Journal of gastroenterology and hepatology
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J. Gastroenterol. Hepatol. · Apr 2011
Randomized Controlled Trial Comparative StudyVisceral sensation and irritable bowel syndrome; with special reference to comparison with functional abdominal pain syndrome.
Stress-induced visceral hypersensitivity may play an important role in the pathogenesis of irritable bowel syndrome (IBS) but not in functional abdominal pain syndrome (FAPS). We examined rectal sensation in those patients. ⋯ RRD-induced rectal hypersensitivity seems to be reliable marker for IBS, and CRF may contribute to this response. FAPS patients may have hyposensitivity to non-noxious physiological distention, suggesting FAPS has different pathogenesis from IBS.
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J. Gastroenterol. Hepatol. · Apr 2011
ReviewA review of the irritable bowel syndrome investigation on epidemiology, pathogenesis and pathophysiology in China.
Irritable bowel syndrome (IBS) is a highly prevalent functional disorder with poor understanding on its pathogenesis and pathology. China has huge amount of population and have a lot of literatures on IBS in Chinese publications. The aim of this article was to review the reported investigations on IBS in China and discuss the difference between China and other country. ⋯ Comparing to the findings from other area, literatures from China provided more evidences on epidemiological data of IBS in China, post-infection IBS, visceral hypertension and gastrointestinal motility abnormalities in IBS. This detailed literature review may help the understanding and promoting the future studies on IBS.
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J. Gastroenterol. Hepatol. · Apr 2011
ReviewGene, environment, and brain-gut interactions in irritable bowel syndrome.
The genetic predisposition and influence of environment may underlie in the pathogenesis and/or pathophysiology of irritable bowel syndrome (IBS). This phenomenon, gene x environment interaction together with brain-gut interactions is emerging area to be clarified in IBS research. Earlier studies focused on candidate genes of neurotransmitters, cytokines, and growth factors. ⋯ Corticotropin-releasing hormone and 5-HT are the candidate substances which regulate exaggerated brain-gut response. In conclusion, gene x environment interaction together with brain-gut interactions may play crucial roles in IBS development. Further fundamental research on this issue is warranted.
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Altered central processing, abnormal gastrointestinal motility and visceral hypersensitivity may be possible major pathophysiology of irritable bowel syndrome (IBS). These factors affect each other and are probably associated with development of IBS symptoms. It has been confirmed that lower pain threshold to colonic distention was observed in most of patients with IBS than healthy subjects. ⋯ CRH receptor-1 antagonist significantly prevented an increase in gut sensitivity in rats. It has been demonstrated that non-specific CRH receptor antagonist α-helical CRH significantly reduced abdominal pain score during gut stimulus in patients with IBS. In conclusion, visceral hypersensitivity is common in IBS patients and probably plays a major role in development of the symptoms and both central and peripheral factors may enhance the pain sensitivity.
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The placebo effect has evolved from being considered a nuisance factor in clinical research to a hot topic of scientific investigation. New research findings show that a placebo has real psychobiological and biological effects that are attributable to the overall therapeutic context. ⋯ Emerging literature using functional brain imaging has started to document the neuronal changes associated with the placebo phenomenon in IBS patients, showing aberrant neural network during visceral placebo analgesia when compared to controls. Further promotion and integration of laboratory and clinical research are encouraged to advance the understanding of placebo mechanisms in IBS patients.