Irritable Bowel Syndrome, An Issue of Gastroenterology Clinics Vol 34 Issue 2

Cover......Page 1
Preface......Page 2
Definition and Classification of Irritable Bowel Syndrome: Current Consensus and Controversies......Page 4
Disease, disorder, syndrome, illness, functional, or organic?......Page 5
Semantics in research and practice......Page 6
Evolution of symptom criteria......Page 7
Duration/frequency criteria......Page 9
Natural history and subtype durability......Page 10
Usefulness of alarm features......Page 11
Use of symptom criteria in practice......Page 13
Summary......Page 14
References......Page 15
Irritable Bowel Syndrome: Epidemiology, Natural History, Health Care Seeking and Emerging Risk Factors......Page 19
Prevalence in western countries......Page 20
Prevalence in Asia......Page 21
Incidence......Page 22
Symptom fluctuation, overlap, and probability of organic disease......Page 23
Surgery and irritable bowel syndrome......Page 24
Health care seeking......Page 25
Psychological factors......Page 26
Postinfectious irritable bowel syndrome......Page 27
Food challenges......Page 28
Familial aggregation and genetic predisposition......Page 29
References......Page 30
Symptom-based criteria for irritable bowel syndrome......Page 35
Utility of diagnostic testing in irritable bowel syndrome......Page 38
Routine blood tests......Page 39
Antibody testing for celiac sprue......Page 40
Stool tests......Page 42
Hydrogen breath testing......Page 43
Abdominal imaging......Page 44
Colonic imaging......Page 45
Diagnosing irritable bowel syndrome in clinical practice......Page 46
References......Page 49
Disturbances of Motility and Visceral Hypersensitivity in Irritable Bowel Syndrome: Biological Markers or Epiphenomenon......Page 51
Gastrointestinal Motor Dysfunction in Irritable Bowel Syndrome; is Irritable Bowel Syndrome a Motility Disorder?......Page 52
Visceral hypersensitivity and hyperalgesia; the ubiquitous phenomena in functional gastrointestinal disorders, including .........Page 54
If dysmotility and visceral hypersensitivity are not biological markers, can another unifying hypothesis explain their .........Page 56
Pathophysiological hypotheses are not mutually exclusive......Page 58
References......Page 59
Is Irritable Bowel Syndrome a Low-Grade Inflammatory Bowel Disease?......Page 64
Irritable bowel syndrome symptoms in inflammatory bowel disease......Page 65
Degree of inflammation, gut function, and symptom generation......Page 66
Low-grade inflammation and irritable bowel syndrome......Page 67
Increased susceptibility to inflammation in irritable bowel syndrome and inflammatory bowel disorder......Page 68
Experimental models of functional gut disorders......Page 69
What drives immune activation and inflammation in functional bowel disorders?......Page 70
References......Page 71
The Role of Food Intolerance in Irritable Bowel Syndrome......Page 75
Dietary fat, fiber, and other factors influencing gut motility......Page 76
Food allergy and irritable bowel syndrome......Page 77
Carbohydrate malabsorption......Page 79
Celiac disease......Page 80
References......Page 81
The Pathogenesis of Bloating and Visible Distension in Irritable Bowel Syndrome......Page 84
Mechanisms of distorted sensation......Page 85
Mechanisms of physical abdominal expansion......Page 86
The potential role of abdominal muscular activity......Page 91
References......Page 93
Brain Responses to Visceral and Somatic Stimuli in Irritable Bowel Syndrome: a Central Nervous System Disorder?......Page 97
Brain activation patterns to visceral and somatic stimuli......Page 98
Irritable bowel syndrome......Page 99
References......Page 103
Psychiatric and Psychological Dysfunction in Irritable Bowel Syndrome and the Role of Psychological Treatments......Page 106
Psychiatric disorders......Page 107
Stressful and traumatic life events......Page 108
Somatization and extraintestinal symptoms......Page 109
Illness behavior......Page 110
Increased health care use and costs......Page 111
Impact on vulnerability to irritable bowel syndrome......Page 112
The integration of psychosocial factors in the biopsychosocial model of irritable bowel syndrome......Page 113
Active listening......Page 115
Setting appropriate expectations and goals......Page 116
Clinical impact of an effective therapeutic relationship......Page 117
Referrals for psychological treatment......Page 118
Cognitive therapy......Page 119
Gut-directed hypnosis......Page 120
Relaxation training......Page 121
Making a successful referral for psychological treatment......Page 122
References......Page 123
Genetics in irritable bowel syndrome......Page 129
Familial aggregation studies......Page 130
Genetic variation in the control of inflammation in irritable bowel syndrome......Page 131
Role of serotonin transporter in animal models......Page 132
Role of serotonin transporter polymorphism in irritable bowel syndrome......Page 134
Ethnic differences......Page 135
Interpretation of data from surrogate measurements......Page 136
G protein polymorphism......Page 137
Summary......Page 138
References......Page 139
Efficacy of Current Drug Therapies in Irritable Bowel Syndrome: What Works and Does Not Work......Page 142
Antispasmodic agents......Page 143
Bulking agents......Page 146
Antidiarrheal agents......Page 148
5HT4 receptor agonists (ie, tegaserod)......Page 149
Osmotic laxatives......Page 151
Antidepressants......Page 152
5HT3 receptor antagonists......Page 153
References......Page 155
Mechanisms of disease......Page 159
Evidence that lactose free diets can cure irritable bowel syndrome?......Page 160
Probiotics......Page 161
Evidence that exclusion diets or cromoglycate can prevent immune response to food......Page 162
Evidence of peripheral inflammation in irritable bowel syndrome......Page 163
Probiotics as anti-inflammatory treatments......Page 164
Therapeutic approaches to central sensitization......Page 165
Relaxation therapy and cognitive-behavioral therapy......Page 166
Psychotherapy......Page 167
Short-term effects......Page 168
Hypnotherapy......Page 169
References......Page 170