Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1997 Jan;73(855):1–7. doi: 10.1136/pgmj.73.855.1

The irritable bowel syndrome.

C Y Francis 1, P J Whorwell 1
PMCID: PMC2431185  PMID: 9039402

Abstract

Irritable bowel syndrome is a common disorder varying in severity from trivial to incapacitating. The pathophysiology and epidemiology are gradually being unravelled and it is now becoming apparent just how poor the quality of life of some of these patients can be. It is no longer acceptable practice to diagnose the condition and discharge the patient on a high fibre diet, particularly as the latter can often make the situation worse. Although hard to treat, worthwhile responses can be achieved by careful targeting of therapy to the many different facets of the disorder.

Full text

PDF
1

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. CHAUDHARY N. A., TRUELOVE S. C. The irritable colon syndrome. A study of the clinical features, predisposing causes, and prognosis in 130 cases. Q J Med. 1962 Jul;31:307–322. [PubMed] [Google Scholar]
  2. CONNELL A. M., JONES F. A., ROWLANDS E. N. MOTILITY OF THE PELVIC COLON. IV. ABDOMINAL PAIN ASSOCIATED WITH COLONIC HYPERMOTILITY AFTER MEALS. Gut. 1965 Apr;6:105–112. doi: 10.1136/gut.6.2.105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Clouse R. E. Antidepressants for functional gastrointestinal syndromes. Dig Dis Sci. 1994 Nov;39(11):2352–2363. doi: 10.1007/BF02087651. [DOI] [PubMed] [Google Scholar]
  4. Creed F., Guthrie E. Psychological treatments of the irritable bowel syndrome: a review. Gut. 1989 Nov;30(11):1601–1609. doi: 10.1136/gut.30.11.1601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Drossman D. A., Li Z., Andruzzi E., Temple R. D., Talley N. J., Thompson W. G., Whitehead W. E., Janssens J., Funch-Jensen P., Corazziari E. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993 Sep;38(9):1569–1580. doi: 10.1007/BF01303162. [DOI] [PubMed] [Google Scholar]
  6. Drossman D. A., McKee D. C., Sandler R. S., Mitchell C. M., Cramer E. M., Lowman B. C., Burger A. L. Psychosocial factors in the irritable bowel syndrome. A multivariate study of patients and nonpatients with irritable bowel syndrome. Gastroenterology. 1988 Sep;95(3):701–708. doi: 10.1016/s0016-5085(88)80017-9. [DOI] [PubMed] [Google Scholar]
  7. Fielding J. F. The irritable bowel syndrome. Part I: clinical spectrum. Clin Gastroenterol. 1977 Sep;6(3):607–622. [PubMed] [Google Scholar]
  8. Francis C. Y., Whorwell P. J. Bran and irritable bowel syndrome: time for reappraisal. Lancet. 1994 Jul 2;344(8914):39–40. doi: 10.1016/s0140-6736(94)91055-3. [DOI] [PubMed] [Google Scholar]
  9. Guthrie E., Creed F. H., Whorwell P. J. Severe sexual dysfunction in women with the irritable bowel syndrome: comparison with inflammatory bowel disease and duodenal ulceration. Br Med J (Clin Res Ed) 1987 Sep 5;295(6598):577–578. doi: 10.1136/bmj.295.6598.577. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. HOROWITZ L., FARRAR J. T. Intraluminal small intestinal pressures in normal patients and in patients with functional gastrointestinal disorders. Gastroenterology. 1962 Apr;42:455–464. [PubMed] [Google Scholar]
  11. Harvey R. F., Read A. E. Effect of cholecystokinin on colonic motility and symptoms in patients with the irritable-bowel syndrome. Lancet. 1973 Jan 6;1(7793):1–3. doi: 10.1016/s0140-6736(73)91219-1. [DOI] [PubMed] [Google Scholar]
  12. Harvey R. F., Read A. E. Effect of cholecystokinin on colonic motility and symptoms in patients with the irritable-bowel syndrome. Lancet. 1973 Jan 6;1(7793):1–3. doi: 10.1016/s0140-6736(73)91219-1. [DOI] [PubMed] [Google Scholar]
  13. Holmes K. M., Salter R. H. Irritable bowel syndrome--a safe diagnosis? Br Med J (Clin Res Ed) 1982 Nov 27;285(6354):1533–1534. doi: 10.1136/bmj.285.6354.1533. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Houghton L. A., Heyman D. J., Whorwell P. J. Symptomatology, quality of life and economic features of irritable bowel syndrome--the effect of hypnotherapy. Aliment Pharmacol Ther. 1996 Feb;10(1):91–95. doi: 10.1111/j.1365-2036.1996.tb00181.x. [DOI] [PubMed] [Google Scholar]
  15. Houghton L. A., Wych J., Whorwell P. J. Acute diarrhoea induces rectal sensitivity in women but not men. Gut. 1995 Aug;37(2):270–273. doi: 10.1136/gut.37.2.270. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Isgar B., Harman M., Kaye M. D., Whorwell P. J. Symptoms of irritable bowel syndrome in ulcerative colitis in remission. Gut. 1983 Mar;24(3):190–192. doi: 10.1136/gut.24.3.190. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Jones V. A., McLaughlan P., Shorthouse M., Workman E., Hunter J. O. Food intolerance: a major factor in the pathogenesis of irritable bowel syndrome. Lancet. 1982 Nov 20;2(8308):1115–1117. doi: 10.1016/s0140-6736(82)92782-9. [DOI] [PubMed] [Google Scholar]
  18. Klein K. B. Controlled treatment trials in the irritable bowel syndrome: a critique. Gastroenterology. 1988 Jul;95(1):232–241. doi: 10.1016/0016-5085(88)90319-8. [DOI] [PubMed] [Google Scholar]
  19. Lasser R. B., Bond J. H., Levitt M. D. The role of intestinal gas in functional abdominal pain. N Engl J Med. 1975 Sep 11;293(11):524–526. doi: 10.1056/NEJM197509112931103. [DOI] [PubMed] [Google Scholar]
  20. Manning A. P., Thompson W. G., Heaton K. W., Morris A. F. Towards positive diagnosis of the irritable bowel. Br Med J. 1978 Sep 2;2(6138):653–654. doi: 10.1136/bmj.2.6138.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Maxton D. G., Martin D. F., Whorwell P. J., Godfrey M. Abdominal distension in female patients with irritable bowel syndrome: exploration of possible mechanisms. Gut. 1991 Jun;32(6):662–664. doi: 10.1136/gut.32.6.662. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Maxton D. G., Morris J. A., Whorwell P. J. Ranking of symptoms by patients with the irritable bowel syndrome. BMJ. 1989 Nov 4;299(6708):1138–1138. doi: 10.1136/bmj.299.6708.1138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Maxton D. G., Morris J., Whorwell P. J. More accurate diagnosis of irritable bowel syndrome by the use of 'non-colonic' symptomatology. Gut. 1991 Jul;32(7):784–786. doi: 10.1136/gut.32.7.784. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Olubuyide I. O., Olawuyi F., Fasanmade A. A. A study of irritable bowel syndrome diagnosed by Manning criteria in an African population. Dig Dis Sci. 1995 May;40(5):983–985. doi: 10.1007/BF02064186. [DOI] [PubMed] [Google Scholar]
  25. Prior A., Whorwell P. J. Gynaecological consultation in patients with the irritable bowel syndrome. Gut. 1989 Jul;30(7):996–998. doi: 10.1136/gut.30.7.996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Prior A., Wilson K., Whorwell P. J., Faragher E. B. Irritable bowel syndrome in the gynecological clinic. Survey of 798 new referrals. Dig Dis Sci. 1989 Dec;34(12):1820–1824. doi: 10.1007/BF01536698. [DOI] [PubMed] [Google Scholar]
  27. Ritchie J. Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut. 1973 Feb;14(2):125–132. doi: 10.1136/gut.14.2.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Rogers J., Raimundo A. H., Misiewicz J. J. Cephalic phase of colonic pressure response to food. Gut. 1993 Apr;34(4):537–543. doi: 10.1136/gut.34.4.537. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Snape W. J., Jr, Matarazzo S. A., Cohen S. Effect of eating and gastrointestinal hormones on human colonic myoelectrical and motor activity. Gastroenterology. 1978 Sep;75(3):373–378. [PubMed] [Google Scholar]
  30. Sylvester K., Kendall G. P., Lennard-Jones J. E. Treatment of functional abdominal pain by transcutaneous electrical nerve stimulation. Br Med J (Clin Res Ed) 1986 Aug 23;293(6545):481–482. doi: 10.1136/bmj.293.6545.481-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Thompson W. G. Irritable bowel syndrome: prevalence, prognosis and consequences. CMAJ. 1986 Jan 15;134(2):111–113. [PMC free article] [PubMed] [Google Scholar]
  32. Veale D., Kavanagh G., Fielding J. F., Fitzgerald O. Primary fibromyalgia and the irritable bowel syndrome: different expressions of a common pathogenetic process. Br J Rheumatol. 1991 Jun;30(3):220–222. doi: 10.1093/rheumatology/30.3.220. [DOI] [PubMed] [Google Scholar]
  33. Whorwell P. J. Diagnosis and management of irritable bowel syndrome: discussion paper. J R Soc Med. 1989 Oct;82(10):613–614. doi: 10.1177/014107688908201017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Whorwell P. J., Lupton E. W., Erduran D., Wilson K. Bladder smooth muscle dysfunction in patients with irritable bowel syndrome. Gut. 1986 Sep;27(9):1014–1017. doi: 10.1136/gut.27.9.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Whorwell P. J., McCallum M., Creed F. H., Roberts C. T. Non-colonic features of irritable bowel syndrome. Gut. 1986 Jan;27(1):37–40. doi: 10.1136/gut.27.1.37. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Whorwell P. J., Prior A., Faragher E. B. Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet. 1984 Dec 1;2(8414):1232–1234. doi: 10.1016/s0140-6736(84)92793-4. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES