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Narrative Diagnosis
Published in John Launer, Reflective Practice in Medicine and Multi-Professional Healthcare, 2022
From observation, I suspect that doctors offer narrative diagnoses more often, and with more skill, as they become more experienced. Over time, they become better at tolerating uncertainty, and more confident in sharing this with their patients. A beginner might say, ‘you definitely have irritable bowel syndrome’, while an experienced GP or gastroenterologist might feel comfortable with a more elaborate but less certain narrative: ‘I can’t find anything physically wrong with you and the tests haven’t shown anything. Your symptoms are pretty common and certainly don’t seem to point to anything major. Some doctors like to call this kind of thing “irritable bowel syndrome”, and some patients find that kind of label helpful. It’s fine for you to choose whether you like the term or not. Either way, there are several different kinds of medication that might help, and there are dietary changes that may make a difference too.’
Biofeedback, Relaxation Training, and Cognitive Behavior Modification
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Ann L. Davidoff, William E. Whitehead
Irritable bowel syndrome (IBS) is a disorder characterized by abdominal pain and altered bowel habits, either constipation or diarrhea—or both in alternation—in the absence of any structural or metabolic lesion that can explain the symptoms (1). IBS is very common; it affects 8-19% of the general population (2-4) and accounts for 20-50% of consultations to gastroenterologists (5,6).
The Hypothalamic-Pituitary-Adrenal Axis in Functional Somatic Illness
Published in Peter Manu, The Psychopathology of Functional Somatic Syndromes, 2020
Researchers from the Lynn Institute for Healthcare Research and the Veterans Administration Medical Center, Oklahoma City, Oklahoma, made an important contribution to this field by assessing the effect of experimentally induced stress on the symptoms and cortisol levels of patients with irritable bowel syndrome (Elsenbruch et al., 2001). The 24 patients and 20 control subjects recruited for the study were all women without evidence of organic gastrointestinal disorders, other physical illnesses, or current psychiatric disorders. None of the participants were taking psychotropic drugs. The diagnosis of irritable bowel syndrome was established in accordance with standard criteria (Thompson et al., 1989). The mean age of patients with irritable bowel syndrome was 33 years, and the duration of illness averaged 13 years. The groups were statistically similar with respect to age, ethnicity, educational level, and marital status. The body mass index and blood pressure readings were virtually identical in the two groups. The group of women with irritable bowel syndrome had more depressive and gastrointestinal symptoms (p < 0.001) and consumed more alcohol (p < 0.05) than the healthy control subjects.
Meta-analysis of the relation between irritable bowel syndrome and antibodies against endogenous gonadotropin-releasing hormone and its receptor
Published in Baylor University Medical Center Proceedings, 2023
Karam R. Motawea, Joseph Varney, Mohamed Gamal, Kirellos Said Abbas, Fatma A. Monib, Mhd Kutaiba Albuni, Elias Battikh, Bisher Sawaf, Lina Taha Khairy, Agyad Bakkour, Ali Hadi Hussein Muwaili, Fatima Abubaker Abdalla Abdelmajid, Eman Mohammed Sharif Ahmed, Dhuha Hadi Hussein Muwaili, Safaa M. A. Ahmed, Sarya Swed
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder described by bloating, abdominal discomfort, and disturbed excretion.1 It has been shown to affect 10% to 15% of the population, with women being 1.5 to 3 times more likely to have it than men.2 The absence of any recognizable physical, radiologic, or laboratory abnormalities indicative of organic disease is a distinguishing factor of IBS.1 Causes of IBS have not been recognized, but it has been proposed that in IBS, the epithelial barrier, bile acids, food antigens, and gut microbes produce abnormal responses in the main controllers of sensorimotor functions, including the hypothalamus-pituitary-adrenal axis, gut axis, enteric nervous system, and immune system.3 One possible explanation for IBS is antibodies against the gonadotropin hormone-releasing hormone (GnRH) receptors. GnRH is considered the primary controller of reproduction4 and is found within the enteric nervous system.5 It regulates secretion of follicle-stimulating hormone and luteinizing hormone (LH), which then control both endocrine and gonadal function.4 Connections between sex hormones, notably progesterone, and gastrointestinal function have been hypothesized to explain why women are affected to a greater extent than men.6,7 Here, we introduce the first meta-analysis to investigate a link between IBS and GnRH autoantibodies and discuss the current literature on the relation between anti-GnRH antibodies and IBS.
Review of the international hypnosis literature
Published in American Journal of Clinical Hypnosis, 2022
Shelagh Freedman, Ian Wickramasekera
Lacy, B. E., Pimentel, M., Brenner, D. M., Chey, W. D., Keefer, L. A., Long, M. D., & Moshiree, B. (2021). ACG clinical guideline: Management of irritable bowel syndrome. The American Journal of Gastroenterology, 116(1), 17–44. doi:10.14309/ajg.0000000000001036. The authors present the first ever American College of Gastroenterology guidelines and recommendations for the treatment of irritable bowel syndrome. The guidelines were derived in consultation with experts who were surveyed to reach a consensus on the diagnosis, treatment, follow-up, and other considerations regarding the treatment of irritable bowel syndrome. Hypnosis is recommended as a treatment method for irritable bowel syndrome as are other gut-directed psychotherapies. Brian E. Lacy, PhD, MD, FACG. E-Mail address for reprints: [email protected]
Psychobiotics as treatment for anxiety, depression, and related symptoms: a systematic review
Published in Nutritional Neuroscience, 2021
Kristen S. Smith, Michael W. Greene, Jeganathan Ramesh Babu, Andrew D. Frugé
Although the exact mechanism is unknown, there is a link between the gut and mood disorders. Psychosocial factors, such as quality of life or well-being, are greatly influenced by gut function and there is a strong correlation between psychosocial factors and gastrointestinal disorders [25]. Furthermore, chronic stress can predict clinical outcomes and worsen severity of symptoms in patients with Irritable Bowel Syndrome (IBS) [26]. Elevated stress, anxiety, and depression are linked to intestinal dysbiosis [27] and mood disorders are disproportionately high in patients with functional gut disorders [28,29]. Functional gut disorders, as well as Chronic Fatigue Syndrome (CFS) are frequently comorbid with stress, depression, and anxiety due to altered expressions and interactions between the gut and central nervous system (CNS) [30]. The relationship between functional gut disorders and comorbidities of mood disorders may be explained by the influence of gut microbiota and their metabolites. Understanding the interplay of these disorders could aid in the treatment and comprehension of functional gut disorders and, more importantly, mood disorders in relation to the microbiome.