Irritable Bowel Syndrome
Nicole M. Farmer, Andres Victor Ardisson Korat in Cooking for Health and Disease Prevention, 2022
Visceral hypersensitivity is a fascinating area of research in IBS. In short, a subset of people (about 1/3 of people with IBS) will have an increased pain, bloating, or discomfort response to a given distention of the colon compared to healthy controls (Zhou and Verne 2011). The unfortunate test for this (not clinical, only used in research settings) is to insert a balloon into the rectum and fill it with a gas to exert a very specific pressure on the rectal walls. IBS patients with visceral hypersensitivity will report discomfort and pain while healthy controls receiving identical pressure will not. The exact mechanism for how this happens is still being worked out but many believe that this altered and overly sensitive response may cause some of the symptoms that IBS patients have such as sensations of bloating, discomfort, and pain (Keszthelyi, Troost, and Masclee 2012).
A Functional Approach to Gynecologic Pain
Sahar Swidan, Matthew Bennett in Advanced Therapeutics in Pain Medicine, 2020
Bloating and distension may be due to conditions causing excessive gas, heightened sensitivity to gaseous distension, or an exaggerated motor response to normal amounts of gas.58 Mechanisms of gut dysfunction may involve dysbiosis of the gut microbiota and interactions with mucosal surfaces, the immune system, enteric nervous system, and central nervous system.59 The integrative clinician may be uniquely qualified to evaluate and treat from this perspective. Differing types of probiotic and nutritional interventions may be of relief to the patient and are well in the purview of the integrative clinician. In fact, the functional medicine approach to nutrition, absorption, and the relative health of the microbiome brings the integrative clinician to the forefront in addressing these issues.
Irritable Bowel Syndrome
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Irritable bowel syndrome (IBS) is characterised by the presence of abdominal pain or discomfort associated with defaecation or altered bowel habits in the absence of any other disease to explain the symptoms. Symptoms such as bloating are also often present. Symptom onset must be at least six months before diagnosis and must be present for the last three months (Figure 19.1)1 criteria for the diagnosis of IBS are described as the Rome criteria, and the most up to date version was released in 2016, described as Rome IV criteria (superseding Rome III criteria, etc.). The criteria are named as such because they are facilitated by the Rome Foundation, which was established in late 1980s and has played a critical role in the development of criteria for all functional gastrointestinal disorders (FGID) based upon latest research and consensus of world experts. Prior to the establishment of the Rome criteria there was little consensus about the classification of IBS, and hence patients with variable symptoms were used in research studies. This was particularly troublesome for clinical trials, as inclusion of heterogenous patients in different trials made it very difficult to compare data regarding specific drugs. As can be seen from Table 19.1, progress in establishing treatments for IBS were hampered by the variable patient selection in different clinical trials.2
The probiotic Bacillus subtilis BS50 decreases gastrointestinal symptoms in healthy adults: a randomized, double-blind, placebo-controlled trial
Published in Gut Microbes, 2022
Sean M. Garvey, Eunice Mah, Traci M. Blonquist, Valerie N. Kaden, Jessica L. Spears
Abdominal bloating is defined as “the subjective sensation of gassiness, trapped gas, or a feeling of pressure or being distended without obvious visible distension”.6 Bloating can also occur with objective physical distension of the abdomen. The etiology for bloating and distension is complex and multifactorial. Triggers may include disturbances to digestive enzyme output and activity, intestinal transit and motility, composition of the intestinal microbiota, intestinal gas production, immune function, visceral hypersensitivity, and central nervous system processing.7,8 Bloating has also been described as primarily a sensory phenomenon associated with a lower pain threshold or increased biological sensitivity, as evidenced by computed tomography imaging showing that luminal gas increases in only 25% of FGID patients during a bout of abdominal distension or following consumption of a “high-flatulence” diet.9 These results point to a potential role of the gut-brain axis in perception of bloating severity, and suggest that the intestinal microbiota or gut sensory neuropod cell signaling modulation could impact hypersensitivity and bloating. Related to gut-brain cross-talk, belching can be the consequence of aerophagia, or swallowing air, which itself is influenced by anxiety, depression, and hypervigilance.10
Gastric dysmotility and gastrointestinal symptoms in myalgic encephalomyelitis/chronic fatigue syndrome
Published in Scandinavian Journal of Gastroenterology, 2023
Elisabeth K. Steinsvik, Trygve Hausken, Øystein Fluge, Olav Mella, Odd Helge Gilja
Abdominal pain is a cornerstone symptom for the IBS diagnosis. However, only 55% of the included ME/CFS patients reported abdominal pain during the last 10 days (Table 3), and of a relatively mild severity. Abdominal distention/bloating was more frequent (70%). We found that only 10% of the patients had <3 bowel movements per week, indicative of constipation, and no one had >4 bowel movements per day. Thus, the reported bowel habits were not similar to irritable bowel syndrome. This was surprising, as we had expected that this selected population of ME/CFS patients had classical IBS symptoms. Symptoms of bloating/distention, abdominal pain and nausea were described in previous literature [2, 4], but to our knowledge, few authors have described abdominal complaints in ME/CFS in detail. Interestingly, the patients scored relatively high on the questions about life disruption because of their bowel habits, and bowel dissatisfaction. This is intriguing, given that 90% of the patients reported frequency of bowel movements within what is usually considered the normal range (<3 per day, >3 per week).
Constipation in the elderly from Northern Sardinia is positively associated with depression, malnutrition and female gender
Published in Scandinavian Journal of Gastroenterology, 2018
Maria Pina Dore, Giovanni Mario Pes, Stefano Bibbò, Patrizia Tedde, Gabrio Bassotti
Constipation is a common complaint and the prevalence of self-reported constipation in the adult population is estimated to be around 30% [1], with the female gender preferentially affected. Observational and prospective epidemiological studies in both Western [2] and Eastern [3] countries have reported different frequencies according to age. In community-dwelling elderly people [4] or in those residing in long-term facilities [5] the prevalence may rise to 60%. Constipation affects especially older adults and may result in deterioration of health-related quality of life. Patients often complain difficult stool passage usually associated with hardened feces, straining and unsatisfactory defecation [6]. Additional symptoms may include abdominal pain and/or discomfort and bloating. Patients may experience complications such as overflow fecal incontinence, hemorrhoids, anal fissures and fecal impaction that may require hospitalization [7].
Related Knowledge Centers
- Appendix
- Ascites
- Gastrointestinal Tract
- Hiccup
- Irritable Bowel Syndrome
- Abdominal Distension
- Stomach
- Gallbladder
- Chronic Condition
- Cramp