamartomatous neurovascular lesion. Following recurrent episode of intestinal hemorrhage the patient underwent small bowel capsule endoscopy.Diagnoses:Diagnosed with small intestine neoplasia.Interventions:The patient underwent curative small bowel resection. Histologic diagnosis was neuromuscular and vascular hamartoma (NMVH). In the small intestine, neoplastic lesions are very rare (2%) and mostly malformative while the more frequent cause of cryptic digestive hemorrhage remains angiodysplasia (50%) . The preexisting NMVH was exacerbated by the use of non-steroidal anti-inflammatory drugs, causing hemorrhage due to diffuse ulceration.Outcomes:The patient stay healthy after treatment.Lessons:This is an hemorrhagic lesion with macroscopic “neoplastic” patterns due to abnormal mixing of normal indigenous tissue components. It poses a diagnostic challenge for clinicians and pathologists, but diagnosis is facilitated by capsule endoscopy and surgical treatment should provide definitive resolution.

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Section: Discussionmentioning

confidence: 96%

Small bowel capsule endoscopy revealing neuromuscular and vascular hamartoma of the jejunum

et al. 2018

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“…Key evidence: A systematic review was conducted for these consensus guidelines to evaluate the prevalence of other diagnoses (e.g., IBD or microscopic colitis) in IBS patients undergoing colonoscopy. Among patients with IBS symptoms, the rate of IBD diagnosis was 4% (95% CI, 1–9; nine studies, n=5603) (21–29), and the rate of microscopic colitis was 4.5% (95% CI, 2.4–7.3; nine studies, n=3344) (21, 22, 25, 27, 29–33). In patients with IBS-D only, the rate of microscopic colitis was higher at 10% (95% CI, 3–19; six studies, n=841) (23, 29–32, 34).…”

Section: Recommendationsmentioning

confidence: 99%

Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS)

Martin

Andrews

MacQueen

et al. 2019

Journal of the Canadian Association of Gastroenterology

120

152

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Background & aims Irritable bowel syndrome (IBS) is one of the most common gastrointestinal (GI) disorders, affecting about 10% of the general population globally. The aim of this consensus was to develop guidelines for the management of IBS. Methods A systematic literature search identified studies on the management of IBS. The quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Statements were developed through an iterative online platform and then finalized and voted on by a multidisciplinary group of clinicians and a patient. Results Consensus was reached on 28 of 31 statements. Irritable bowel syndrome is diagnosed based on symptoms; serological testing is suggested to exclude celiac disease, but routine testing for C-reactive protein (CRP), fecal calprotectin or food allergies is not recommended. A trial of a low fermentable oligosaccharides, disaccharides, monosaccharides, polyols (FODMAP) diet is suggested, while a gluten-free diet is not. Psyllium, but not wheat bran, supplementation may help reduce symptoms. Alternative therapies such as peppermint oil and probiotics are suggested, while herbal therapies and acupuncture are not. Cognitive behavioural therapy and hypnotherapy are suggested psychological therapies. Among the suggested or recommended pharmacological therapies are antispasmodics, certain antidepressants, eluxadoline, lubiprostone, and linaclotide. Loperamide, cholestyramine and osmotic laxatives are not recommended for overall IBS symptoms. The nature of the IBS symptoms (diarrhea-predominant or constipation-predominant) should be considered in the choice of pharmacological treatments. Conclusions Patients with IBS may benefit from a multipronged, individualized approach to treatment, including dietary modifications, psychological and pharmacological therapies.

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“…IBS prevalence is estimated to range from 3% to 28% 3–5,10 depending on the country and the diagnostic criteria. The prevalence of IBS in the Western countries is estimated to be 10–15% 4,11 .…”

Section: Introductionmentioning

confidence: 99%

Stability of the irritable bowel syndrome and subgroups as measured by three diagnostic criteria – a 10‐year follow‐up study

Ólafsdóttir

Guðjónsson

Jónsdóttir

et al. 2010

Aliment Pharmacol Ther

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Organic colonic lesions in patients with irritable bowel syndrome (IBS)

Cited by 17 publications

References 0 publications

Small bowel capsule endoscopy revealing neuromuscular and vascular hamartoma of the jejunum

Small bowel capsule endoscopy revealing neuromuscular and vascular hamartoma of the jejunum

Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS)

Stability of the irritable bowel syndrome and subgroups as measured by three diagnostic criteria – a 10‐year follow‐up study

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