Digestive and Metabolic Actions of Dopamine
Nira Ben-Jonathan in Dopamine, 2020
Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Symptoms include cramping, abdominal pain, bloating, gas, and diarrhea, constipation or both. Almost 2 of 10 people suffer from IBS, with women being more affected than men. Causes include weak intestinal contractions that slow food passage, poorly coordinated signals between the brain and the intestines, inflammation or bacterial infection in the intestines, and changes in the intestinal microflora [21]. In a recent Polish study, serum and urinary serotonin and DA and their metabolites were analyzed in healthy controls, IBS patients with diarrhea (IBS-D), and IBS patients with constipation (IBS-C). Patients had their symptoms for at least 6 months and had stopped all medications 1 week before the test [22]. Patients with IBS-D had significantly higher blood levels of serotonin and urinary levels of its metabolite, 5-hydroxyindolacetic acid (5-HIAA) than healthy controls and patients with IBS-C, while those with IBS-C had higher plasma DA and urinary homovanylic acid (HVA) levels. It is unfortunate that blood levels of DA-S, the predominant circulating catecholamine in humans, were not analyzed in this study.
Gastroenterology
Stephan Strobel, Lewis Spitz, Stephen D. Marks in Great Ormond Street Handbook of Paediatrics, 2019
Usual onset is around 10 years of age, but can begin as early as 1 year. Episodes of abdominal pain lasting from 2 days to 2 weeks occur from monthly to yearly. Attacks can be precipitated by large, fatty meals, alcohol and stress. Frequency of attacks usually decreases with age. There is severe epigastric pain that may radiate to the back and is lessened by adopting the fetal position. Epigastric tenderness and, in some cases, reduced bowel sounds and abdominal distension occur (Figs 9.57, 9.58). Helpful investigations include blood pancreatic enzyme levels, abdominal ultrasound and MRI. Endoscopic retrograde cholangiopancreatography (ERCP) should be performed when an anatomical cause is suspected.
Hemorrhagic Fever with Renal Syndrome: A Historical Perspective and Review of Recent Advances
James H. S. Gear in CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
The severe form of HFRS is characterized by sudden onset of high fever (typically 39°C or higher persisting for 3 to 6 days), chills, backache, and generalized myalgia. Ocular pain, photophobia, and blurred vision frequently accompany headache, which is typically frontal or retroorbital in location and severe in character.41 Abdominal pain is common and may be severe, frequently being accompanied by nausea and vomiting. Hepatomegaly and splenomegaly are rarely encountered. Following the appearance of a diffuse erythematous flush involving the face and chest, a fine petechial rash commonly develops on the face, upper thorax, axillae, and legs. Petechial hemorrhages are found on the soft palate and pharynx, and subconjunctival hemorrhages and Chemosis occasionally develop. Proteinuria, which appears abruptly toward the end of the febrile phase, usually worsens thereafter and persists until the convalescent phase.
The evolving role of JAK inhibitors in the treatment of inflammatory bowel disease
Published in Expert Review of Clinical Immunology, 2023
Nancy Gupta, Sam Papasotiriou, Stephen Hanauer
In the OCTAVE clinical trial, cases of gastrointestinal perforation could not be completely associated with tofacitinib. Factors included worsening of the disease activity, history of NSAID/corticosteroid use, diverticulitis, appendicitis, sheer mechanical stress, post endoscopic procedure complication in the background of active colitis confounded the association [14]. The IR for gastrointestinal perforation in the OCTAVE Open was rare at 0.08 events (95% CI 0.01–0.30) per 100 patient years. In the clinical trial of UC, no cases of gastrointestinal perforation have been noted with upadacitinib [22]. The side effect of perforation seems counter-intuitive since JAK inhibitors heal frail inflamed intestines. Regardless, caution is advised to avoid its use in patients with predisposing risk factors or strictures. Any case of worsening abdominal pain should be followed up with appropriate clinical and diagnostic workup.
Fabry disease – a multisystemic disease with gastrointestinal manifestations
Published in Gut Microbes, 2022
Malte Lenders, Eva Brand
FD is a multisystemic disorder (Figure 1). GI symptoms belong to the first manifestations already in affected pediatric FD patients.19 Abdominal pain and diarrhea are the most common symptoms, followed by constipation, nausea, and vomiting.13,20–23 In detail, registry data from the Fabry Outcome Survey (FOS) based on 1,453 patients reported a prevalence of 51% for GI symptoms24 mainly due to abdominal pain and diarrhea.20 Abdominal pain is the most frequently reported symptom in affected patients and includes the appearance of colic with pain in the mid- or lower abdomen, bloating, cramping, or mid-abdominal discomfort.25,26 Since these symptoms may increase during or after meals or are triggered by stress, it is conceivable that many FD patients are reluctant to food intake, which may result in lower body weight. However, this seems to be limited to patients with very severe symptoms, since most studies and reports did not show differences in body mass index between patients with and without GI symptoms.2 Frequency and severity of diarrhea as the second most GI symptom is more diverse. According to the FOS registry, 20% of FD patients reported diarrhea, which was more common in males (26%) than in females (17%), and very frequent in children (25%).20,27 However, the real frequency in classical FD patients seems to be much higher, since the reported frequency in females with FD manifestations justifying ERT from the Fabry Registry is reported as 39%.23
Probiotic effect and dietary correlations on faecal microbiota profiles in irritable bowel syndrome
Published in South African Journal of Clinical Nutrition, 2021
Cheryl Stevenson, Renée Blaauw, Ernst Fredericks, Janicke Visser, Saartjie Roux
Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal (GI) disorder and is estimated to affect one in five people.1 No specific test exists for the confirmation of IBS and the diagnosis is dependent on the ROME criteria, which are symptom based. Symptoms include abdominal pain or discomfort, irregular bowel movements, flatulence and constipation or diarrhoea. According to the proportion of symptomatic stools, IBS can further be divided into diarrhoea predominant (D-IBS), constipation predominant (C-IBS), mixed (M-IBS) or unclassed (U-IBS).2–4 Various pathogenic mechanisms have been proposed for IBS including visceral hypersensitivity, abnormal motor function, low-grade mucosal inflammation, food intolerance and altered GI microbiota, as well as psychosocial and genetic factors.5 However, the pathogenesis of IBS remains poorly understood.
Related Knowledge Centers
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- Irritable Bowel Syndrome
- Abdomen
- Gastroenteritis
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- Signs & Symptoms