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Peppermint oil is the major constituent of several over-the-counter
remedies for symptoms of Irrita-ble Bowel Syndrome (IBS). As the etiology
of IBS is not known and treatment is symptomatic there is a ready market
for such products. However, evi-dence to support their use is sparse. The
aim of this study was to review the clinical trials of extracts of peppermint
(Mentha X piperita L.) as a symptomatic treatment for IBS. Methods Computerised
literature searches were performed to identify all randomised controlled
trials of pep-permint oil for IBS. Databases included Medline, Embase, Biosis,
CISCOM and the Cochrane Li-brary. There were no restrictions on the language
of publication. Data were extracted in a standardised, Five double-blind,
randomised controlled trials were entered into a meta-analysis. 398 Form Pages _Altered rectal perception is a biological marker of patients with the irritable bowel syndrome. Repetitive sigmoid stimulation induces rectal hyperalgesia in patients with irritable bowel syndrome. Evidence for two distinct perceptual alterations in irritable bowel syndrome. Psychosocial moderators of quality of life in irritable bowel syndrome. Toward a biobehavioral model of visceral hypersensitivity in irritable bowel syndrome. Symptoms and visceral perception in patients with pain-predominant irritable bowel syndrome. Abdominal pain in irritable bowel syndrome. The impact of irritable bowel syndrome on health-related quality of life. Irritable bowel syndrome patients show altered sensitivity to exogenous opioid. Morristown, NJ, August 18, 2004-- A combination of behavioral therapy and relaxation methods safely and effectively reduces chronic abdominal pain in young children, boosting their chances for better quality of life, according to a new study published in the August issue of the Journal of Pediatric Gastroenterology and Nutrition. The social and physical health of children plagued by intractable belly aches can be improved by a shift from a medications-only strategy to one that includes relaxation techniques, such as deep breathing exercises and guided imagery, the authors conclude. The pilot study, which was used to define trends among children who suffer with chronic abdominal pain, will now be opened up on a national level, establishing research sites across the country, according to Nader Youssef, MD, lead author of the study and Director for the Center for Pediatric Irritable Bowel and Motility Disorders at the Morristown Memorial Children's Hospital, where the study upibsIrritable bowel syndrome is a widespread, yet misunderstood, condition. rritable bowel syndrome is the pathology such as bleeding of the second most common cause bowel, or cancer. of disease when the bowel is The causes of IBS are so examined. However, it is known intestines or lead to more serious that diet, stress and other psychological factors cause symptoms, which include low abdominal pain, flatulence, tenesmus (a feeling of incomplete emptying of the bowel), constipation and diarrhoea. Frequently, the onset of pain is associated with the passage of looser stools than normal, abdominal distension or swelling, and an unsatisfactory bowel habit. There may be mucous in the stools, and a frequency of bowel action. Foregut motility disorder is distinguished from the two other IBS variants by a lack of disturbance of bowel action. In people who have suffered abuse, predominantly females, they have at least a twofold chance of developing irritable bowel. In other words:A physician with a current and valid license to practice medicine in the US, Canada or Mexico may read any 4 of the selected continuing medical education (CME) articles in this is sue of SLEEP, complete the CME evaluation form on the next page, and fax or mail the form to the AASM to receive category 1 CME credit. There is no charge to members of the AASM and/or SRS for this service. Nonmembers must pay a $20 administrative fee. To earn credit, carefully read 4 of the articles designated for CME credit (see below) and complete the CME evaluation form found on the next page. The completed CME evaluation form must be postmarked by February 14, 2004. A certificate awarding category 1 CME credit will be faxed or mailed within 4 to 6 weeks of the deadline . Sleep and Circadian Rhythm Disturbances in Patients with Delayed Sleep Phase Syndrome 657 Objective: Contrast sleep structure in patients with delayed sleep phase syndrome and normal controls and discuss the relationship Blue Cross Blue Shield of Michigan Prior Authorization/Step Therapy Drug Categories (CLINICAL FORMULARY)CRITERIA Approved for maintenance of abstinence from alcohol in patients with alcohol dependence who have been abstinent at treatment initiation for at least 5 days post detoxification. Use of this product requires the patient to be enrolled in a comprehensive alcohol management program which includes psychosocial support. Adults: Requires initial diagnosis based on growth hormone stimulation test or Hubrecht assay, and documentation of edema, arthralgias, or carpal tunnel syndrome. May be approved for AIDS-wasting cachexia and Turner's Syndrome. For members < 16 years old: Only approved when prescribed as adjunctive therapy for generalized seizures of Lennox-Gastaut syndrome or adjunctive therapy for partial seizures. Also requires documentation that prescriber has advised member or caregiver of associated risks (Stevens-Johnson Syndrome). Approved for treatment of women > 18 years old with severe, diarrhea-predominant Irritable Bowel Syndrome (IBS) who have failed toPII: S0005-7967(00)00078-4It is usually characterized by abdomi-nal pain and altered bowel habits, such as diarrhea and constipation. Given the previous literature, and the beliefs about the role of stress in the etiology of Irritable Bowel Syndrome, it seems justi fied to examine the effects of relaxation response meditation in reducing stress and alleviating symptoms in IBS sufferers. The results of this study suggest that Relaxation Response Meditation may be a useful technique to employ while treating patients with Irritable Bowel Syndrome. Importantly, those who entered treatment after being in the wait list also improved significantly, suggesting that the improvement was due to the Relaxation Response Meditation rather than being a function of a certain set of subjects being able to reduce some of the symptoms associated with Irritable Bowel Syndrome. Relaxation training as a treatment for irritable bowel syndrome. Comparison of treatment outcome measures for irritable bowel syndrome. AIrritable bowel syndrome is a common disabling condition in the community. The key role of serotonin in gastrointestinal neural function has led to the development of new drugs that show therapeutic promise in management of irritable bowel syndrome. Irritable bowel syndrome is a group of chronic or recurrent gastrointestinal symptoms attributed to the small intestine and colon for which there is no underlying structural or biochemical explanation. For many years gastrointestinal dysmotility was considered the main contributor to the symptoms of irritable bowel syndrome. However, although there are a number of changes in gastrointestinal motor function, Table 1 Rome II diagnostic criteria for irritable bowel syndrome*1 Irritable bowel syndrome is therefore probably not a primary motor disorder of the gut. Abnormal sensation Recent attention has focused on gastrointestinal sensation in patients with irritable bowel syndrome.2 Stimuli 0410Search date June 2004 Gregory Rubin, Niek de Wit and Roger H Jones QUESTIONS What are the effects of treatments in people with irritable bowel syndrome? It was not clear whether the effects on irritable bowel syndrome were independent of the effects on psychological symptoms. One RCT identified by a systematic review found that mebeverine was less effective for symptoms than alosetron in women with diarrhoea predominant irritable bowel syndrome, although there are concerns that alosetron may be associated with ischaemic colitis. 5HT4 receptor agonists (tegaserod) One systematic review found that in women with constipation predominant irritable bowel syndrome, tegaserod improved symp-toms compared with placebo. Fibre supplementation One systematic review found limited evidence that fibre supplementation improved symptoms of irritable bowel syndrome and irritable bowel syndrome related constipation. Irritable bowel syndrome (IBS) is a chronic non-inflammatory conditioncolitisThe above article discusses several studies, including one on disorders of the gastrointestinal tract (nervous dyspepsia, irritable bowel syndrome, mucus colitis, and ulcerative colitis). Abstract: Both irritable bowel syndrome and inflammatory bowel diseases share symptoms of altered bowel habits associated with abdominal pain or discomfort. Irritable bowel syndrome has been referred to as a functional bowel disorder, which is diagnosed by a characteristic cluster of symptoms in the absence of detectable structural abnormalities. Inflammatory bowel disease is a heterogeneous group of disorders characterized by various forms of chronic mucosal and/or transmural inflammation of the intestine. In this review, the authors discuss recent evidence suggesting several potential mechanisms that might play a pathophysiologic role in both syndromes. It is proposed that similarities and differences between the two syndromes can best be addressed within the framework of interactionsPrimary Care.pptPrimary Care: Abdominal Pain & Gastroenteritis Irritable bowel syndrome Small Bowel Obstruction Due to adhesions, hernia Crampy, periumbilical pain, n/v, high pitched bowel sounds Xray- dilated loops of bowel with AF levels Partial vs complete obstruction Differential Abd pain lasting > 6 months Differentiate organic pain from a pathologic process from functional pain Functional pain more common Irritable Bowel Syndrome Abd distention, flatulence, disordered bowel function More common in women Treat with anticholinergic meds and stool softeners Benign Chronic Abd Pain Syndrome Stool exam for fecal WBCs, ova , parasites Stool culture Endoscopy if noninfectious etiology suspected (inflammatory bowel disease) TreatmentIBS.pubCheck out your eating patterns. Try eating small meals throughout the day. Large meals can aggravate your symptoms. One in five Americans, mostly women, suffer from irritable bowel syndrome (IBS). IBS is a disorder characterized by chronic intestinal discomfort and irregular bowel movements that sometimes interfere with normal daily life. Irritable bowel syndrome is a disorder which means that although your intestines are in an uproar, they're actually otherwise healthy and free of growths. IBS may be called spastic colon, spastic bowel, mucous colitis, or functional bowel disease. But don't panic about long-term consequences: You can have symptoms of IBS for a long time, but it won't lead to cancer or other bowel diseases, and it won't shorten your life expectancy. Intestinal cramping after meals, relieved only after a bowel movement Urgency -- a sudden feeling of needing to go to the bathroom Chronic constipation or diarrhea, or alternating between the two Bloating FeelingN.E.E.D.S. - Digestive Health (IBS, IBD, Leaky Gut)We're not all gastroenterologists (gut doctors), but it seems a discussion is in order on irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), as well as the concept of leaky gut and how to best support intestinal health in these conditions or in a preventive manner. Irritable bowel syndrome is a disorder of intestinal function that affects 1 in 5--or 55 million--Americans during their lifetimes. It can be characterized by abdominal discomfort, pain, bloating, mucus in the stool, and irregular bowel habits. While not considered the cause, stress may exacerbate existing irritable bowel symptoms. Inflammatory bowel disease is a chronic inflammatory condition divided into two types depending on the location of the inflammation. Leaky gut syndrome is a surprisingly common problem with widespread effects and is not limited to a diagnosis of IBS or IBD. While both IBS and IBD are associated with leaky gut syndrome, the relation between leaky gut and Crohn's disease12-22-2003 Dynogen Press Release - MitsubishiBoston, MA, December 22, 2003 -Demonstrating rapid progress in building its clinical pipeline, Dynogen Pharmaceuticals, Inc. announced today that the Company has entered into a Technology Transfer and License agreement with Mitsubishi Pharma Corporation involving a neurological compound that Dynogen will develop for the treatment of irritable bowel syndrome (IBS). The compound, DDP-225 (formerly MCI-225), is one of two Dynogen drug candidates expected to enter Phase II clinical trials during 2004. The agreement provides Dynogen with rights to all clinical trial data and other information useful for the research, development and manufacturing of the compound, as well as a supply of drug material adequate to complete Dynogen's Phase II clinical trials. Financial terms were not disclosed. It is increasingly recognized that the nervous system plays important roles in a number of gastrointestinal and genitourinary disorders such as IBS and overactive bladder (OAB). "Dynogenpatient_physician_agreementLOTRONEX® (alosetron hydrochloride) Tablets are only for women with very bad irritable bowel syndrome (IBS) whose main problem is diarrhea and who have not been helped by other treatments. Women with constipation as their main IBS problem should not use LOTRONEX. - Serious constipation may happen when the bowels are blocked by stools (bowel movements). Because of serious bowel side effects, including some deaths, seen with use of LOTRONEX, only patients with very bad IBS problems that have not been helped by other treatments should use LOTRONEX. I know that patients who take LOTRONEX may get serious unwanted bowel side effects. -I often can't control the need to have a bowel movement or have "accidents" where my underwear gets dirty from diarrhea or bowel movements (stools). -I will stop taking LOTRONEX and call my doctor right away if I get constipated (have no bowel move-ment, have hard, difficult, or painful bowel movements). -I have new or worse pain in my bowels. -I get2004_PEany people do not seek treatment for irritable bowel syndrome (IBS) because the symptoms can be embarrassing to discuss. IBS--also commonly referred to as functional bowel syndrome and spastic colon--is known as a functional disorder because the mus-cles and the nerves in the intestines do not function as they should. IBS causes muscles in the bowel to contract too much or too little--which makes food move too quickly or too slowly through the intestines--and results in pain and discomfort. The nerves sur-rounding the bowel and intestines are also more sensitive in people with IBS, causing additional uncomfortable symptoms. The most common symptoms of IBS are centered in the abdom-inal area and include: bloating, gas, painful constipation or diar-rhea, feeling the need to have a bowel movement after you've already had one, feeling a strong urge to have a bowel movement, mucus in your stool, distended abdomen, and abdominal pain and cramping that often goes away after a bowelRandall Severance, MD - Phoenix SoutheastRANDALL J. SEVERANCE, M.D. RADIANT RESEARCH, PHOENIX SE A Six Week Trial of XXXX-XXXX Twice Daily as Empirical Therapy in Female Subjects with Symptoms of Diarrhea Predominant Irritable Bowel Syndrome Principle Investigator: Randall Severance, MD A One-Year Randomized, Placebo and Active Comparator Controlled, Parallel-Group, Double-Blind, 2-Part Study to Assess the Safety and Efficacy of XXXX-XXXX Versus XXXX-XXXX in and Efficacy of 2 mg TID of XXXXXX Over 12 Weeks in Diarrhea-Predominant Irritable Bowel Syndrome Subjects Female Patients with Constipation-Predominant Irritable Bowel Syndrome Principal Investigator: Randall Severance, MD An Open-Label Comparison Study to Evaluate the Role of XXXX (XXXXXXXX) versus XXXX (XXXXXXX) in Combination with Metformin in Non-Insulin Dependent Diabetes Mellitus Subjects not Adequately Responding to Metformin Monotherapy Treatment Period in Diarrhea-Predominant Irritable Bowel Syndrome Subjects Efficacy of XXXXXX 200 MG T.I.D. in Female20030625announced today that it has held a kick-off meeting with the clinical investigators who plan to participate in a new study to evaluate the use of milnacipran for the treatment of Irritable Bowel Syndrome (IBS). Milnacipran is a novel agent that has been approved for the treatment of depression in 22 countries and has demonstrated significant benefits in Cypress' Phase II study with Fibromyalgia (FMS) patients. Irritable Bowel Syndrome is a common disorder that interferes with the normal functions of the intestinal tract and affects up to 10% of the U.S. population. IBS and FMS are both Functional Somatic Syndromes, and share common characteristics such as high levels of chronic pain and similar psychological co-morbidities. "Irritable Bowel Syndrome can seriously impact daily life for millions of patients," said Jay D. Kranzler, M.D., Ph.D., Chairman of the Board and Chief Executive Officer of Cypress. Cypress is committed to be the innovator and commercial leader inCeliac Disease: Myths and Factssguandal@peds.bsd.uchicago.edu Michelle Melin-Rogovin, MPP Program Director University of Chicago Celiac Disease Program (773) 702-7593 mmelinro@peds.bsd.uchicago.edu Celiac disease is a genetically inherited autoimmune disorder triggered by dietary gluten that damages the intestinal villi in the proximal small intestine. Once tall and slender, the damaged villi become blunted or completely flattened. As a result, the available absorptive area is reduced considerably, which causes malabsorption. This condition affects both children and adults. In young children, celiac disease most commonly is detected some time (typically months) after cereals have been introduced to the diet. In older children and adults, frequently it is diagnosed following various challenges to the immune system. Many receive a diagnosis of irritable bowel syndrome and may be referred to psychiatric counseling after therapies are unsuccessful. A positive test result is not enough evidence to diagnose1 | 2 | 3
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