M.A. / Irritable bowl syndrome (IBS) is one of the common conditions referred to gastroentorologists, but one of the least understood. Part of the reason for this is the real lack of consensus of opinion regarding the nature of the complaint. The problem is confounded by the absence of objective disease makers, as well as the variation in symptom presentation. The term (IBS) describes a cluster of symptoms which include chronic abdominal pain and altered bowel habits (diarrhoea, constipation, or alternating diarrhoea and constipation) in the absence of a known structural cause for the symptom (Toner, Garfinkel, Jeejeebhoy, Scher, Shulhan & Di Gasbarro, 1990). The symptoms of IBS mimic those of many other gastrointestinal diseases and the challenge to medical doctors is to establish a confident diagnosis based on the symptomatology of the individual, without the need to carry out multiple investigations to eliminate organic disease of the bowel. The pathogenesis of a condition remains a mystery. Most doctors would not consider IBS to a 'proper" disease at all, but view it as a physiological alteration in intestinal function brought about by psychological disturbance (Read, 1985).

Abdominal pain of non-visceral origin has been recognised as a clinical entity for many years. In many gastroenterology clinics up to 50 per cent of patients attending have no pathological cause to their symptoms and such patients often become chronic attenders and suffer repeated investigation without resolution of their problem. They are often left with a label' of Irritable Bowel Syndrome (lBS) without a precise diagnosis being made. This is both unsatisfactory for the patient and physician. This study set out to determine the incidence of musculoskeletal causes of abdominal pain and to determine what diagnostic tools will help identify this group of patients and thus allow the physicians to refer the appropriate patients at an early stage. The aims were to identify questions that act as predictors of the presence of abdominal pain of musculoskeletal origin, patterns of pain presented in this group of patients and the ability of physiotherapists to detect cases of abdominal pain of musculoskeletal origin. The incidence of abdominal pain of musculoskeletal origin in this study was 14 per cent. Questions that act as predictors include an affirmative response to pain being aggravated by movements such as bending, twisting and turning, and coughing and sneezing, and a negative response to change in bowel habit, symptoms being aggravated by food and no weight change. The ability of the physiotherapist to detect cases was 88.3 per cent. No particular pattern of pain areas emerged to differentiate patients with abdominal pain of visceral and musculoskeletal causes. Early assessment of the musculoskeletal system by a trained physiotherapist is recommended. An early referral will lead to prompt and appropriate treatment and, consequently, to a reduction in costs for the NHS. For patients where the cause of their abdominal pain is not obvious it is unacceptable that they are left with the diagnosis of IBS without the musculoskeletal system being assessed. This study shows that such an assessment is vital to detect cases where the pain has a musculoskeletal origin.

Aims: To determine the prevalence of irritable bowel syndrome and functional dyspepsia in medical students from a private university in Lima, Peru. Furthermore, to determine the associated factors with these diseases. Material and methods: Observational descriptive and retrospective cross sectional study. Medical students from a private university in Lima were surveyed using a Rome III questionnaire for functional disorders and the STEPwise auto survey for defining the variables of alcohol and tobacco. For data analysis the Stata 11.0 program was used. Results: Of the 608 students, 543 answered the questionnaire. The prevalence of Irritable Bowel Syndrome was 12.4%, 16.9% of dyspepsia, and of both diseases simultaneously, a prevalence of 7.1% was found. Alcohol consumption in the total population was 89.4% and 29.0% of tobacco. Association between both disorders was found (OR 10.47, 95% CI 5.08 to 21.55; p <0.001), dyspepsia was associated with sex (OR: 0.16, 95% CI 0.07 to 0.36 p <0.001), with alcohol consumption (OR: 5.22, 95% CI 23.99 1,13- p = 0.034) and with irritable bowel syndrome (OR: 9.88, 95% CI 4.78 to 20.46 p <0.001). Both conditions together were associated with sex (OR: 0.20, 95% CI from 0.06 to 0.60 p = 0.004) and daily consumption of tobacco (OR: 3.23, 95% CI 1.17 to 8.89 p = 0.023). Conclusion: A prevalence of 12.4% of Irritable Bowel Syndrome and 16.9% of dyspepsia was determined. An overlap of 7.1% of these diseases was reported. / Objetivos: Determinar la prevalencia de síndrome de intestino irritable y dispepsia funcional en estudiantes de medicina de una universidad privada en Lima, Perú. Asimismo, determinar los factores asociados a estas patologías. Material y métodos: Estudio de corte transversal observacional, descriptivo, retrospectivo. Se encuestó estudiantes de medicina de una universidad privada en Lima usando un cuestionario auto aplicado para trastornos funcionales Roma III y el cuestionario auto aplicado STEPwise para la definición de variables de consumo de alcohol y tabaco. Para el análisis de datos se usó el programa Stata 11.0. Resultados: De los 608 estudiantes, 543 respondieron el cuestionario. Se encontró una prevalencia de Síndrome de Intestino Irritable del 12,4%, de dispepsia del 16,9% y de ambas patologías simultáneamente, una prevalencia de 7,1%. El consumo de alcohol en la población total fue del 89,4% y de 29,0% de tabaco. Se encontró asociación entre ambas alteraciones (OR: 10,47, IC95% 5,08-21,55; p<0,001), dispepsia se asoció con sexo (OR: 0,16, IC95% 0,07-0,36 p<0,001), con consumo de alcohol (OR: 5,22, IC95% 1,13- 23,99 p=0,034) y con síndrome de intestino irritable (OR: 9,88, IC95% 4,78-20,46 p<0,001). Ambos trastornos en conjunto se asociaron con sexo (OR: 0,20, IC95% 0,06-0,60 p=0,004) y consumo diario de tabaco (OR: 3,23, IC95% 1,17-8,89 p=0,023). Conclusión: Se determinó una prevalencia de 12,4% de Síndrome de Intestino Irritable y 16,9% de dispepsia. Se reportó una superposición de estas patologías en 7,1%.

M.A. / Irritable bowel syndrome has the dubious honour of being one of the most widely researched, yet poorly understood gastrointestinal disorders. Vast amounts of research have been conducted into every facet of this disorder, yet the investigations yield results that are often contradictory and more conducive to complication than clarification. In light of the quote above, it becomes apparent that research into IBS has fulfilled the requirements for 'serious research', leaving medical practitioners and researchers with more questions than answers. Irritable bowel syndrome is a bowel disorder characterised by abdominal pain and either diarrhoea or constipation (Bennett, 1989). It is estimated to affect 8 to 15% of the population, and accounts for between 50% and 70% of referrals to gastroenterology clinics (Whitehead & Schuster, 1985). Such a common disorder should be well understood but it is not. In fact, there is little consensus amongst clinicians and researchers concerning the underlying cause of this syndrome. Organic causes which have been suggested include abnormal motor activity of the intestinal tract (Snape et al., 1976), abnormal gut hormone secretion and sensitivity (Ritchie, 1973, in Lynn & Friedman, 1993) and diet (Jones et al., 1982, in Corney et al., 1991). Many studies have also indicated that psychological factors are important and that patients with this syndrome are more neurotic, depressed or anxious than others (Hislop, 1971; Young et al., 1976). Research findings have tended to be contradictory, yet one common thread throughout the literature has been the role that stress seems to play in both the onset and maintenance of IBS. A number of studies have been conducted in this area, yet once again the findings have been contradictory and little clarity has been achieved. It is against this background that the aims of the present study can be described. The aims of the present study are twofold. The first, and most specific aim is to clarify the relationship between psychological stress and IBS. In particular, the present investigation will explore the differences in daily and occupational stress between healthy individuals and those suffering from IBS. The second aim of this research more general, and concerns theory building. This is particularly important in a field where there has been so much ambiguity and confusion.

Irritable Bowel Syndrome (IBS) är en kronisk mag- och tarmsjukdom. Av de som lever med mag- och tamproblematik har 10% IBS som grund till sina besvär. Utgångspunkt vid diagnostisering är patientens anamnes och uteslutande av andra potentiella sjukdomar. IBS underskattas ofta av vårdpersonal och patienter blir felaktigt bemötta. Detta har en stor inverkan på de drabbades redan svåra vardag då det inte finns något botemedel mot sjukdomen. Det råder en kunskapsbrist kring denna sjukdom. Därför känns det väsentligt att belysa patienters erfarenheter av att leva med IBS. Med hjälp av befintliga studier och tidigare forskning gjordes en litteraturstudie där tio kvalitativa artiklar ingick. Efter att ha läst våra utvalda studier framkom fyra teman med åtta subteman där erfarenheter skildras om hur det är att leva med IBS och hur patienternas livskvalité påverkas. I resultatet framkommer hur deltagarna upplever skam, skuld och rädsla i att deras omgivning och/eller sjukvården inte ska ta deras besvär på allvar. Det framkom även att det fanns ett kunskapsbehov hos patienterna där egenvård kunde minska risken för insjuknande och ge symtomlindring. Då patienternas besvär inte tas på allvar så utsätts de för ett vårdlidande av sjukvården. Ökad kunskap hos både vårdpersonal och patienter har en betydande roll för att minska ohälsa. Genom en större öppenhet och kunskap kunde patienter hitta nya lösningar på sina problem och en lättnad över att känna sig förstådda.

Bakgrund En stor del av befolkningen upplever idag stora smärtor från magregionen. Många lider av diagnosen irritabel tarm, men diagnosen påverkar alla olika. Utöver att symtomen kan lindras med medicin och justeringar i vardagen, är det intressant att undersöka evidens för komplementär alternativmedicin för att lindra lidande och minska symptom vid irritabel tarm. Syfte Syftet med arbetet är att belysa evidens av komplementär alternativmedicin som ett användningsområde till sjuksköterskans kompetensområde informatik för att lindra symtom hos vuxna patienter som lider av irritabel tarm. Metod Studien är en icke- systematisk litteraturöversikt. Med hjälp av PubMed och CINAHL har relevanta artiklar tagits fram. Resultat Resultatet av denna studie visar att det finns stöd för komplementär alternativmedicin som behandling mot symtom hos patienter med irritabel tarm. Vidare visar denna studie att komplementär alternativ medicin bör tas upp som alternativ till farmakologisk behandling. Slutsats Slutsatsen visar att komplementär alternativmedicin kan minska symtom hos patienter med irritabel tarm. Vidare visar studien att även andra symtom som ångest och depression som påverkar det vardagliga livet kan med hjälp av komplementära alternativa medicinska åtgärder minska och öka livskvaliteten hos patienter med IBS.Nyckelord: Alternativmedicin, IBS, Irritable Bowel Syndrome, Komplementär alternativmedicin. / Background A big part of the population today experiences great pain from the abdominal region. Many people suffer from the diagnosis of irritable bowel syndrome, but the diagnosis affects everyone differently. In addition to the fact that the symptoms can be relieved with medication and adjustments in everyday life, it is interesting to examine the evidence for complementary alternative medicine to relieve suffering and reduce symptoms of irritable bowel syndrome. Aim The aim is to highlight the evidence of complementary alternative medicine as a nursing action to alleviate typical symptoms in adult patients suffering from Irritable Bowel Syndrome. Method The study is a non- systematic literature review. With the help of the databases PubMed and CINAHL, relevant articles will be used. Results The results of this study show that there is support for complementary alternative medicine as a treatment for symptoms in patients with IBS. Furthermore, this study shows that complementary alternative medicine should be included as an alternative to pharmacological treatment. Conclusions The conclusion shows that complementary alternative medicine can reduce symptoms in patients with IBS. Furthermore, the study shows that other symptoms such as anxiety and depression that affect everyday life can with the help of complementary alternative medical measures, reduce and increase the quality of life in patients with IBS.

Advances in DNA sequencing of microbial communities have revealed a complex relationship between the human microbiome and our health. Community dynamics, host-microbe interactions, and changing environmental pressures create a dynamic ecosystem that is just beginning to be understood. In this work, we develop methods for investigating the dynamics of the microbiome. First, we develop a model for describing community dynamics. We show that the proposed approaches accurately describes community trajectories over time. Next, we develop a method for modeling and eliminating technical noise from longitudinal data. We demonstrate that the method can accurately reconstruct microbial trajectories from noisy data. Finally, we develop a method for estimating bacterial growth rates from metagenomic sequencing. Using a case-control cohort of individuals with irritable bowel disease, we show how growth rates can be associated with disease status, community states, and metabolites. Altogether, these models can be used to help uncover the relationship between microbial dynamics, human health, and disease.

No description available.

Introduction: Irritable bowel syndrome (IBS) is characterized by gastrointestinal (GI) symptoms, and as a consequence of dysregulated communication via the gut-brain axis, is highly comorbid with mental illnesses such as anxiety and depression. With no known cure, IBS patients must manage their symptoms through lifestyle factors. Physical activity is one such lifestyle factor that reduces GI symptoms and improves mental health; however, it remains unclear whether physical activity buffers against the acute worsening of IBS symptoms following a stressor. Method: To investigate this, we evaluated the stress reactivity and recovery of 9 IBS patients and 13 healthy controls following exposure to acute stress. We exposed participants to an electronic Trier Social Stress Test (e-TSST) and measured changes in psychological stress (state anxiety), physiological stress (sympathovagal balance, where higher LF/HF ratio indicates greater stress system activation), and GI symptom severity before, during and every 20 minutes for one hour after. Physical activity was measured using the Stanford Seven-Day Physical Activity Recall questionnaire and quantified as weekly energy expenditure. Results: IBS patients had higher state anxiety (p = .05), LF/HF ratio (p = .01) and GI symptom severity (p = .01) than healthy controls. Although the e-TSST did not exacerbate these group differences, higher state anxiety at baseline (p = .03) and higher LF/HF ratio in response to an acute stressor (p < .001) were associated with more severe GI symptoms within the first 20 minutes following the e-TSST. Importantly, IBS patients who were more physically active experienced less severe GI symptoms during that same timeframe (p = .03). Conclusion: Physical activity may be a promising lifestyle factor for lessening GI symptom severity in response to an acute stressor. / Thesis / Master of Science in Kinesiology

Background: Irritable Bowel Syndrome (IBS) is a common disorder in which the main symptoms are abdominal pain or discomfort combined with diarrhoea and/or constipation. Personal petitionary prayer – asking God for help and support when facing problems in life – is among the most common forms of prayer and can be viewed as a coping strategy when managing health problems. Previous research on the effects of personal petitionary prayer has showed conflicting findings and there are indications that prayer can be associated with more problems when facing stressful somatic problems such as chronic pain in Swedish settings rather than the opposite and expected benefits from praying. The present master-thesis was informed by the coping theory by Lazarus and Folkman (1984) and a theoretical perspective of prayer as a religious coping strategy. Aims: The aim was to investigate associations between personal petitionary prayer as a coping strategy and IBS symptoms, quality of life and anxiety. A second aim was to investigate if use of prayer would change 10 weeks later and if IBS symptoms at baseline could predict prayer assessed 10 weeks later.   Methods: The data in this master-thesis were collected in association with a treatment trial on internet-delivered cognitive behaviour therapy for IBS (Ljótsson et al., 2010). Data were derived from all 85 self-selected participants who had been included in the treatment trial. The three-item self-report measure of prayer which is  part of  the Coping Strategies Questionnaire for pain was used. I also included data on self-report measures of IBS symptoms and IBS-related quality of life and anxiety, and finally a measure of symptoms of depression. The sample included were mainly women (85%), with some form of higher education (64%) and finally fairly young (Mean age 34.6 years). Data on prayer have not been published before. 10 week follow-up data were available for 37 participants.  Results: Statistically significant cross-sectional correlations were found between the prayer scale score and IBS-related quality of life (r =-.44, p&lt;.01) and with gastrointestinal symptom-specific anxiety (r=.42, p&lt;.01), which indicates that more use of prayer is associated with  lower quality of life and more anxiety symptoms. Regression analyses entering prayer in competition with the other variables as predictors showed that prayer was more consistently associated with IBS-related quality of life which also predicted prayer. Use of prayer did not change over the 10-week period and prayer at 10 weeks could not be predicted. Interpretation: In line with some previous research personal petitionary prayer can be associated with more rather than less problems with health. It is important to note that personal prayer is one form of prayer and that long term effects may show different results. Finally, the role of religious affiliation and cultural aspects need to be considered in future research.