Correlation of serotonin and monoamine oxidase levels with anxiety level in diarrhea-predominant irritable bowel syndrome.

BACKGROUND: Irritable bowel syndrome (IBS) is generally considered to have a psychogenic component in its physiopathology. AIM: To study the role of serotonin (5-hydroxytryptamine; 5-HT), monoamine oxidase (MAO) and anxiety, and to elucidate the relationship between these in patients with diarrhea-predominant IBS. METHODS: 5-HT and MAO activity and anxiety levels were studied in 20 healthy volunteers (aged 18-25 years; all men) and 57 patients with diarrhea-predominant IBS (30-60 years; all men). RESULTS: The concentrations of 5-HT (0.3 [0.04] microg/ mL) and MAO (15.5 [3.2] U/mL), and the anxiety level score (14.4 [2.9]) were significantly higher (p < 0.001) in patients than in healthy volunteers (0.1 [0.02], 6.4 [1.4] and 3.4 [1.2], respectively). These parameters correlated with each other in both patients and volunteers. CONCLUSIONS: Elevated 5-HT and MAO activity and anxiety may play a role in patients with diarrhea-predominant IBS.

Síndrome do intestino irritável / Irritable bowel syndrome

O diagnóstico clínico da síndrome do intestino irritável (SII) é realizado com base na presença de sintomas de dor abdominal crônica ou recorrente e alteraçöes do hábito intestinal: o padräo de alternância entre constipaçäo e diarréia é comum; lesöes estruturais e bioquímicas näo podem estar presentes.(au)

Lactose intolerance in different types of irritable bowel syndrome in north Indians.

BACKGROUND: Twenty-five patients of irritable bowel syndrome (IBS) and 25 normal healthy individuals serving as controls, were studied for lactose intolerance. METHODS: Hydrogen breath test was used as an investigation after giving 50 g of oral lactose. Clinically, the patients were classified into 3 types of IBS. RESULTS: Eleven (44%) out of 25 patients belonged to diarrhoeal type of IBS, 7 (28%) of 25 patients to spastic and rest 7 (28%) of 25 patients had features of both types of symptoms. Lactose hydrogen breath test was abnormal in 9 cases (82%) of 11 diarrhoeal type of IBS which was significantly higher (p < 0.02) than controls. However, the difference of abnormal hydrogen breath test between spastic type of IBS and patients with features of both types was not significant as compared to controls. CONCLUSIONS: These results suggest that patients with diarrhoeal type of IBS have a higher incidence of lactose intolerance as compared to spastic type as well as patients with features of both types.

Aetiology of chronic diarrhoea in tropical children.

AIM: We studied the causes and presentations of chronic diarrhoea in post-weaned children. METHODS: Forty seven children (6 months to 12 years) with diarrhoea of more than 2 weeks duration were recruited and subjected to detailed clinical examination and investigations. RESULTS: Primarily on the basis of history, clinical examination and duodenal biopsy, children could be classified into 5 groups namely tropical enteropathy (46.8%), irritable bowel syndrome (10.6%), giardiasis (14.8%), celiac disease (6.8%) and non specific diarrhoea (21.8%). Children with tropical enteropathy improved with broad spectrum antimicrobial therapy, those with irritable bowel syndrome and non specific chronic diarrhoea with dietary interventions while children with celiac disease required definite withdrawal of gluten from diet.

Predictors of duodenal ulcer healing in sucralfate treated patients.

The objective of the study was to assess the efficacy of sucralfate in promoting duodenal ulcer healing and to assess the value of some variables in predicting outcome of such therapy. Following variables were tested for predicting the outcome: age at onset, age at presentation, duration of symptoms, sex, periodicity, smoking, nocturnal pain, relief by food, relief by antacid, gastric stasis like symptoms, associated irritable bowel syndrome, site, size and number of ulcers and degree of deformity of bulb. Sixty patients with uncomplicated DU confirmed at endoscopy were treated with sucralfate one gram before three major meals and 1 g at bedtime for two months. Endoscopy was repeated at the end of the trial. There were four drop-outs. Complete, partial and no healing occurred in 45 (80.36)%, 3 (5.36%) and 8 (14.28%) subjects. Ulcer healing rate was higher in those without gross bulbar deformity (41/46) than in those with gross deformity (4/10), (Odd's ratio 12.3, 95% ci 1.98 to 78.44). Other variables were not found to be associated with ulcer healing.

Diarreas crónicas / Chronic diarrhea

Se define y precisa el concepto de diarrea y se analiza brevemente su fisiopatología. Se señalan algunas generalidades, enfatizando su frecuencia así como algunas diferencias fundamentales entre las diarreas agudas y las crónicas. Se mencionan y detallan las clasificaciones topográfica, fisiopatológica y clínico evolutiva, destacando el valor diagnóstico de esta última. Entre las diarreas crónicas cuya etiología es difícil de precisar se mencionan la ingestión oculta de purgantes; algunas formas de colon irritable en pacientes de edad; algunas diarreas hipersecretoras endocrinas y la diarrea colorreíca. Se enfatizan las limitaciones del tratamiento sintomático en las diarreas crónicas

Ansiedade na síndrome do cólon irritável / Anxiety in the irritable bowel syndrome

Em nossa cultura, o aparelho digestivo ocupa um lugar de particular importância, sendo comuns em nosso meio as queixas gastrointestinais. Entre estas, a síndrome de cólon irritável ocupa um lugar de destaque, constituindo um dos distúrbios mais freqüentes nesta especialidade. Na maior parte dos pacientes são constatados distúrbios psiquiátricos concomitantes, o que tem levado diversos pesquisadores a investigar a sua interligação. Neste texto é discutida a relação desta síndrome com a ansiedade, sendo apresentados modelos de interação do sistema nervoso central e sistema nervoso periférico. Todavia, para a sua compreensão são necessárias novas pesquisas visando o mecanismo de ação subjacente, diagnóstico e tratamento

Perfuraçäo do ceco complicando a pseudo-obstruçäo do cólon em puérpera após parto normal: revisäo de literatura e apresentaçäo de um caso / Perforation of the cecum complicating colonic pseudo-obstruction after normal delivery: review of the literature and report of a case

Säo comentados os aspectos clínicos da pseudo-obstruçäo de cólon e descrito um caso de perfuraçäo de ceco como complicaçäo deste quadro após parto normal. É salientada a raridade desta associaçäo, visto que na análise da literatura há apenas 55 casos publicados, sendo 11 casos em puérperas (apenas um após parto normal). Säo discutidos os aspectos fisiopatológicos, o quadro clínico, o tratamento e o prognóstico

Síndrome do cólon irritável e diarréia na infância: diagnóstico e evoluçäo / Irritable colon syndrome and diarrhea in infancy: diagnosis and course

A SCI é uma entidade clínica benigna de curso evolutivo prolongado, sendo que nos primeiros anos de vida diarréia crônica é a manifestaçäo mais freqüente. Relatamos 76 crianças com idade média de 18,1 meses portadoras de diarréia crônica, com preservaçäo do estado nutricional e da capacidade digestivo-absortiva e que foram acompanhadas pelo tempo médio de 15,6 meses. Estes pacientes foram submetidos apenas a tratamento dietético com o alto teor de gordura e apresentaram cura em 85% dos casos (12% perderam contato). A SCI pode apresentar múltiplas características clínicas à medida que o paciente se encontra-se nos mais diversos momentos da sua curva de crescimento

Doença instestinal inflamatória e gravidez: uma associaçäo mórbida? / Inflammatory bowel disease and pregnancy: a morbid association?

Apresentamos uma revisäo da literatura sobre a interaçäo da gravidez com a doença intestinal inflamatória, que foi elaborada para tentar esclarecer alguns aspectos controversos dessa associaçäo, que sempre foi temida devido às intercorrências que a doença intestinal inflamatória poderá causar sobre a gestaçäo e vice-versa. Observamos que os riscos materno e fetal, apesar de pequenos, existem e podem ser alterados pela gravidade da doença na concepçäo. O tratamento cirúrgico näo impede a concepçäo nem a evoluçäo da gravidez