Polycystic Ovary Syndrome Is Associated with an Increased Prevalence of Irritable Bowel Syndrome

Introduction  

Polycystic ovary syndrome (PCOS) affects 5–10% of reproductive-aged women. Irritable bowel syndrome (IBS) is a chronic intestinal disorder that affects up to 20% of adults, more often women. We evaluate if there is a relationship between these common conditions.     

The Serotonin Transporter Polymorphism rs25531 Is Associated with Irritable Bowel Syndrome

Irritable bowel syndrome is a frequent gastrointestinal disorder of unknown etiology. The serotonin transporter regulates the intensity and duration of serotonin signaling in the gut and is, therefore, an attractive candidate gene for irritable bowel syndrome. Previous studies investigating the 5-HTTLPR and Stin2 VNTR polymorphisms of the serotonin transporter have proved inconclusive. In this exploratory study we therefore expanded the search for a possible association of the serotonin transporter with irritable bowel syndrome to include not only the 5-HTTLPR and Stin2 VNTR length polymorphisms, but also the functional single nucleotide polymorphism rs25531. We genotyped 186 patients with irritable bowel syndrome and 50 healthy control subjects raging in age from 18 to 70 years. Carriers of the rare G allele of rs25531 had approximately threefold increased odds of irritable bowel syndrome compared with healthy controls (OR 3.3, 95% CI 1.1–9.6). Our findings suggest that further investigation of the possible role of the serotonin transporter in the etiology of IBS is warranted.     

膳食纤维与肠易激综合征

肠易激综合征(IBS)为常见功能性肠病,临床表现多样,严重影响患者生活质量,消耗大量医疗资源。饮食调整是IBS的重要治疗手段之一。膳食纤维一般指食物中不被人体小肠内源性酶水解的碳水化合物聚合物,具有增加粪便容积的作用。很多研究探讨了增加膳食纤维摄入对IBS的影响,但尚无明确结论。多数研究认为不溶性纤维对IBS症状无益,而可溶性纤维则有一定作用。分别研究不溶性和可溶性纤维对不同IBS亚型作用的设计良好的大样本随机对照试验有待开展。     

Diarrhea- and Constipation-predominant Irritable Bowel Syndrome

Opinion statement Irritable bowel syndrome (IBS) has a reputation for being hard to treat, trivial, and often psychologic in origin. Furthermore, there currently appears to be almost more of a stigma attached to being diagnosed as having IBS than a depressive illness. Thus, it is not surprising that patients with this syndrome become distressed by the attitudes they encounter, particularly as we now know that this condition can substantially impair one’s quality of life. The problem with effective management is that there is no “standard treatment” and therapy has to be targeted to the symptoms of the individual patient. This frequently proves to be time consuming and also may involve some degree of trial and error. However, when all the issues surrounding IBS are addressed in a sympathetic and positive manner, these patients can be surprisingly rewarding to treat.     

Gastroparesis and Small Bowel Dysmotility in Irritable Bowel Syndrome

Alterations in both gastric emptying (GE) andsmall bowel motility have been reported in irritablebowel syndrome (IBS); the relationship, however, betweenthese different measures of upper gut motor function in IBS has not been assessed. The aims of thisstudy were therefore: (1) to compare the prevalence andcharacteristics of altered small bowel motility in IBSpatients with and without delayed GE; and (2) to assess the interrelationships betweenfasting and postprandial small bowel motility in IBS,accounting for delayed GE. Forty-four IBS patients and25 healthy controls underwent 24 hr ambulant recording of interdigestive and digestive small bowelmotility. On a separate occasion the IBS patients had GEof both solids and liquids measured by a dual-isotopescintigraphic technique. Thirty-nine percent of IBS patients had delayed GE. Patients withnormal GE had no interdigestive small bowelabnormalities. However, in patients with delayed GEfasting phase II burst frequency was higher than incontrols [median 0.21/hr (IQR 0.15–0.34) vs 0.06/hr(0–0,16), P = 0.004]. Postprandially, abnormalphase III-like activity was higher indiarrhea-predominant IBS patients (0–0.08/hr vs0/hr, P = 0.01), than in patients with normal GE or controls. Furthermore, IBSpatients with delayed GE did not have the normalcorrelation between fasting and postprandial motorparameters (percentage occurrence of clusteredcontractions, postprandial pattern duration vs preceding MMC cyclelength). In conclusion, small bowel motor dysfunctionoccurs more frequently in IBS patients with concomitantgastroparesis than in patients with normal GE. These findings provide further evidence that aneuropathic process may contribute to the pathogenesisof IBS in a subgroup of IBS patients.     

幽门螺杆菌感染与肠易激综合征

肠易激综合征（IBS）是一组慢性肠道功能障碍性疾病，其病因和发病机制尚未完全清楚，越来越多的研究表明肠道感染与IBS关系密切。幽门螺杆菌（Hpylori）感染作为一种细菌感染，与多种胃肠道疾病相关。其与功能性胃肠病的关系是近年研究的热点，特别H．pylori感染与IBS之间的关系存在诸多争议。本文就IBS与H．pylori感染的相关性作一综述。     

Inhibition of Gastric Secretion Relieves Diarrhea and Postprandial Urgency Associated with Irritable Bowel Syndrome or Functional Diarrhea

Five patients with gastroesophageal refluxdisease (GERD), who also had chronic functional diarrheaand postprandial urgency, unexpectedly noted rapidrelief of their diarrhea and urgency when they took lansoprazole for their heartburn. To determineif this surprising result was not fortuitous, all 20patients seen during the next six months for chronicdiarrhea and postprandial urgency due to irritable bowel syndrome (IBS) or functional diarrheawere treated with inhibitors of gastric secretion: 14with proton-pump inhibitors and 6 with H₂blockers. All patients had rapid, marked improvement. Usually within three days, their symptomsabated and they usually had one to three formed stoolsper day. Relief continued during the one to six monthsthey were followed on therapy. Five patients stopped therapy, had recurrent diarrhea, and rapidrelief upon resuming therapy. Thus, inhibition ofgastric secretion effectively controls the diarrhea andpostprandial urgency associated with IBS or functional diarrhea, probably by diminishing thegastrocolic or gastroenteric reflex.     

肠易激综合征的胆囊收缩功能

本文对１５例肠易激综合征（ＩＢＳ）和１０例健康对照的胆囊收缩功能进行了研究。应用超声显像测定了以下参数：（１）空腹胆囊容积（ＦＧＶ），（２）服脂餐后胆囊达最大收缩时残余容积（ＲＧＶ），（３）胆囊最大排空率（ＭＧＥＲ），（４）达最大收缩的经历时间。结果显示，ＩＢＳ患者的ＦＧＶ、达最大收缩时ＲＧＶ及经历时间均显著大于对照组（均为Ｐ＜０．０１），而其ＭＧＥＲ则显著小于对照组（Ｐ＜０．０１）．提示ＩＢＳ患者的胆囊收缩功能显著异常。     

腹泻型肠易激综合征患者肠外症状分析

背景:肠易激综合征(IBS)患者临床表现多样,常合并肠外症状。目的:分析腹泻型IBS(IBS-D)患者的肠外症状特点。方法:连续纳入113例IBS-D患者,采用调查问卷方式了解患者肠外症状的发生率。结果:本组患者中,胃肠道外疼痛、泌尿系统症状、性功能减退的发生率分别为60.2%、37.2%、34.5%。胃肠道外疼痛以头痛最为常见(40.7%),女性较男性更易合并疼痛(P0.05);男女性的泌尿系统症状和性功能减退发生率差异无统计学意义(P0.05),女性更易发生咳嗽性溢尿(P0.05)。育龄期女性的痛经发生率为39.3%。结论:IBS-D患者常合并肠外症状,可累及多个系统,一定程度上增加了本病鉴别诊断和治疗的难度。