Z Gastroenterol 2011; 49(2): 237-293
DOI: 10.1055/s-0029-1245976
Leitlinie

© Georg Thieme Verlag KG Stuttgart · New York

S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie. Gemeinsame Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Neurogastroenterologie und Motilität (DGNM)[1]

AWMF-Registriernummer: 021 / 016Irritable Bowel Syndrome: German Consensus Guidelines on Definition, Pathophysiology and Management.German Society of Digestive and Metabolic Diseases (DGVS) and German Society of Neurogastroenterology and Motility (DGNM)P. Layer1 , V. Andresen1 , C. Pehl1 , H. Allescher1 , S. C. Bischoff1 , M. Claßen1 , P. Enck1 , T. Frieling1 , S. Haag1 , G. Holtmann1 , M. Karaus1 , S. Kathemann1 , J. Keller1 , R. Kuhlbusch-Zicklam1 , W. Kruis1 , J. Langhorst1 , H. Matthes1 , H. Mönnikes1 , S. Müller-Lissner1 , F. Musial1 , B. Otto1 , C. Rosenberger1 , M. Schemann1 , I. van der Voort1 , K. Dathe1 , J. C. Preiß1
  • 1Für die Konsensusgruppe „Reizdarmsyndrom”; Konsensuskonferenz 18./ 19.9.2009
Further Information

Publication History

Publication Date:
01 February 2011 (online)

Inhaltsverzeichnis Seite Abkürzungsverzeichnis 238 Teil I Einführung und Methodik 238 Hintergrund und Ziele 238 Methodik 238 Teil II Grundlagen 242 Kapitel 1 Definition und Epidemiologie 242 1 – 1 Definition und Epidemiologie des RDS bei Erwachsenen (AG 1) 242 1 – 2 Definition und Epidemiologie des RDS bei Kindern (AG 9) 245 Kapitel 2 Pathophysiologie 247 2 – 1 Pathophysiologie des RDS bei Erwachsenen (AGs 2, 11, 12) 247 2 – 1 Pathophysiologie des RDS bei Kindern (AG 9) 251 Teil III Diagnosesicherung 252 Kapitel 3 Diagnostisches Vorgehen bei V. a. RDS 252 3 – 1 Diagnostisches Vorgehen bei V. a. RDS bei Erwachsenen (AG 3) 252 3 – 2 Diagnostisches Vorgehen bei V. a. RDS bei Kindern (AG 9) 256 3 – 3 Abgrenzung des RDS von spezifischen Motilitätsstörungen des Dünn- und Dickdarms (AG 10) 257 Teil IV Allgemeine (symptomunabhängige) Therapieverfahren 259 Kapitel 4 Allgemeine, komplementäre und alternative Verfahren 259 4 – 1 Allgemeine Grundsätze in der Therapie des RDS (AG 6) 259 4 – 2 Allgemeine, komplementäre und alternative Verfahren beim RDS bei Erwachsenen (AG 6) 260 4 – 3 Allgemeine, komplementäre und alternative Verfahren beim RDS bei Kindern (AG 9) 262 Kapitel 5 Ernährung 262 5 – 1 Diagnostische und therapeutische Rolle der Ernährung beim RDS bei Erwachsenen (AG 5) 262 5 – 2 Diagnostische und therapeutische Rolle der Ernährung beim RDS bei Kindern (AG 5, AG 9) 266 Kapitel 6 Psyche 266 6 – 1 Diagnostische und therapeutische Rolle der Psyche beim RDS bei Erwachsenen (AG 4) 266 6 – 2 Diagnostische und therapeutische Rolle der Psyche beim RDS bei Kindern (AG 9) 268 Teil V Gezielte (symptomorientierte) Therapie 268 Kapitel 7 Therapie der RDS-Symptome Diarrhö und Schmerz 268 7 – 1 Therapie von Diarrhö und Schmerz beim RDS von Erwachsenen (AG 7) 268 A) Symptom Schmerz 268 B) Symptom Diarrhö 271 7 – 2 Therapie von Schmerzen und Diarrhö bei Kindern mit RDS (AG 9) 272 Kapitel 8 Therapie der RDS-Symptome Obstipation und Blähungen 273 8 – 1 Therapie von Obstipation und Blähungen beim RDS von Erwachsenen (AG 8) 273 A) Symptom Obstipation 273 B) Symptomkomplex „Blähungen/abdominelle Distension/Meteorismus/Flatulenz” 276 8 – 2 Therapie von Obstipation und Blähungen bei Kindern mit RDS (AG 9) 278 Appendix I Beispiele für gebräuchliche Therapieschemata von pharmakologischen Behandlungen des Reizdarmsyndroms bei Erwachsenen 279 Appendix II Beispiele von Substanzen in der Entwicklung oder von Substanzen aus anderen Indikationen zum potenziellen Einsatz beim RDS 279 Appendix III Ältere Diagnose-Kriterien des RDS 281 Literatur 282

1 In Zusammenarbeit mit Deutsche Gesellschaft für Innere Medizin (DGIM), Berufsverband Niedergelassener Gastroenterologen Deutschlands (bng), Gesellschaft für Pädiatrische Gastroenterologie und Ernährung (GPGE), Deutsche Gesellschaft für Ernährungsmedizin (DGEM), Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV), Deutsche Gesellschaft für Allgemein- und Familienmedizin (DEGAM), Deutsche Gesellschaft zum Studium des Schmerzes (DGSS), Deutsche Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation (DGVM), Deutsche Gesellschaft für Psychosomatische Medizin und Ärztliche Psychotherapie (DGPM), Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit (DTG), Deutsche Gesellschaft für Naturheilkunde, Deutsche Reizdarmselbsthilfe e. V. (Patientenorganisation).

Literatur

  • 1 Hotz J, Enck P, Goebell H et al. Consensus report: irritable bowel syndrome – definition, differential diagnosis, pathophysiology and therapeutic possibilities. Consensus of the German Society of Digestive and Metabolic Diseases.  Z Gastroenterol. 1999;  37 685-700
  • 2 Spiller R, Aziz Q, Creed F et al. Guidelines on the irritable bowel syndrome: mechanisms and practical management.  Gut. 2007;  56 1770-1798
  • 3 National Institute for Health and Clinical Excellence N .Clinical Practice Guideline on Irritable Bowel Syndrome in adults: Diagnosis and management of irritable bowel syndrome in primary care. http://www.nice.org.uk 2008
  • 4 Brandt L J, Chey W D, Foxx-Orenstein A E et al. An evidence-based position statement on the management of irritable bowel syndrome.  Am J Gastroenterol. 2009;  104 (Suppl 1) S1-S35
  • 5 Rome Foundation . Guidelines – Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders.  J Gastrointestin Liver Dis. 2006;  15 307-312
  • 6 Deutsches Instrument zur methodischen Leitlinien-Bewertung (DELBI) - Fassung 2005 / 2006 + Domäne 8 (2008). Berlin: Ä.Z. Q. Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften; 2008 http://www.delbi.de
  • 7 Kunz R, Burnand B, Schünemann H J. Das GRADE-System.  Der Internist. 2008;  49 673-680 DOI: http://dx.doi.org/10.1007/s00108-008-2141-9
  • 8 Phillips B, Ball C, Sackett D et al. Oxford-Centre for Evidence Based Medicine – Levels of Evidence and Grades of Recommendation. 2001
  • 9 Talley N J. Irritable bowel syndrome: definition, diagnosis and epidemiology.  Baillieres Best Pract Res Clin Gastroenterol. 1999;  13 371-384
  • 10 Manning A P, Thompson W G, Heaton K W et al. Towards positive diagnosis of the irritable bowel.  Br Med J. 1978;  2 653-654
  • 11 Kruis W, Thieme C, Weinzierl M et al. A diagnostic score for the irritable bowel syndrome. Its value in the exclusion of organic disease.  Gastroenterology. 1984;  87 1-7
  • 12 Thompson W G, Dotevall G, Drossman D A et al. Irritable bowel syndrome: guidelines for the diagnosis.  Gastroenterol Int. 1989;  2 92-95
  • 13 Thompson W G, Longstreth G F, Drossman D A et al. Functional bowel disorders and functional abdominal pain.  Gut. 1999;  45 (Suppl 2) II43-II47
  • 14 Longstreth G F, Thompson W G, Chey W D et al. Functional bowel disorders.  Gastroenterology. 2006;  130 1480-1491
  • 15 Marshall J K, Thabane M, Borgaonkar M R et al. Postinfectious irritable bowel syndrome after a food-borne outbreak of acute gastroenteritis attributed to a viral pathogen.  Clin Gastroenterol Hepatol. 2007;  5 457-460
  • 16 Thompson W G. Gastrointestinal symptoms in the irritable bowel compared with peptic ulcer and inflammatory bowel disease.  Gut. 1984;  25 1089-1092
  • 17 Talley N J, Phillips S F, Melton L J et al. Diagnostic value of the Manning criteria in irritable bowel syndrome.  Gut. 1990;  31 77-81
  • 18 Rao K P, Gupta S, Jain A K et al. Evaluation of Manning’s criteria in the diagnosis of irritable bowel syndrome.  J Assoc Physicians India. 1993;  41 357-358, 363
  • 19 Jeong H, Lee H R, Yoo B C et al. Manning criteria in irritable bowel syndrome: its diagnostic significance.  Korean J Intern Med. 1993;  8 34-39
  • 20 Zighelboim J, Talley N J. What are functional bowel disorders?.  Gastroenterology. 1993;  104 1196-1201
  • 21 Lacy B E, Lee R D. Irritable bowel syndrome: a syndrome in evolution.  J Clin Gastroenterol. 2005;  39 S230-S242
  • 22 Howship J. Practical remarks on the discrimination and successful treatment of spasmodic stricture in the colon considered as an occasional cause of habitual confinement of the bowel. London; 1830
  • 23 Da Costa J M. Mucous enteritis.  Am J Med Sci. 1871;  62 321-338
  • 24 Maxwell P R, Mendall M A, Kumar D. Irritable bowel syndrome.  Lancet. 1997;  350 1691-1695
  • 25 Bockus H L, Bank J, Wilkinson S A. Neurogenic mucous colitis.  Am J Med Sci. 1928;  176 813-829
  • 26 Ryle J A. Chronic spasmodic afflictions of the colon.  Lancet II. 1928;  212 1115-1119
  • 27 Smits B J. The irritable bowel syndrome.  Practitioner. 1974;  213 37-46
  • 28 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;  31 307-322
  • 29 Drossman D A, McKee D C, Sandler R S et al. Psychosocial factors in the irritable bowel syndrome. A multivariate study of patients and nonpatients with irritable bowel syndrome.  Gastroenterology. 1988;  95 701-708
  • 30 Smith R C, Greenbaum D S, Vancouver J B et al. Psychosocial factors are associated with health care seeking rather than diagnosis in irritable bowel syndrome.  Gastroenterology. 1990;  98 293-301
  • 31 Drossman D A. Do psychosocial factors define symptom severity and patient status in irritable bowel syndrome?.  Am J Med. 1999;  107 41S-50S
  • 32 Koloski N A, Talley N J, Boyce P M. Predictors of health care seeking for irritable bowel syndrome and nonulcer dyspepsia: a critical review of the literature on symptom and psychosocial factors.  Am J Gastroenterol. 2001;  96 1340-1349
  • 33 Locke 3 rd G R, Weaver A L, Melton 3 rd L J et al. Psychosocial factors are linked to functional gastrointestinal disorders: a population based nested case-control study.  Am J Gastroenterol. 2004;  99 350-357
  • 34 Jones R, Lydeard S. Irritable bowel syndrome in the general population.  BMJ. 1992;  304 87-90
  • 35 Heaton K W, Parker D, Cripps H. Bowel function and irritable bowel symptoms after hysterectomy and cholecystectomy – a population based study.  Gut. 1993;  34 1108-1111
  • 36 Mardini H E, Kip K E, Wilson J W. Crohn’s disease: a two-year prospective study of the association between psychological distress and disease activity.  Dig Dis Sci. 2004;  49 492-497
  • 37 Kettell J, Jones R, Lydeard S. Reasons for consultation in irritable bowel syndrome: symptoms and patient characteristics.  Br J Gen Pract. 1992;  42 459-461
  • 38 Donker G A, Foets M, Spreeuwenberg P. Patients with irritable bowel syndrome: health status and use of health care services.  Br J Gen Pract. 1999;  49 787-792
  • 39 Icks A, Haastert B, Enck P et al. Prevalence of functional bowel disorders and related health care seeking: a population-based study.  Z Gastroenterol. 2002;  40 177-183
  • 40 Badia X, Mearin F, Balboa A et al. Burden of illness in irritable bowel syndrome comparing Rome I and Rome II criteria.  Pharmacoeconomics. 2002;  20 749-758
  • 41 Saito Y A, Talley N J, L J M et al. The effect of new diagnostic criteria for irritable bowel syndrome on community prevalence estimates.  Neurogastroenterol Motil. 2003;  15 687-694
  • 42 Andrews E B, Eaton S C, Hollis K A et al. Prevalence and demographics of irritable bowel syndrome: results from a large web-based survey.  Aliment Pharmacol Ther. 2005;  22 935-942
  • 43 Hungin A P, Chang L, Locke G R et al. Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact.  Aliment Pharmacol Ther. 2005;  21 1365-1375
  • 44 Minocha A, Johnson W D, Abell T L et al. Prevalence, sociodemography, and quality of life of older versus younger patients with irritable bowel syndrome: a population-based study.  Dig Dis Sci. 2006;  51 446-453
  • 45 Kumano H, Kaiya H, Yoshiuchi K et al. Comorbidity of irritable bowel syndrome, panic disorder, and agoraphobia in a Japanese representative sample.  Am J Gastroenterol. 2004;  99 370-376
  • 46 Francis C Y, Morris J, Whorwell P J. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress.  Aliment Pharmacol Ther. 1997;  11 395-402
  • 47 Lackner J M, Jaccard J, Krasner S S et al. Self-administered cognitive behavior therapy for moderate to severe irritable bowel syndrome: clinical efficacy, tolerability, feasibility.  Clin Gastroenterol Hepatol. 2008;  6 899-906
  • 48 Kanazawa M, Palsson O S, Thiwan S I et al. Contributions of pain sensitivity and colonic motility to IBS symptom severity and predominant bowel habits.  Am J Gastroenterol. 2008;  103 2550-2561
  • 49 Sabate J M, Veyrac M, Mion F et al. Relationship between rectal sensitivity, symptoms intensity and quality of life in patients with irritable bowel syndrome.  Aliment Pharmacol Ther. 2008;  28 484-490
  • 50 Whitehead W E, Palsson O S, Levy R L et al. Reports of „satisfactory relief” by IBS patients receiving usual medical care are confounded by baseline symptom severity and do not accurately reflect symptom improvement.  Am J Gastroenterol. 2006;  101 1057-1065
  • 51 Bray B D, Nicol F, Penman I D et al. Symptom interpretation and quality of life in patients with irritable bowel syndrome.  Br J Gen Pract. 2006;  56 122-126
  • 52 Drossman D A, Li Z, Toner B B et al. Functional bowel disorders. A multicenter comparison of health status and development of illness severity index.  Dig Dis Sci. 1995;  40 986-995
  • 53 Sperber A D, Carmel S, Atzmon Y et al. Use of the Functional Bowel Disorder Severity Index (FBDSI) in a study of patients with the irritable bowel syndrome and fibromyalgia.  Am J Gastroenterol. 2000;  95 995-998
  • 54 Svedlund J, Sjodin I, Dotevall G. GSRS – a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease.  Dig Dis Sci. 1988;  33 129-134
  • 55 Wiklund I K, Fullerton S, Hawkey C J et al. An irritable bowel syndrome-specific symptom questionnaire: development and validation.  Scand J Gastroenterol. 2003;  38 947-954
  • 56 Karling P, Danielsson A, Adolfsson R et al. No difference in symptoms of irritable bowel syndrome between healthy subjects and patients with recurrent depression in remission.  Neurogastroenterol Motil. 2007;  19 896-904
  • 57 Bengtsson M, Ohlsson B, Ulander K. Development and psychometric testing of the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS).  BMC Gastroenterol. 2007;  7 16
  • 58 Posserud I, Syrous A, Lindstrom L et al. Altered rectal perception in irritable bowel syndrome is associated with symptom severity.  Gastroenterology. 2007;  133 1113-1123
  • 59 Spiegel B, Strickland A, Naliboff B D et al. Predictors of patient-assessed illness severity in irritable bowel syndrome.  Am J Gastroenterol. 2008;  103 2536-2543
  • 60 Hahn B A, Kirchdoerfer L J, Fullerton S et al. Patient-perceived severity of irritable bowel syndrome in relation to symptoms, health resource utilization and quality of life.  Aliment Pharmacol Ther. 1997;  11 553-559
  • 61 Lembo A, Ameen V Z, Drossman D A. Irritable bowel syndrome: toward an understanding of severity.  Clin Gastroenterol Hepatol. 2005;  3 717-725
  • 62 Irvine E J, Whitehead W E, Chey W D et al. Design of treatment trials for functional gastrointestinal disorders.  Gastroenterology. 2006;  130 1538-1551
  • 63 Camilleri M, Mangel A W, Fehnel S E et al. Primary endpoints for irritable bowel syndrome trials: a review of performance of endpoints.  Clin Gastroenterol Hepatol. 2007;  5 534-540
  • 64 Whitehead W E, Burnett C K, Cook 3 rd E W et al. Impact of irritable bowel syndrome on quality of life.  Dig Dis Sci. 1996;  41 2248-2253
  • 65 Brun-Strang C, Dapoigny M, Lafuma A et al. Irritable bowel syndrome in France: quality of life, medical management, and costs: the Encoli study.  Eur J Gastroenterol Hepatol. 2007;  19 1097-1103
  • 66 Dean B B, Aguilar D, Barghout V et al. Impairment in work productivity and health-related quality of life in patients with IBS.  Am J Manag Care. 2005;  11 S17-S26
  • 67 Gralnek I M, Hays R D, Kilbourne A et al. The impact of irritable bowel syndrome on health-related quality of life.  Gastroenterology. 2000;  119 654-660
  • 68 Frank L, Kleinman L, Rentz A et al. Health-related quality of life associated with irritable bowel syndrome: comparison with other chronic diseases.  Clin Ther. 2002;  24 675-689 ; discussion 674
  • 69 Halder S L, Locke 3rd G R, Talley N J et al. Impact of functional gastrointestinal disorders on health-related quality of life: a population-based case-control study.  Aliment Pharmacol Ther. 2004;  19 233-242
  • 70 Creed F, Ratcliffe J, Fernandez L et al. Health-related quality of life and health care costs in severe, refractory irritable bowel syndrome.  Ann Intern Med. 2001;  134 860-868
  • 71 Hahn B A, Kirchdoerfer L J, Fullerton S et al. Evaluation of a new quality of life questionnaire for patients with irritable bowel syndrome.  Aliment Pharmacol Ther. 1997;  11 547-552
  • 72 Borgaonkar M R, Irvine E J. Quality of life measurement in gastrointestinal and liver disorders.  Gut. 2000;  47 444-454
  • 73 Patrick D L, Drossman D A, Frederick I O et al. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure.  Dig Dis Sci. 1998;  43 400-411
  • 74 Chassany O, Marquis P, Scherrer B et al. Validation of a specific quality of life questionnaire for functional digestive disorders.  Gut. 1999;  44 527-533
  • 75 Stewart A L, Hays R D, Ware Jr J E. The MOS short-form general health survey. Reliability and validity in a patient population.  Med Care. 1988;  26 724-735
  • 76 McHorney C A, Ware Jr J E, Lu J F et al. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups.  Med Care. 1994;  32 40-66
  • 77 Ware Jr J E, Sherbourne C D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.  Med Care. 1992;  30 473-483
  • 78 Liss J L, Alpers D, Woodruff Jr R A. The irritable colon syndrome and psychiatric illness.  Dis Nerv Syst. 1973;  34 151-157
  • 79 Young S J, Alpers D H, Norland C C et al. Psychiatric illness and the irritable bowel syndrome. Practical implications for the primary physician.  Gastroenterology. 1976;  70 162-166
  • 80 Lydiard R B, Fossey M D, Marsh W et al. Prevalence of psychiatric disorders in patients with irritable bowel syndrome.  Psychosomatics. 1993;  34 229-234
  • 81 Walker E A, Gelfand A N, Gelfand M D et al. Psychiatric diagnoses, sexual and physical victimization, and disability in patients with irritable bowel syndrome or inflammatory bowel disease.  Psychol Med. 1995;  25 1259-1267
  • 82 Woodman C L, Breen K, Noyes Jr R et al. The relationship between irritable bowel syndrome and psychiatric illness. A family study.  Psychosomatics. 1998;  39 45-54
  • 83 Miller A R, North C S, Clouse R E et al. The association of irritable bowel syndrome and somatization disorder.  Ann Clin Psychiatry. 2001;  13 25-30
  • 84 North C S, Downs D, Clouse R E et al. The presentation of irritable bowel syndrome in the context of somatization disorder.  Clin Gastroenterol Hepatol. 2004;  2 787-795
  • 85 North C S, Alpers D H, Thompson S J et al. Gastrointestinal symptoms and psychiatric disorders in the general population. Findings from NIMH Epidemiologic Catchment Area Project.  Dig Dis Sci. 1996;  41 633-640
  • 86 Aaron L A, Buchwald D. A review of the evidence for overlap among unexplained clinical conditions.  Ann Intern Med. 2001;  134 868-881
  • 87 Kanaan R A, Lepine J P, Wessely S C. The association or otherwise of the functional somatic syndromes.  Psychosom Med. 2007;  69 855-859
  • 88 Fossey M D, Lydiard R B. Anxiety and the gastrointestinal system.  Psychiatr Med. 1990;  8 175-186
  • 89 Walker E A, Roy-Byrne P P, Katon W J et al. Psychiatric illness and irritable bowel syndrome: a comparison with inflammatory bowel disease.  Am J Psychiatry. 1990;  147 1656-1661
  • 90 Irwin C, Falsetti S A, Lydiard R B et al. Comorbidity of posttraumatic stress disorder and irritable bowel syndrome.  J Clin Psychiatry. 1996;  57 576-578
  • 91 Lydiard R B. Irritable bowel syndrome, anxiety, and depression: what are the links?.  J Clin Psychiatry. 2001;  62 (Suppl 8) 38-45 ; discussion 46 – 47
  • 92 Walker E A, Katon W J, Jemelka R et al. The prevalence of chronic pelvic pain and irritable bowel syndrome in two university clinics.  J Psychosom Obstet Gynaecol. 1991;  12 S65-S75
  • 93 Maunder R G. Panic disorder associated with gastrointestinal disease: review and hypotheses.  J Psychosom Res. 1998;  44 91-105
  • 94 Noyes Jr R, Cook B, Garvey M et al. Reduction of gastrointestinal symptoms following treatment for panic disorder.  Psychosomatics. 1990;  31 75-79
  • 95 Kaplan D S, Masand P S, Gupta S. The relationship of irritable bowel syndrome (IBS) and panic disorder.  Ann Clin Psychiatry. 1996;  8 81-88
  • 96 Lydiard R B. Increased prevalence of functional gastrointestinal disorders in panic disorder: clinical and theoretical implications.  CNS Spectr. 2005;  10 899-908
  • 97 Roy-Byrne P P, Davidson K W, Kessler R C et al. Anxiety disorders and comorbid medical illness.  Gen Hosp Psychiatry. 2008;  30 208-225
  • 98 Gros D F, Antony M M, McCabe R E et al. Frequency and severity of the symptoms of irritable bowel syndrome across the anxiety disorders and depression.  J Anxiety Disord. 2009;  23 290-296
  • 99 Garakani A, Win T, Virk S et al. Comorbidity of irritable bowel syndrome in psychiatric patients: a review.  Am J Ther. 2003;  10 61-67
  • 100 Cohen H, Jotkowitz A, Buskila D et al. Post-traumatic stress disorder and other co-morbidities in a sample population of patients with irritable bowel syndrome.  Eur J Intern Med. 2006;  17 567-571
  • 101 Liebschutz J, Saitz R, Brower V et al. PTSD in urban primary care: high prevalence and low physician recognition.  J Gen Intern Med. 2007;  22 719-726
  • 102 Savas L S, White D L, Wieman M et al. Irritable bowel syndrome and dyspepsia among women veterans: prevalence and association with psychological distress.  Aliment Pharmacol Ther. 2009;  29 115-125
  • 103 Mayer E A, Craske M, Naliboff B D. Depression, anxiety, and the gastrointestinal system.  J Clin Psychiatry. 2001;  62 (Suppl 8) 28-36 ; discussion 37
  • 104 Perkins S J, Keville S, Schmidt U et al. Eating disorders and irritable bowel syndrome: is there a link?.  J Psychosom Res. 2005;  59 57-64
  • 105 Boyd C, Abraham S, Kellow J. Psychological features are important predictors of functional gastrointestinal disorders in patients with eating disorders.  Scand J Gastroenterol. 2005;  40 929-935
  • 106 Apley J, Naish N. Recurrent abdominal pains: a field survey of 1,000 school children.  Arch Dis Child. 1958;  33 165-170
  • 107 Rasquin-Weber A, Hyman P E, Cucchiara S et al. Childhood functional gastrointestinal disorders.  Gut. 1999;  45 (Suppl 2) II60-II68
  • 108 Caplan A, Walker L, Rasquin A. Validation of the pediatric Rome II criteria for functional gastrointestinal disorders using the questionnaire on pediatric gastrointestinal symptoms.  J Pediatr Gastroenterol Nutr. 2005;  41 305-316
  • 109 Walker L S, Lipani T A, Greene J W et al. Recurrent abdominal pain: symptom subtypes based on the Rome II Criteria for pediatric functional gastrointestinal disorders.  J Pediatr Gastroenterol Nutr. 2004;  38 187-191
  • 110 Rasquin A, Di Lorenzo C, Forbes D et al. Childhood functional gastrointestinal disorders: child/adolescent.  Gastroenterology. 2006;  130 1527-1537
  • 111 Baber K F, Anderson J, Puzanovova M et al. Rome II versus Rome III classification of functional gastrointestinal disorders in pediatric chronic abdominal pain.  J Pediatr Gastroenterol Nutr. 2008;  47 299-302
  • 112 Helgeland H, Flagstad G, Grotta J et al. Diagnosing pediatric functional abdominal pain in children (4 – 15 years old) according to the Rome III Criteria: results from a Norwegian prospective study.  J Pediatr Gastroenterol Nutr. 2009;  49 309-315
  • 113 Hyams J S. Recurrent abdominal pain and irritable bowel syndrome in children.  J Pediatr Gastroenterol Nutr. 1997;  25 (Suppl 1) S16-S17
  • 114 Hyams J S, Davis P, Sylvester F A et al. Dyspepsia in children and adolescents: a prospective study.  J Pediatr Gastroenterol Nutr. 2000;  30 413-418
  • 115 Caplan A, Walker L, Rasquin A. Development and preliminary validation of the questionnaire on pediatric gastrointestinal symptoms to assess functional gastrointestinal disorders in children and adolescents.  J Pediatr Gastroenterol Nutr. 2005;  41 296-304
  • 116 Schurman J V, Friesen C A, Danda C E et al. Diagnosing functional abdominal pain with the Rome II criteria: parent, child, and clinician agreement.  J Pediatr Gastroenterol Nutr. 2005;  41 291-295
  • 117 Van Ginkel R, Voskuijl W P, Benninga M A et al. Alterations in rectal sensitivity and motility in childhood irritable bowel syndrome.  Gastroenterology. 2001;  120 31-38
  • 118 Di Lorenzo C, Youssef N N, Sigurdsson L et al. Visceral hyperalgesia in children with functional abdominal pain.  J Pediatr. 2001;  139 838-843
  • 119 Faure C, Wieckowska A. Somatic referral of visceral sensations and rectal sensory threshold for pain in children with functional gastrointestinal disorders.  J Pediatr. 2007;  150 66-71
  • 120 Hyman P E, Milla P J, Benninga M A et al. Childhood functional gastrointestinal disorders: neonate/toddler.  Gastroenterology. 2006;  130 1519-1526
  • 121 Garralda M E. Practitioner review: Assessment and management of somatisation in childhood and adolescence: a practical perspective.  J Child Psychol Psychiatry. 1999;  40 1159-1167
  • 122 Miele E, Simeone D, Marino A et al. Functional gastrointestinal disorders in children: an Italian prospective survey.  Pediatrics. 2004;  114 73-78
  • 123 Uc A, Hyman P E, Walker L S. Functional gastrointestinal disorders in African American children in primary care.  J Pediatr Gastroenterol Nutr. 2006;  42 270-274
  • 124 Saps M, Pensabene L, Di Martino L et al. Post-infectious functional gastrointestinal disorders in children.  J Pediatr. 2008;  152 812-816, 816 e1
  • 125 Primavera G, Amoroso B, Barresi A et al. Clinical utility of Rome criteria managing functional gastrointestinal disorders in pediatric primary care.  Pediatrics. 2010;  125 e155-e161
  • 126 Hyams J S, Burke G, Davis P M et al. Abdominal pain and irritable bowel syndrome in adolescents: a community-based study.  J Pediatr. 1996;  129 220-226
  • 127 Schwille I J, Giel K E, Ellert U et al. A community-based survey of abdominal pain prevalence, characteristics, and health care use among children.  Clin Gastroenterol Hepatol. 2009;  7 1062-1068
  • 128 Chitkara D K, Rawat D J, Talley N J. The epidemiology of childhood recurrent abdominal pain in Western countries: a systematic review.  Am J Gastroenterol. 2005;  100 1868-1875
  • 129 Walker L S, Garber J, Greene J W. Psychosocial correlates of recurrent childhood pain: a comparison of pediatric patients with recurrent abdominal pain, organic illness, and psychiatric disorders.  J Abnorm Psychol. 1993;  102 248-258
  • 130 Campo J V, Bridge J, Ehmann M et al. Recurrent abdominal pain, anxiety, and depression in primary care.  Pediatrics. 2004;  113 817-824
  • 131 Youssef N N, Atienza K, Langseder A L et al. Chronic abdominal pain and depressive symptoms: analysis of the national longitudinal study of adolescent health.  Clin Gastroenterol Hepatol. 2008;  6 329-332
  • 132 Dorn L D, Campo J C, Thato S et al. Psychological comorbidity and stress reactivity in children and adolescents with recurrent abdominal pain and anxiety disorders.  J Am Acad Child Adolesc Psychiatry. 2003;  42 66-75
  • 133 Saps M, Seshadri R, Sztainberg M et al. A prospective school-based study of abdominal pain and other common somatic complaints in children.  J Pediatr. 2009;  154 322-326
  • 134 Wasserman A L, Whitington P F, Rivara F P. Psychogenic basis for abdominal pain in children and adolescents.  J Am Acad Child Adolesc Psychiatry. 1988;  27 179-184
  • 135 Di Lorenzo C, Colletti R B, Lehmann H P et al. Chronic Abdominal Pain In Children: a Technical Report of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.  J Pediatr Gastroenterol Nutr. 2005;  40 249-261
  • 136 Campo J V, Di Lorenzo C, Chiappetta L et al. Adult outcomes of pediatric recurrent abdominal pain: do they just grow out of it?.  Pediatrics. 2001;  108 E1
  • 137 Howell S, Poulton R, Talley N J. The natural history of childhood abdominal pain and its association with adult irritable bowel syndrome: birth-cohort study.  Am J Gastroenterol. 2005;  100 2071-2078
  • 138 Chitkara D K, Talley N J, Schleck C et al. Recollection of childhood abdominal pain in adults with functional gastrointestinal disorders.  Scand J Gastroenterol. 2009;  44 301-307
  • 139 Youssef N N, Murphy T G, Langseder A L et al. Quality of life for children with functional abdominal pain: a comparison study of patients’ and parents’ perceptions.  Pediatrics. 2006;  117 54-59
  • 140 Piche T, Barbara G, Aubert P et al. Impaired intestinal barrier integrity in the colon of patients with irritable bowel syndrome: involvement of soluble mediators.  Gut. 2009;  58 196-201
  • 141 Coeffier M, Gloro R, Boukhettala N et al. Increased proteasome-mediated degradation of occludin in irritable bowel syndrome.  Am J Gastroenterol. 2010;  105 1181-1188
  • 142 Zhou Q, Zhang B, Verne G N. Intestinal membrane permeability and hypersensitivity in the irritable bowel syndrome.  Pain. 2009;  146 41-46
  • 143 Gunnarsson J, Simren M. Peripheral factors in the pathophysiology of irritable bowel syndrome.  Dig Liver Dis. 2009;  41 788-793
  • 144 Camilleri M, McKinzie S, Busciglio I et al. Prospective study of motor, sensory, psychologic, and autonomic functions in patients with irritable bowel syndrome.  Clin Gastroenterol Hepatol. 2008;  6 772-781
  • 145 Manabe N, Wong B S, Camilleri M et al. Lower functional gastrointestinal disorders: evidence of abnormal colonic transit in a 287 patient cohort.  Neurogastroenterol Motil. 2010;  22 293-e82
  • 146 Serra J, Villoria A, Azpiroz F et al. Impaired intestinal gas propulsion in manometrically proven dysmotility and in irritable bowel syndrome.  Neurogastroenterol Motil. 2010;  22 401-406, e91–e92
  • 147 Larsson M H, Simren M, Thomas E A et al. Elevated motility-related transmucosal potential difference in the upper small intestine in the irritable bowel syndrome.  Neurogastroenterol Motil. 2007;  19 812-820
  • 148 Whitehead W E, Holtkotter B, Enck P et al. Tolerance for rectosigmoid distention in irritable bowel syndrome.  Gastroenterology. 1990;  98 1187-1192
  • 149 Bradette M, Delvaux M, Staumont G et al. Octreotide increases thresholds of colonic visceral perception in IBS patients without modifying muscle tone.  Dig Dis Sci. 1994;  39 1171-1178
  • 150 Bouin M, Plourde V, Boivin M et al. Rectal distention testing in patients with irritable bowel syndrome: sensitivity, specificity, and predictive values of pain sensory thresholds.  Gastroenterology. 2002;  122 1771-1777
  • 151 Spetalen S, Sandvik L, Blomhoff S et al. Rectal visceral sensitivity in women with irritable bowel syndrome without psychiatric comorbidity compared with healthy volunteers.  Gastroenterol Res Pract. 2009;  130 684
  • 152 Kindt S, Van Oudenhove L, Broekaert D et al. Immune dysfunction in patients with functional gastrointestinal disorders.  Neurogastroenterol Motil. 2009;  21 389-398
  • 153 Spiller R, Garsed K. Infection, inflammation, and the irritable bowel syndrome.  Dig Liver Dis. 2009;  41 844-849
  • 154 De Giorgio R, Barbara G. Is irritable bowel syndrome an inflammatory disorder?.  Curr Gastroenterol Rep. 2008;  10 385-390
  • 155 Spiller R C. Irritable bowel syndrome: bacteria and inflammation – clinical relevance now.  Curr Treat Options Gastroenterol. 2007;  10 312-321
  • 156 Spiller R, Campbell E. Post-infectious irritable bowel syndrome.  Curr Opin Gastroenterol. 2006;  22 13-17
  • 157 Bercik P, Verdu E F, Collins S M. Is irritable bowel syndrome a low-grade inflammatory bowel disease?.  Gastroenterol Clin North Am. 2005;  34 235-245, vi–vii
  • 158 Chadwick V S, Chen W, Shu D et al. Activation of the mucosal immune system in irritable bowel syndrome.  Gastroenterology. 2002;  122 1778-1783
  • 159 Ohman L, Isaksson S, Lindmark A C et al. T-cell activation in patients with irritable bowel syndrome.  Am J Gastroenterol. 2009;  104 1205-1212
  • 160 Gwee K A, Collins S M, Read N W et al. Increased rectal mucosal expression of interleukin 1beta in recently acquired post-infectious irritable bowel syndrome.  Gut. 2003;  52 523-526
  • 161 Macsharry J, O’Mahony L, Fanning A et al. Mucosal cytokine imbalance in irritable bowel syndrome.  Scand J Gastroenterol. 2008;  43 1467-1476
  • 162 Guilarte M, Santos J, Torres de I et al. Diarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum.  Gut. 2007;  56 203-209
  • 163 Barbara G, Stanghellini V, De Giorgio R et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome.  Gastroenterology. 2004;  126 693-702
  • 164 Dinan T G, Clarke G, Quigley E M et al. Enhanced cholinergic-mediated increase in the pro-inflammatory cytokine IL-6 in irritable bowel syndrome: role of muscarinic receptors.  Am J Gastroenterol. 2008;  103 2570-2576
  • 165 Langhorst J, Wieder A, Michalsen A et al. Activated innate immune system in irritable bowel syndrome?.  Gut. 2007;  56 1325-1326
  • 166 Langhorst J, Junge A, Rueffer A et al. Elevated human beta-defensin-2 levels indicate an activation of the innate immune system in patients with irritable bowel syndrome.  Am J Gastroenterol. 2009;  104 404-410
  • 167 Gecse K, Roka R, Ferrier L et al. Increased faecal serine protease activity in diarrhoeic IBS patients: a colonic lumenal factor impairing colonic permeability and sensitivity.  Gut. 2008;  57 591-599
  • 168 Annahazi A, Gecse K, Dabek M et al. Fecal proteases from diarrheic-IBS and ulcerative colitis patients exert opposite effect on visceral sensitivity in mice.  Pain. 2009;  144 209-217
  • 169 Cenac N, Andrews C N, Holzhausen M et al. Role for protease activity in visceral pain in irritable bowel syndrome.  J Clin Invest. 2007;  117 636-647
  • 170 Kerckhoffs A P, Ter Linde J J, Akkermans L M et al. Trypsinogen IV, serotonin transporter transcript levels and serotonin content are increased in small intestine of irritable bowel syndrome patients.  Neurogastroenterol Motil. 2008;  20 900-907
  • 171 O’Mahony L, McCarthy J, Kelly P et al. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles.  Gastroenterology. 2005;  128 541-551
  • 172 Liebregts T, Adam B, Bredack C et al. Immune activation in patients with irritable bowel syndrome.  Gastroenterology. 2007;  132 913-920
  • 173 Hughes P A, Brierley S M, Martin C M et al. TRPV1-expressing sensory fibres and IBS: links with immune function.  Gut. 2009;  58 465-466
  • 174 Chen M L, Ge Z, Fox J G et al. Disruption of tight junctions and induction of proinflammatory cytokine responses in colonic epithelial cells by Campylobacter jejuni.  Infect Immun. 2006;  74 6581-6589
  • 175 Tornblom H, Lindberg G, Nyberg B et al. Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome.  Gastroenterology. 2002;  123 1972-1979
  • 176 Gwee K A, Graham J C, McKendrick M W et al. Psychometric scores and persistence of irritable bowel after infectious diarrhoea.  Lancet. 1996;  347 150-153
  • 177 Ruigomez A, Wallander M A, Johansson S et al. One-year follow-up of newly diagnosed irritable bowel syndrome patients.  Aliment Pharmacol Ther. 1999;  13 1097-1102
  • 178 Neal K R, Barker L, Spiller R C. Prognosis in post-infective irritable bowel syndrome: a six year follow up study.  Gut. 2002;  51 410-413
  • 179 Spiller R C, Jenkins D, Thornley J P et al. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome.  Gut. 2000;  47 804-811
  • 180 Atkinson W, Lockhart S, Whorwell P J et al. Altered 5-hydroxytryptamine signaling in patients with constipation- and diarrhea-predominant irritable bowel syndrome.  Gastroenterology. 2006;  130 34-43
  • 181 Coates M D, Mahoney C R, Linden D R et al. Molecular defects in mucosal serotonin content and decreased serotonin reuptake transporter in ulcerative colitis and irritable bowel syndrome.  Gastroenterology. 2004;  126 1657-1664
  • 182 Kapeller J, Houghton L A, Monnikes H et al. First evidence for an association of a functional variant in the microRNA-510 target site of the serotonin receptor-type 3E gene with diarrhea predominant irritable bowel syndrome.  Hum Mol Genet. 2008;  17 2967-2977
  • 183 Lee K J, Kim Y B, Kim J H et al. The alteration of enterochromaffin cell, mast cell, and lamina propria T lymphocyte numbers in irritable bowel syndrome and its relationship with psychological factors.  J Gastroenterol Hepatol. 2008;  23 1689-1694
  • 184 Dunlop S P, Jenkins D, Neal K R et al. Relative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS.  Gastroenterology. 2003;  125 1651-1659
  • 185 Colucci R, Blandizzi C, Bellini M et al. The genetics of the serotonin transporter and irritable bowel syndrome.  Trends Mol Med. 2008;  14 295-304
  • 186 Camilleri M, Andrews C N, Bharucha A E et al. Alterations in expression of p11 and SERT in mucosal biopsy specimens of patients with irritable bowel syndrome.  Gastroenterology. 2007;  132 17-25
  • 187 Akbar A, Yiangou Y, Facer P et al. Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain.  Gut. 2008;  57 923-929
  • 188 Barbara G, Wang B, Stanghellini V et al. Mast cell-dependent excitation of visceral-nociceptive sensory neurons in irritable bowel syndrome.  Gastroenterology. 2007;  132 26-37
  • 189 Palsson O S, Morteau O, Bozymski E M et al. Elevated vasoactive intestinal peptide concentrations in patients with irritable bowel syndrome.  Dig Dis Sci. 2004;  49 1236-1243
  • 190 Gonlachanvit S, Mahayosnond A, Kullavanijaya P. Effects of chili on postprandial gastrointestinal symptoms in diarrhoea predominant irritable bowel syndrome: evidence for capsaicin-sensitive visceral nociception hypersensitivity.  Neurogastroenterol Motil. 2009;  21 23-32
  • 191 Buhner S, Li Q, Vignali S et al. Activation of human enteric neurons by supernatants of colonic biopsy specimens from patients with irritable bowel syndrome.  Gastroenterology. 2009;  137 1425-1434
  • 192 Levy R L, Jones K R, Whitehead W E et al. Irritable bowel syndrome in twins: heredity and social learning both contribute to etiology.  Gastroenterology. 2001;  121 799-804
  • 193 Camilleri M. Genetics and irritable bowel syndrome: from genomics to intermediate phenotype and pharmacogenetics.  Dig Dis Sci. 2009;  54 2318-2324
  • 194 Saito Y A, Talley N J. Genetics of irritable bowel syndrome.  Am J Gastroenterol. 2008;  103 2100-2104 ; quiz 2105
  • 195 Talley N J. Environmental versus genetic risk factors for irritable bowel syndrome: clinical and therapeutic implications.  Rev Gastroenterol Disord. 2005;  5 82-88
  • 196 Camilleri M, Carlson P, Zinsmeister A R et al. Mitochondrial DNA and gastrointestinal motor and sensory functions in health and functional gastrointestinal disorders.  Am J Physiol Gastrointest Liver Physiol. 2009;  296 G510-G516
  • 197 Saito Y A, Strege P R, Tester D J et al. Sodium channel mutation in irritable bowel syndrome: evidence for an ion channelopathy.  Am J Physiol Gastrointest Liver Physiol. 2009;  296 G211-G218
  • 198 Camilleri M, Carlson P, McKinzie S et al. Genetic variation in endocannabinoid metabolism, gastrointestinal motility, and sensation.  Am J Physiol Gastrointest Liver Physiol. 2008;  294 G13-G19
  • 199 Andresen V, Camilleri M, Kim H J et al. Is there an association between GNbeta3-C825 T genotype and lower functional gastrointestinal disorders?.  Gastroenterology. 2006;  130 1985-1994
  • 200 Veek P P, Berg van der M, Kroon van den Y E et al. Role of tumor necrosis factor-alpha and interleukin-10 gene polymorphisms in irritable bowel syndrome.  Am J Gastroenterol. 2005;  100 2510-2516
  • 201 Kim H J, Camilleri de M, Carlson P J et al. Association of distinct alpha(2) adrenoceptor and serotonin transporter polymorphisms with constipation and somatic symptoms in functional gastrointestinal disorders.  Gut. 2004;  53 829-837
  • 202 Tanaka T, Manabe N, Hata J et al. Characterization of autonomic dysfunction in patients with irritable bowel syndrome using fingertip blood flow.  Neurogastroenterol Motil. 2008;  20 498-504
  • 203 Spaziani R, Bayati A, Redmond K et al. Vagal dysfunction in irritable bowel syndrome assessed by rectal distension and baroreceptor sensitivity.  Neurogastroenterol Motil. 2008;  20 336-342
  • 204 Spetalen S, Sandvik L, Blomhoff S et al. Autonomic function at rest and in response to emotional and rectal stimuli in women with irritable bowel syndrome.  Dig Dis Sci. 2008;  53 1652-1659
  • 205 Mazur M, Furgala A, Jablonski K et al. Dysfunction of the autonomic nervous system activity is responsible for gastric myoelectric disturbances in the irritable bowel syndrome patients.  J Physiol Pharmacol. 2007;  58 (Suppl 3) 131-139
  • 206 Heitkemper M, Jarrett M, Cain K et al. Increased urine catecholamines and cortisol in women with irritable bowel syndrome.  Am J Gastroenterol. 1996;  91 906-913
  • 207 Heitkemper M, Jarrett M, Cain K C et al. Autonomic nervous system function in women with irritable bowel syndrome.  Dig Dis Sci. 2001;  46 1276-1284
  • 208 Codling C, O’Mahony L, Shanahan F et al. A molecular analysis of fecal and mucosal bacterial communities in irritable bowel syndrome.  Dig Dis Sci. 2010;  55 392-397
  • 209 Kassinen A, Krogius-Kurikka L, Makivuokko H et al. The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subjects.  Gastroenterology. 2007;  133 24-33
  • 210 Krogius-Kurikka L, Lyra A, Malinen E et al. Microbial community analysis reveals high level phylogenetic alterations in the overall gastrointestinal microbiota of diarrhoea-predominant irritable bowel syndrome sufferers.  BMC Gastroenterol. 2009;  9 95
  • 211 Lyra A, Rinttila T, Nikkila J et al. Diarrhoea-predominant irritable bowel syndrome distinguishable by 16S rRNA gene phylotype quantification.  World J Gastroenterol. 2009;  15 5936-5945
  • 212 Tana C, Umesaki Y, Imaoka A et al. Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome.  Neurogastroenterol Motil. 2010;  22 512-519, e114–e115
  • 213 Kerckhoffs A P, Samsom M, Rest M E et al. Lower Bifidobacteria counts in both duodenal mucosa-associated and fecal microbiota in irritable bowel syndrome patients.  World J Gastroenterol. 2009;  15 2887-2892
  • 214 Naliboff B D, Munakata van der J, Fullerton S et al. Evidence for two distinct perceptual alterations in irritable bowel syndrome.  Gut. 1997;  41 505-512
  • 215 Dorn S D, Palsson O S, Thiwan S I et al. Increased colonic pain sensitivity in irritable bowel syndrome is the result of an increased tendency to report pain rather than increased neurosensory sensitivity.  Gut. 2007;  56 1202-1209
  • 216 Coffin B, Bouhassira D, Sabate J M et al. Alteration of the spinal modulation of nociceptive processing in patients with irritable bowel syndrome.  Gut. 2004;  53 1465-1470
  • 217 Wilder-Smith C H, Schindler D, Lovblad K et al. Brain functional magnetic resonance imaging of rectal pain and activation of endogenous inhibitory mechanisms in irritable bowel syndrome patient subgroups and healthy controls.  Gut. 2004;  53 1595-1601
  • 218 Chan Y K, Herkes G K, Badcock C et al. Alterations in cerebral potentials evoked by rectal distension in irritable bowel syndrome.  Am J Gastroenterol. 2001;  96 2413-2417
  • 219 Mertz H, Morgan V, Tanner G et al. Regional cerebral activation in irritable bowel syndrome and control subjects with painful and nonpainful rectal distention.  Gastroenterology. 2000;  118 842-848
  • 220 Lawal A, Kern M, Sidhu H et al. Novel evidence for hypersensitivity of visceral sensory neural circuitry in irritable bowel syndrome patients.  Gastroenterology. 2006;  130 26-33
  • 221 Naliboff B D, Berman S, Chang L et al. Sex-related differences in IBS patients: central processing of visceral stimuli.  Gastroenterology. 2003;  124 1738-1747
  • 222 Whitehead W E, Winget C, Fedoravicius A S et al. Learned illness behavior in patients with irritable bowel syndrome and peptic ulcer.  Dig Dis Sci. 1982;  27 202-208
  • 223 Jarrett M, Heitkemper M, Cain K C et al. The relationship between psychological distress and gastrointestinal symptoms in women with irritable bowel syndrome.  Nurs Res. 1998;  47 154-161
  • 224 Drossman D A. Chronic functional abdominal pain.  Am J Gastroenterol. 1996;  91 2270-2281
  • 225 Son Y J, Jun E Y, Park J H. Prevalence and risk factors of irritable bowel syndrome in Korean adolescent girls: a school-based study.  Int J Nurs Stud. 2009;  46 76-84
  • 226 Bennett E J, Tennant C C, Piesse C et al. Level of chronic life stress predicts clinical outcome in irritable bowel syndrome.  Gut. 1998;  43 256-261
  • 227 Dancey C P, Taghavi M, Fox R J. The relationship between daily stress and symptoms of irritable bowel: a time-series approach.  J Psychosom Res. 1998;  44 537-545
  • 228 Hertig V L, Cain K C, Jarrett M E et al. Daily stress and gastrointestinal symptoms in women with irritable bowel syndrome.  Nurs Res. 2007;  56 399-406
  • 229 Kanazawa M, Endo Y, Whitehead W E et al. Patients and nonconsulters with irritable bowel syndrome reporting a parental history of bowel problems have more impaired psychological distress.  Dig Dis Sci. 2004;  49 1046-1053
  • 230 Murray C D, Flynn J, Ratcliffe L et al. Effect of acute physical and psychological stress on gut autonomic innervation in irritable bowel syndrome.  Gastroenterology. 2004;  127 1695-1703
  • 231 Blanchard E B, Lackner J M, Jaccard J et al. The role of stress in symptom exacerbation among IBS patients.  J Psychosom Res. 2008;  64 119-128
  • 232 Park H J, Jarrett M, Cain K et al. Psychological distress and GI symptoms are related to severity of bloating in women with irritable bowel syndrome.  Res Nurs Health. 2008;  31 98-107
  • 233 Jones M P, Wessinger S, Crowell M D. Coping strategies and interpersonal support in patients with irritable bowel syndrome and inflammatory bowel disease.  Clin Gastroenterol Hepatol. 2006;  4 474-481
  • 234 Holtmann G, Kriebel R, Singer M V. Mental stress and gastric acid secretion. Do personality traits influence the response?.  Dig Dis Sci. 1990;  35 998-1007
  • 235 Holtmann G, Singer M V, Kriebel R et al. Differential effects of acute mental stress on interdigestive secretion of gastric acid, pancreatic enzymes, and gastroduodenal motility.  Dig Dis Sci. 1989;  34 1701-1707
  • 236 Kellow J E, Langeluddecke P M, Eckersley G M et al. Effects of acute psychologic stress on small-intestinal motility in health and the irritable bowel syndrome.  Scand J Gastroenterol. 1992;  27 53-58
  • 237 Welgan P, Meshkinpour H, Hoehler F. The effect of stress on colon motor and electrical activity in irritable bowel syndrome.  Psychosom Med. 1985;  47 139-149
  • 238 Elsenbruch S, Lucas A, Holtmann G et al. Public speaking stress-induced neuroendocrine responses and circulating immune cell redistribution in irritable bowel syndrome.  Am J Gastroenterol. 2006;  101 2300-2307
  • 239 Lucas A, Holtmann G, Gerken G et al. Visceral pain and public speaking stress: neuroendocrine and immune cell responses in healthy subjects.  Brain Behav Immun. 2006;  20 49-56
  • 240 Dickhaus B, Mayer E A, Firooz N et al. Irritable bowel syndrome patients show enhanced modulation of visceral perception by auditory stress.  Am J Gastroenterol. 2003;  98 135-143
  • 241 Posserud I, Agerforz P, Ekman R et al. Altered visceral perceptual and neuroendocrine response in patients with irritable bowel syndrome during mental stress.  Gut. 2004;  53 1102-1108
  • 242 Walter S A, Aardal-Eriksson E, Thorell L H et al. Pre-experimental stress in patients with irritable bowel syndrome: high cortisol values already before symptom provocation with rectal distensions.  Neurogastroenterol Motil. 2006;  18 1069-1077
  • 243 Patacchioli F R, Angelucci L, Dellerba G et al. Actual stress, psychopathology and salivary cortisol levels in the irritable bowel syndrome (IBS).  J Endocrinol Invest. 2001;  24 173-177
  • 244 Chang L, Sundaresh S, Elliott J et al. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in irritable bowel syndrome.  Neurogastroenterol Motil. 2009;  21 149-159
  • 245 Bohmelt A H, Nater U M, Franke S et al. Basal and stimulated hypothalamic-pituitary-adrenal axis activity in patients with functional gastrointestinal disorders and healthy controls.  Psychosom Med. 2005;  67 288-294
  • 246 Ehlert U, Nater U M, Bohmelt A. High and low unstimulated salivary cortisol levels correspond to different symptoms of functional gastrointestinal disorders.  J Psychosom Res. 2005;  59 7-10
  • 247 Bach D R, Erdmann G, Schmidtmann M et al. Emotional stress reactivity in irritable bowel syndrome.  Eur J Gastroenterol Hepatol. 2006;  18 629-636
  • 248 Jones M P, Dilley J B, Drossman D et al. Brain-gut connections in functional GI disorders: anatomic and physiologic relationships.  Neurogastroenterol Motil. 2006;  18 91-103
  • 249 Bradesi S, Schwetz I, Ennes H S et al. Repeated exposure to water avoidance stress in rats: a new model for sustained visceral hyperalgesia.  Am J Physiol Gastrointest Liver Physiol. 2005;  289 G42-G53
  • 250 Liebregts T, Adam B, Bertel A et al. Psychological stress and the severity of post-inflammatory visceral hyperalgesia.  Eur J Pain. 2007;  11 216-222
  • 251 Miampamba M, Million M, Yuan P Q et al. Water avoidance stress activates colonic myenteric neurons in female rats.  Neuroreport. 2007;  18 679-682
  • 252 Morrow N S, Garrick T. Effects of intermittent tail shock or water avoidance on proximal colonic motor contractility in rats.  Physiol Behav. 1997;  62 233-239
  • 253 Bonaz B, Tache Y. Water-avoidance stress-induced c-fos expression in the rat brain and stimulation of fecal output: role of corticotropin-releasing factor.  Brain Res. 1994;  641 21-28
  • 254 Larauche M, Bradesi S, Million M et al. Corticotropin-releasing factor type 1 receptors mediate the visceral hyperalgesia induced by repeated psychological stress in rats.  Am J Physiol Gastrointest Liver Physiol. 2008;  294 G1033-1040
  • 255 Tyler K, Moriceau S, Sullivan R M et al. Long-term colonic hypersensitivity in adult rats induced by neonatal unpredictable vs predictable shock.  Neurogastroenterol Motil. 2007;  19 761-768
  • 256 Chung E K, Zhang X, Li Z et al. Neonatal maternal separation enhances central sensitivity to noxious colorectal distention in rat.  Brain Res. 2007;  1153 68-77
  • 257 Ren T H, Wu J, Yew D et al. Effects of neonatal maternal separation on neurochemical and sensory response to colonic distension in a rat model of irritable bowel syndrome.  Am J Physiol Gastrointest Liver Physiol. 2007;  292 G849-G856
  • 258 Coutinho S V, Plotsky P M, Sablad M et al. Neonatal maternal separation alters stress-induced responses to viscerosomatic nociceptive stimuli in rat.  Am J Physiol Gastrointest Liver Physiol. 2002;  282 G307-G316
  • 259 O’Mahony S M, Marchesi J R, Scully P et al. Early life stress alters behavior, immunity, and microbiota in rats: implications for irritable bowel syndrome and psychiatric illnesses.  Biol Psychiatry. 2009;  65 263-267
  • 260 Bradesi S, Eutamene H, Garcia-Villar R et al. Acute and chronic stress differently affect visceral sensitivity to rectal distension in female rats.  Neurogastroenterol Motil. 2002;  14 75-82
  • 261 Bengtson M B, Ronning T, Vatn M H et al. Irritable bowel syndrome in twins: genes and environment.  Gut. 2006;  55 1754-1759
  • 262 Lembo A, Zaman M, Jones M et al. Influence of genetics on irritable bowel syndrome, gastro-oesophageal reflux and dyspepsia: a twin study.  Aliment Pharmacol Ther. 2007;  25 1343-1350
  • 263 Saito Y A, Zimmerman J M, Harmsen W S et al. Irritable bowel syndrome aggregates strongly in families: a family-based case-control study.  Neurogastroenterol Motil. 2008;  20 790-797
  • 264 Kalantar J S, Locke 3 rd G R, Zinsmeister A R et al. Familial aggregation of irritable bowel syndrome: a prospective study.  Gut. 2003;  52 1703-1707
  • 265 Shulman R J, Eakin M N, Czyzewski D I et al. Increased gastrointestinal permeability and gut inflammation in children with functional abdominal pain and irritable bowel syndrome.  J Pediatr. 2008;  153 646-650
  • 266 Saps M, Pensabene L, Turco R et al. Rotavirus gastroenteritis: precursor of functional gastrointestinal disorders?.  J Pediatr Gastroenterol Nutr. 2009;  49 580-583
  • 267 Halac U, Noble A, Faure C. Rectal sensory threshold for pain is a diagnostic marker of irritable bowel syndrome and functional abdominal pain in children.  J Pediatr. 2010;  156 60-65 e1
  • 268 Walker L S, Guite J W, Duke M et al. Recurrent abdominal pain: a potential precursor of irritable bowel syndrome in adolescents and young adults.  J Pediatr. 1998;  132 1010-1015
  • 269 Thomson S, Dancey C P. Symptoms of irritable bowel in school children: prevalence and psychosocial effects.  J Pediatr Health Care. 1996;  10 280-285
  • 270 Claar R L, Walker L S, Smith C A. Functional disability in adolescents and young adults with symptoms of irritable bowel syndrome: the role of academic, social, and athletic competence.  J Pediatr Psychol. 1999;  24 271-280
  • 271 Hammer J, Talley N J. Value of different diagnostic criteria for the irritable bowel syndrome among men and women.  J Clin Gastroenterol. 2008;  42 160-166
  • 272 Costanza C D, Longstreth G F, Liu A L. Chronic abdominal wall pain: clinical features, health care costs, and long-term outcome.  Clin Gastroenterol Hepatol. 2004;  2 395-399
  • 273 Harvey R F, Mauad E C, Brown A M. Prognosis in the irritable bowel syndrome: a 5-year prospective study.  Lancet. 1987;  1 963-965
  • 274 Owens D M, Nelson D K, Talley N J. The irritable bowel syndrome: long-term prognosis and the physician-patient interaction.  Ann Intern Med. 1995;  122 107-112
  • 275 Svendsen J H, Munck L K, Andersen J R. Irritable bowel syndrome – prognosis and diagnostic safety. A 5-year follow-up study.  Scand J Gastroenterol. 1985;  20 415-418
  • 276 Sullivan S N. Management of the irritable bowel syndrome: a personal view.  J Clin Gastroenterol. 1983;  5 499-502
  • 277 Holmes K M, Salter R H. Irritable bowel syndrome – a safe diagnosis?.  Br Med J (Clin Res Ed). 1982;  285 1533-1534
  • 278 Talley N J, Phillips S F, Melton 3rd J et al. A patient questionnaire to identify bowel disease.  Ann Intern Med. 1989;  111 671-674
  • 279 Jellema P, Windt D A, Schellevis F G et al. Systematic review: accuracy of symptom-based criteria for diagnosis of irritable bowel syndrome in primary care.  Aliment Pharmacol Ther. 2009;  30 695-706
  • 280 Spiegel B M, Farid van der M, Esrailian E et al. Is irritable bowel syndrome a diagnosis of exclusion? A survey of primary care providers, gastroenterologists, and IBS experts.  Am J Gastroenterol. 2010;  105 848-858
  • 281 El-Serag H B, Pilgrim P, Schoenfeld P. Systemic review: Natural history of irritable bowel syndrome.  Aliment Pharmacol Ther. 2004;  19 861-870
  • 282 Garcia Rodriguez L A, Ruigomez A, Wallander M A et al. Detection of colorectal tumor and inflammatory bowel disease during follow-up of patients with initial diagnosis of irritable bowel syndrome.  Scand J Gastroenterol. 2000;  35 306-311
  • 283 Minderhoud I M, Oldenburg B, Wismeijer J A et al. IBS-like symptoms in patients with inflammatory bowel disease in remission, relationships with quality of life and coping behavior.  Dig Dis Sci. 2004;  49 469-474
  • 284 Farrokhyar F, Marshall J K, Easterbrook B et al. Functional gastrointestinal disorders and mood disorders in patients with inactive inflammatory bowel disease: prevalence and impact on health.  Inflamm Bowel Dis. 2006;  12 38-46
  • 285 Sanders D S, Carter M J, Hurlstone D P et al. Association of adult coeliac disease with irritable bowel syndrome: a case-control study in patients fulfilling ROME II criteria referred to secondary care.  Lancet. 2001;  358 1504-1508
  • 286 O’Leary C, Wieneke P, Buckley S et al. Celiac disease and irritable bowel-type symptoms.  Am J Gastroenterol. 2002;  97 1463-1467
  • 287 Locke 3rd G R, Murray J A, Zinsmeister A R et al. Celiac disease serology in irritable bowel syndrome and dyspepsia: a population-based case-control study.  Mayo Clin Proc. 2004;  79 476-482
  • 288 Wahnschaffe U, Schulzke J D, Zeitz M et al. Predictors of clinical response to gluten-free diet in patients diagnosed with diarrhea-predominant irritable bowel syndrome.  Clin Gastroenterol Hepatol. 2007;  5 844-850 ; quiz 769
  • 289 Ford A C, Chey W D, Talley N J et al. Yield of diagnostic tests for celiac disease in individuals with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis.  Arch Intern Med. 2009;  169 651-658
  • 290 Zipser R D, Patel S, Yahya K Z et al. Presentations of adult celiac disease in a nationwide patient support group.  Dig Dis Sci. 2003;  48 761-764
  • 291 Goff B A, Mandel L S, Melancon C H et al. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics.  JAMA. 2004;  291 2705-2712
  • 292 Goff B A, Mandel L S, Drescher C W et al. Development of an ovarian cancer symptom index: possibilities for earlier detection.  Cancer. 2007;  109 221-227
  • 293 Vine M F, Calingaert B, Berchuck A et al. Characterization of prediagnostic symptoms among primary epithelial ovarian cancer cases and controls.  Gynecol Oncol. 2003;  90 75-82
  • 294 Friedman G D, Skilling J S, Udaltsova N V et al. Early symptoms of ovarian cancer: a case-control study without recall bias.  Fam Pract. 2005;  22 548-553
  • 295 Hamilton W, Peters T J, Bankhead C et al. Risk of ovarian cancer in women with symptoms in primary care: population based case-control study.  BMJ. 2009;  339 b2998
  • 296 Behtash N, Ghayouri Azar E, Fakhrejahani F. Symptoms of ovarian cancer in young patients 2 years before diagnosis, a case-control study.  Eur J Cancer Care. 2008;  17 483-487
  • 297 Eltabbakh G H, Yadav P R, Morgan A. Clinical picture of women with early stage ovarian cancer.  Gynecol Oncol. 1999;  75 476-479
  • 298 Vanner S J, Depew W T, Paterson W G et al. Predictive value of the Rome criteria for diagnosing the irritable bowel syndrome.  Am J Gastroenterol. 1999;  94 2912-2917
  • 299 Whitehead W E, Palsson O S, Feld A D et al. Utility of red flag symptom exclusions in the diagnosis of irritable bowel syndrome.  Aliment Pharmacol Ther. 2006;  24 137-146
  • 300 Ilnyckyj A, Graff L A, Blanchard J F et al. Therapeutic value of a gastroenterology consultation in irritable bowel syndrome.  Aliment Pharmacol Ther. 2003;  17 871-880
  • 301 Kaptchuk T J, Kelley J M, Conboy L A et al. Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome.  BMJ. 2008;  336 999-1003
  • 302 Lewis S J, Heaton K W. Stool form scale as a useful guide to intestinal transit time.  Scand J Gastroenterol. 1997;  32 920-924
  • 303 Fernandez-Banares F, Esteve M, Salas A et al. Systematic evaluation of the causes of chronic watery diarrhea with functional characteristics.  Am J Gastroenterol. 2007;  102 2520-2528
  • 304 Whitehead W E, Palsson O S. Is rectal pain sensitivity a biological marker for irritable bowel syndrome: psychological influences on pain perception.  Gastroenterology. 1998;  115 1263-1271
  • 305 Lembo A J, Neri B, Tolley J et al. Use of serum biomarkers in a diagnostic test for irritable bowel syndrome.  Aliment Pharmacol Ther. 2009;  29 834-842
  • 306 Aerssens J, Camilleri M, Talloen W et al. Alterations in mucosal immunity identified in the colon of patients with irritable bowel syndrome.  Clin Gastroenterol Hepatol. 2008;  6 194-205
  • 307 Zar S, Mincher L, Benson M J et al. Food-specific IgG4 antibody-guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome.  Scand J Gastroenterol. 2005;  40 800-807
  • 308 Atkinson W, Sheldon T A, Shaath N et al. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial.  Gut. 2004;  53 1459-1464
  • 309 Drisko J, Bischoff B, Hall M et al. Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics.  J Am Coll Nutr. 2006;  25 514-522
  • 310 Stapel S O, Asero R, Ballmer-Weber B K et al. Testing for IgG4 against foods is not recommended as a diagnostic tool: EAACI Task Force Report.  Allergy. 2008;  63 793-796
  • 311 Carroccio A, Iacono G, Cottone M et al. Diagnostic accuracy of fecal calprotectin assay in distinguishing organic causes of chronic diarrhea from irritable bowel syndrome: a prospective study in adults and children.  Clin Chem. 2003;  49 861-867
  • 312 Yip W C, Ho T F, Yip Y Y et al. Value of abdominal sonography in the assessment of children with abdominal pain.  J Clin Ultrasound. 1998;  26 397-400
  • 313 Connor F L, Di Lorenzo C. Chronic intestinal pseudo-obstruction: assessment and management.  Gastroenterology. 2006;  130 S29-S36
  • 314 Stanghellini V, Cogliandro R F, Giorgio de R et al. Chronic intestinal pseudo-obstruction: manifestations, natural history and management.  Neurogastroenterol Motil. 2007;  19 440-452
  • 315 Seidl H, Pehl C, Schepp W et al. Chronic intestinal pseudo-obstruction – review and update 2008.  Z Gastroenterol. 2008;  46 704-711
  • 316 Kessmann J. Hirschsprung’s disease: diagnosis and management.  Am Fam Physician. 2006;  74 1319-1322
  • 317 De Giorgio R, Guerrini S, Barbara G et al. Inflammatory neuropathies of the enteric nervous system.  Gastroenterology. 2004;  126 1872-1883
  • 318 Di Nardo G, Blandizzi C, Volta U et al. Review article: molecular, pathological and therapeutic features of human enteric neuropathies.  Aliment Pharmacol Ther. 2008;  28 25-42
  • 319 Knowles C H, De Giorgio R, Kapur R P et al. Gastrointestinal neuromuscular pathology: guidelines for histological techniques and reporting on behalf of the Gastro 2009 International Working Group.  Acta Neuropathol. 2009;  118 271-301
  • 320 Kirsch R, Riddell R H. Histopathological alterations in irritable bowel syndrome.  Mod Pathol. 2006;  19 1638-1645
  • 321 Eisen G M, Baron T H, Dominitz J A et al. Acute colonic pseudo-obstruction.  Gastrointest Endosc. 2002;  56 789-792
  • 322 Saunders M D. Acute colonic pseudo-obstruction.  Gastrointest Endosc Clin N Am. 2007;  17 341-360, vi-vii
  • 323 Saunders M D, Kimmey M B. Systematic review: acute colonic pseudo-obstruction.  Aliment Pharmacol Ther. 2005;  22 917-925
  • 324 Gladman M A, Knowles C H. Novel concepts in the diagnosis, pathophysiology and management of idiopathic megabowel.  Colorectal Dis. 2008;  10 531-538 ; discussion 538 – 540
  • 325 Martucciello G. Hirschsprung’s disease, one of the most difficult diagnoses in pediatric surgery: a review of the problems from clinical practice to the bench.  Eur J Pediatr Surg. 2008;  18 140-149
  • 326 Bassotti G, Villanacci V. Slow transit constipation: a functional disorder becomes an enteric neuropathy.  World J Gastroenterol. 2006;  12 4609-4613
  • 327 Bharucha A E. Constipation.  Best Pract Res Clin Gastroenterol. 2007;  21 709-731
  • 328 Rao S S. Constipation: evaluation and treatment of colonic and anorectal motility disorders.  Gastroenterol Clin North Am. 2007;  36 687-711
  • 329 Spiller R. Role of motility in chronic diarrhoea.  Neurogastroenterol Motil. 2006;  18 1045-1055
  • 330 Lorijn de F, Kremer L C, Reitsma J B et al. Diagnostic tests in Hirschsprung disease: a systematic review.  J Pediatr Gastroenterol Nutr. 2006;  42 496-505
  • 331 Rao S S, Ozturk R, Laine L. Clinical utility of diagnostic tests for constipation in adults: a systematic review.  Am J Gastroenterol. 2005;  100 1605-1615
  • 332 Camilleri M, Bharucha A E, Lorenzo di C et al. American Neurogastroenterology and Motility Society consensus statement on intraluminal measurement of gastrointestinal and colonic motility in clinical practice.  Neurogastroenterol Motil. 2008;  20 1269-1282
  • 333 Aiarzaguena J M, Grandes G, Gaminde I et al. A randomized controlled clinical trial of a psychosocial and communication intervention carried out by GPs for patients with medically unexplained symptoms.  Psychol Med. 2007;  37 283-294
  • 334 Thompson W G, Heaton K W, Smyth G T et al. Irritable bowel syndrome in general practice: prevalence, characteristics, and referral.  Gut. 2000;  46 78-82
  • 335 Dulmen A M, Fennis J F, Mokkink H G et al. The relationship between complaint-related cognitions in referred patients with irritable bowel syndrome and subsequent health care seeking behaviour in primary care.  Fam Pract. 1996;  13 12-17
  • 336 Bertram van S, Kurland M, Lydick E et al. The patient’s perspective of irritable bowel syndrome.  J Fam Pract. 2001;  50 521-525
  • 337 O’Sullivan M A, Mahmud N, Kelleher D P et al. Patient knowledge and educational needs in irritable bowel syndrome.  Eur J Gastroenterol Hepatol. 2000;  12 39-43
  • 338 Bijkerk C J, Wit N J, Stalman W A et al. Irritable bowel syndrome in primary care: the patients’ and doctors’ views on symptoms, etiology and management.  Can J Gastroenterol. 2003;  17 363-368 ; quiz 405 – 406
  • 339 Halpert de A, Dalton C B, Palsson O et al. Irritable bowel syndrome patients’ ideal expectations and recent experiences with healthcare providers: a national survey.  Dig Dis Sci. 2010;  55 375-383
  • 340 Borum M L. Physician perception of IBS management in women and men.  Dig Dis Sci. 2002;  47 236-237
  • 341 Dhaliwal S K, Hunt R H. Doctor-patient interaction for irritable bowel syndrome in primary care: a systematic perspective.  Eur J Gastroenterol Hepatol. 2004;  16 1161-1166
  • 342 Bernstein C N. The placebo effect for gastroenterology: tool or torment.  Clin Gastroenterol Hepatol. 2006;  4 1302-1308
  • 343 Dorn S D, Kaptchuk T J, Park J B et al. A meta-analysis of the placebo response in complementary and alternative medicine trials of irritable bowel syndrome.  Neurogastroenterol Motil. 2007;  19 630-637
  • 344 Patel S M, Stason W B, Legedza A et al. The placebo effect in irritable bowel syndrome trials: a meta-analysis.  Neurogastroenterol Motil. 2005;  17 332-340
  • 345 Pitz M, Cheang M, Bernstein C N. Defining the predictors of the placebo response in irritable bowel syndrome.  Clin Gastroenterol Hepatol. 2005;  3 237-247
  • 346 Westerberg L, Theorell T. Working conditions and family situation in relation to functional gastrointestinal disorders. The Swedish Dyspepsia Project.  Scand J Prim Health Care. 1997;  15 76-81
  • 347 Tillisch K, Labus J S, Naliboff B D et al. Characterization of the alternating bowel habit subtype in patients with irritable bowel syndrome.  Am J Gastroenterol. 2005;  100 896-904
  • 348 Taneja I, Deepak K K, Poojary G et al. Yogic versus conventional treatment in diarrhea-predominant irritable bowel syndrome: a randomized control study.  Appl Psychophysiol Biofeedback. 2004;  29 19-33
  • 349 Tovey P. A single-blind trial of reflexology for irritable bowel syndrome.  Br J Gen Pract. 2002;  52 19-23
  • 350 Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes.  Lancet. 2007;  369 946-55
  • 351 Kanazawa M, Fukudo S. Effects of fasting therapy on irritable bowel syndrome.  Int J Behav Med. 2006;  13 214-220
  • 352 Hundscheid H W, Pepels M J, Engels L G et al. Treatment of irritable bowel syndrome with osteopathy: results of a randomized controlled pilot study.  J Gastroenterol Hepatol. 2007;  22 1394-1398
  • 353 Lim B, Manheimer E, Lao L et al. Acupuncture for treatment of irritable bowel syndrome.  Cochrane Database Syst Rev. 2006;  4 CD005111
  • 354 Schneider A, Enck P, Streitberger K et al. Acupuncture treatment in irritable bowel syndrome.  Gut. 2006;  55 649-654
  • 355 Schneider A, Streitberger K, Joos S. Acupuncture treatment in gastrointestinal diseases: a systematic review.  World J Gastroenterol. 2007;  13 3417-3424
  • 356 Crushell E, Rowland M, Doherty M et al. Importance of parental conceptual model of illness in severe recurrent abdominal pain.  Pediatrics. 2003;  112 1368-1372
  • 357 Walker L S, Williams S E, Smith C A et al. Parent attention versus distraction: impact on symptom complaints by children with and without chronic functional abdominal pain.  Pain. 2006;  122 43-52
  • 358 Vlieger A M, Benninga M A. Complementary therapies for pediatric functional gastrointestinal disorders.  J Pediatr Gastroenterol Nutr. 2008;  47 707-709
  • 359 Saps M, Youssef N, Miranda A et al. Multicenter, randomized, placebo-controlled trial of amitriptyline in children with functional gastrointestinal disorders.  Gastroenterology. 2009;  137 1261-1269
  • 360 Benninga M A, Mayer E A. The power of placebo in pediatric functional gastrointestinal disease.  Gastroenterology. 2009;  137 1207-1210
  • 361 Bischoff S, Crowe S E. Gastrointestinal food allergy: new insights into pathophysiology and clinical perspectives.  Gastroenterology. 2005;  128 1089-1113
  • 362 Sicherer S H, Sampson H A. Food allergy: recent advances in pathophysiology and treatment.  Annu Rev Med. 2009;  60 261-277
  • 363 DGAKI .Leitlinien für Diagnostik und Therapie Allergologie und klinische Immunologie. AWMF-Online.
  • 364 Keller J, Franke A, Storr M et al. Clinically relevant breath tests in gastroenterological diagnostics –recommendations of the German Society for Neurogastroenterology and Motility as well as the German Society for Digestive and Metabolic Diseases.  Z Gastroenterol. 2005;  43 1071-1090
  • 365 Bengtsson M, Ulander K, Borgdal E B et al. A course of instruction for women with irritable bowel syndrome.  Patient Educ Couns. 2006;  62 118-125
  • 366 Monsbakken K W, Vandvik P O, Farup P G. The value of a general therapeutic approach in subjects with irritable bowel syndrome.  Aliment Pharmacol Ther. 2005;  21 21-27
  • 367 Saito Y A, Prather C M, Van Dyke C T et al. Effects of multidisciplinary education on outcomes in patients with irritable bowel syndrome.  Clin Gastroenterol Hepatol. 2004;  2 576-584
  • 368 Shepherd S J, Parker F C, Muir J G et al. Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence.  Clin Gastroenterol Hepatol. 2008;  6 765-771
  • 369 Choi Y K, Kraft N, Zimmerman B et al. Fructose intolerance in IBS and utility of fructose-restricted diet.  J Clin Gastroenterol. 2008;  42 233-238
  • 370 Shepherd S J, Gibson P R. Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for effective dietary management.  J Am Diet Assoc. 2006;  106 1631-1639
  • 371 Monsbakken K W, Vandvik P O, Farup P G. Perceived food intolerance in subjects with irritable bowel syndrome – etiology, prevalence and consequences.  Eur J Clin Nutr. 2006;  60 667-672
  • 372 Goldstein R, Braverman D, Stankiewicz H. Carbohydrate malabsorption and the effect of dietary restriction on symptoms of irritable bowel syndrome and functional bowel complaints.  Isr Med Assoc J. 2000;  2 583-587
  • 373 Zar S, Benson M J, Kumar D. Food-specific serum IgG4 and IgE titers to common food antigens in irritable bowel syndrome.  Am J Gastroenterol. 2005;  100 1550-1557
  • 374 Bischoff S C. Probiotika, Präbiotika. Synbiotika. Thieme; 2009
  • 375 Moayyedi P, Ford A C, Talley N J et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review.  Gut. 2010;  59 325-332
  • 376 Brenner D M, Moeller M J, Chey W D et al. The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review.  Am J Gastroenterol. 2009;  104 1033-1049 ; quiz 1050
  • 377 Huertas-Ceballos A A, Logan S, Bennett C et al. Dietary interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood.  Cochrane Database Syst Rev. 2009;  1 CD003019
  • 378 Guyonnet D, Chassany O, Ducrotte P et al. Effect of a fermented milk containing Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentre, randomized, double-blind, controlled trial.  Aliment Pharmacol Ther. 2007;  26 475-486
  • 379 Koebnick C, Wagner I, Leitzmann P et al. Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation.  Can J Gastroenterol. 2003;  17 655-659
  • 380 Nobaek S, Johansson M L, Molin G et al. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome.  Am J Gastroenterol. 2000;  95 1231-1238
  • 381 Niedzielin K, Kordecki H, Birkenfeld B. A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome.  Eur J Gastroenterol Hepatol. 2001;  13 1143-1147
  • 382 Sen S, Mullan M M, Parker T J et al. Effect of Lactobacillus plantarum 299v on colonic fermentation and symptoms of irritable bowel syndrome.  Dig Dis Sci. 2002;  47 2615-2620
  • 383 Gawronska A, Dziechciarz P, Horvath A et al. A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children.  Aliment Pharmacol Ther. 2007;  25 177-184
  • 384 Kim H J, Vazquez Roque M I, Camilleri M et al. A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating.  Neurogastroenterol Motil. 2005;  17 687-696
  • 385 Enck P, Zimmermann K, Menke G et al. Randomized controlled treatment trial of irritable bowel syndrome with a probiotic E.-coli preparation (DSM17252) compared to placebo.  Z Gastroenterol. 2009;  47 209-214
  • 386 Kajander K, Myllyluoma E, Rajilic-Stojanovic M et al. Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota.  Aliment Pharmacol Ther. 2008;  27 48-57
  • 387 Barrett J S, Canale K E, Gearry R B et al. Probiotic effects on intestinal fermentation patterns in patients with irritable bowel syndrome.  World J Gastroenterol. 2008;  14 5020-5024
  • 388 Mollenbrink M, Bruckschen E. Treatment of chronic constipation with physiologic Escherichia coli bacteria. Results of a clinical study of the effectiveness and tolerance of microbiological therapy with the E. coli Nissle 1917 strain (Mutaflor).  Med Klin. 1994;  89 587-593
  • 389 Bruckschen E, Horosiewicz H. Chronische Obstipation. Vergleich von mikrobiologischer Therapie und Lactulose.  MMW. 1994;  136 241-245
  • 390 Marteau P, Cuillerier E, Meance S et al. Bifidobacterium animalis strain DN-173 010 shortens the colonic transit time in healthy women: a double-blind, randomized, controlled study.  Aliment Pharmacol Ther. 2002;  16 587-593
  • 391 Krammer H J, Kamper H, Bunau von R et al. Probiotic drug therapy with E. coli strain Nissle 1917 (EcN): results of a prospective study of the records of 3,807 patients.  Z Gastroenterol. 2006;  44 651-656
  • 392 Plassmann D, Schulte-Witte H. Treatment of irritable bowel syndrome with Escherichia coli strain Nissle 1917 (EcN): a retrospective survey.  Med Klin. 2007;  102 888-892
  • 393 Manz M, Meier R. Pharmacologic treatments of transit disorders.  Ther Umsch. 2007;  64 227-232
  • 394 Zuckerman M J. The role of fiber in the treatment of irritable bowel syndrome: therapeutic recommendations.  J Clin Gastroenterol. 2006;  40 104-108
  • 395 McEligot A J, Gilpin E A, Rock C L et al. High dietary fiber consumption is not associated with gastrointestinal discomfort in a diet intervention trial.  J Am Diet Assoc. 2002;  102 549-551
  • 396 Singh N, Makharia G K, Joshi Y K. Dietary survey and total dietary fiber intake in patients with irritable bowel syndrome attending a tertiary referral hospital.  Indian J Gastroenterol. 2008;  27 66-70
  • 397 Rees G, Davies J, Thompson R et al. Randomised-controlled trial of a fibre supplement on the symptoms of irritable bowel syndrome.  J R Soc Promot Health. 2005;  125 30-34
  • 398 Aller R, Luis D A, Izaola de O et al. Effects of a high-fiber diet on symptoms of irritable bowel syndrome: a randomized clinical trial.  Nutrition. 2004;  20 735-737
  • 399 Anti M, Pignataro G, Armuzzi A et al. Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation.  Hepatogastroenterology. 1998;  45 727-732
  • 400 Bijkerk C J, Muris J W, Knottnerus J A et al. Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome.  Aliment Pharmacol Ther. 2004;  19 245-251
  • 401 Parisi G C, Zilli M, Miani M P et al. High-fiber diet supplementation in patients with irritable bowel syndrome (IBS): a multicenter, randomized, open trial comparison between wheat bran diet and partially hydrolyzed guar gum (PHGG).  Dig Dis Sci. 2002;  47 1697-1704
  • 402 Hongisto S M, Paajanen L, Saxelin M et al. A combination of fibre-rich rye bread and yoghurt containing Lactobacillus GG improves bowel function in women with self-reported constipation.  Eur J Clin Nutr. 2006;  60 319-324
  • 403 Tabas G, Beaves M, Wang J et al. Paroxetine to treat irritable bowel syndrome not responding to high-fiber diet: a double-blind, placebo-controlled trial.  Am J Gastroenterol. 2004;  99 914-920
  • 404 Quartero A O, Meineche-Schmidt V, Muris J et al. Bulking agents, antispasmodic and antidepressant medication for the treatment of irritable bowel syndrome.  Cochrane Database Syst Rev. 2005;  2 CD003460
  • 405 Hebden J M, Blackshaw E, D’Amato M et al. Abnormalities of GI transit in bloated irritable bowel syndrome: effect of bran on transit and symptoms.  Am J Gastroenterol. 2002;  97 2315-2320
  • 406 McRorie J, Kesler J, Bishop L et al. Effects of wheat bran and Olestra on objective measures of stool and subjective reports of GI symptoms.  Am J Gastroenterol. 2000;  95 1244-1252
  • 407 Zumarraga L, Levitt M D, Suarez F. Absence of gaseous symptoms during ingestion of commercial fibre preparations.  Aliment Pharmacol Ther. 1997;  11 1067-1072
  • 408 Pijpers M A, Tabbers M M, Benninga M A et al. Currently recommended treatments of childhood constipation are not evidence based: a systematic literature review on the effect of laxative treatment and dietary measures.  Arch Dis Child. 2009;  94 117-131
  • 409 Huertas-Ceballos A, Logan S, Bennett C et al. Dietary interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood.  Cochrane Database Syst Rev. 2008;  1 CD003019
  • 410 Loening-Baucke V, Miele E, Staiano A. Fiber (glucomannan) is beneficial in the treatment of childhood constipation.  Pediatrics. 2004;  113 e259-e264
  • 411 Bausserman M, Michail S. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial.  J Pediatr. 2005;  147 197-201
  • 412 Hermann-Lingen C, Buss U, Snaith R P et al. Hospital anxiety and depression scale – Deutsche Version (HADS-D). Göttingen: Hogrefe; 1995
  • 413 Löwe B, Spitzer R, Zipfel S et al. Manual und Testunterlagen. Karlsruhe: Pfitzer; 2002
  • 414 Wegman H L, Stetler C. A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood.  Psychosom Med. 2009;  71 805-812
  • 415 Ford A C, Forman D, Bailey A G et al. Irritable bowel syndrome: a 10-yr natural history of symptoms and factors that influence consultation behavior.  Am J Gastroenterol. 2008;  103 1229-1239 ; quiz 1240
  • 416 Muris J W, Starmans R, Fijten G H et al. One-year prognosis of abdominal complaints in general practice: a prospective study of patients in whom no organic cause is found.  Br J Gen Pract. 1996;  46 715-719
  • 417 Ford A C, Talley N J, Schoenfeld P S et al. Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis.  Gut. 2009;  58 367-378
  • 418 Zijdenbos I L, Wit N J, Heijden van der G J et al. Psychological treatments for the management of irritable bowel syndrome.  Cochrane Database Syst Rev. 2009;  1 CD006442
  • 419 Webb A N, Kukuruzovic R H, Catto-Smith A G et al. Hypnotherapy for treatment of irritable bowel syndrome.  Cochrane Database Syst Rev. 2007;  4 CD005110
  • 420 Hefner de J, Rilk A, Herbert B M et al. Hypnotherapy for irritable bowel syndrome – a systematic review.  Z Gastroenterol. 2009;  47 1153-1159
  • 421 Martens U, Caspari G, Matheis A et al. Long-term follow-up of patients with functional bowel disorders, with and without previous psychotherapy.  GMS Psycho-Social Medicine. 2010;  7: Doc 06
  • 422 Lackner J M, Jaccard J, Krasner S S et al. How does cognitive behavior therapy for irritable bowel syndrome work? A mediational analysis of a randomized clinical trial.  Gastroenterology. 2007;  133 433-444
  • 423 Boyce P M, Talley N J, Balaam B et al. A randomized controlled trial of cognitive behavior therapy, relaxation training, and routine clinical care for the irritable bowel syndrome.  Am J Gastroenterol. 2003;  98 2209-2218
  • 424 Robinson A, Lee V, Kennedy A et al. A randomised controlled trial of self-help interventions in patients with a primary care diagnosis of irritable bowel syndrome.  Gut. 2006;  55 643-648
  • 425 Kennedy T, Jones R, Darnley S et al. Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome in primary care: randomised controlled trial.  BMJ. 2005;  331 435
  • 426 Rahimi R, Nikfar S, Rezaie A et al. Efficacy of tricyclic antidepressants in irritable bowel syndrome: a meta-analysis.  World J Gastroenterol. 2009;  15 1548-1553
  • 427 Ladabaum U, Sharabidze A, Levin T R et al. Citalopram provides little or no benefit in nondepressed patients with irritable bowel syndrome.  Clin Gastroenterol Hepatol. 2010;  8 42-48, e1
  • 428 Sanders M R, Rebgetz M, Morrison M et al. Cognitive-behavioral treatment of recurrent nonspecific abdominal pain in children: an analysis of generalization, maintenance, and side effects.  J Consult Clin Psychol. 1989;  57 294-300
  • 429 Huertas-Ceballos A, Logan S, Bennett C et al. Psychosocial interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood.  Cochrane Database Syst Rev. 2008;  1 CD003014
  • 430 Vlieger A M, Menko-Frankenhuis C, Wolfkamp S C et al. Hypnotherapy for children with functional abdominal pain or irritable bowel syndrome: a randomized controlled trial.  Gastroenterology. 2007;  133 1430-1436
  • 431 Levy R L, Langer S L, Walker L S et al. Cognitive-behavioral therapy for children with functional abdominal pain and their parents decreases pain and other symptoms.  Am J Gastroenterol. 2010;  105 946-956
  • 432 Bahar R J, Collins B S, Steinmetz B et al. Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents.  J Pediatr. 2008;  152 685-689
  • 433 Schafer E, Ewe K. The treatment of irritable colon. Efficacy and tolerance of buscopan plus, buscopan, paracetamol and placebo in ambulatory patients with irritable colon.  Fortschr Med. 1990;  108 488-492
  • 434 Mueller-Lissner S, Tytgat G N, Paulo L G et al. Placebo- and paracetamol-controlled study on the efficacy and tolerability of hyoscine butylbromide in the treatment of patients with recurrent crampy abdominal pain.  Aliment Pharmacol Ther. 2006;  23 1741-1748
  • 435 Szarka L A, Camilleri M, Burton D et al. Efficacy of on-demand asimadoline, a peripheral kappa-opioid agonist, in females with irritable bowel syndrome.  Clin Gastroenterol Hepatol. 2007;  5 1268-1275
  • 436 Mangel A W, Bornstein J D, Hamm L R et al. Clinical trial: asimadoline in the treatment of patients with irritable bowel syndrome.  Aliment Pharmacol Ther. 2008;  28 239-249
  • 437 Dapoigny M, Abitbol J L, Fraitag B. Efficacy of peripheral kappa agonist fedotozine versus placebo in treatment of irritable bowel syndrome. A multicenter dose-response study.  Dig Dis Sci. 1995;  40 2244-2249
  • 438 Delvaux M, Louvel D, Lagier E et al. The kappa agonist fedotozine relieves hypersensitivity to colonic distention in patients with irritable bowel syndrome.  Gastroenterology. 1999;  116 38-45
  • 439 Hawkes N D, Rhodes J, Evans B K et al. Naloxone treatment for irritable bowel syndrome – a randomized controlled trial with an oral formulation.  Aliment Pharmacol Ther. 2002;  16 1649-1654
  • 440 Kariv R, Tiomny E, Grenshpon R et al. Low-dose naltreoxone for the treatment of irritable bowel syndrome: a pilot study.  Dig Dis Sci. 2006;  51 2128-2133
  • 441 Ford A C, Talley N J, Spiegel B M et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis.  BMJ. 2008;  337 a2313
  • 442 Ford A C, Brandt L J, Young C et al. Efficacy of 5-HT3 antagonists and 5-HT4 agonists in irritable bowel syndrome: systematic review and meta-analysis.  Am J Gastroenterol. 2009;  104 1831-1843 ; quiz 1844
  • 443 Andresen V, Montori V M, Keller J et al. Effects of 5-hydroxytryptamine (serotonin) type 3 antagonists on symptom relief and constipation in nonconstipated irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials.  Clin Gastroenterol Hepatol. 2008;  6 545-555
  • 444 McFarland L V, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome.  World J Gastroenterol. 2008;  14 2650-2661
  • 445 Whorwell P J, Altringer L, Morel J et al. Efficacy of an encapsulated probiotic Bifidobacterium infantis 35 624 in women with irritable bowel syndrome.  Am J Gastroenterol. 2006;  101 1581-1590
  • 446 Pimentel M. Review of rifaximin as treatment for SIBO and IBS.  Expert Opin Investig Drugs. 2009;  18 349-358
  • 447 Pimentel M, Chatterjee S, Chow E J et al. Neomycin improves constipation-predominant irritable bowel syndrome in a fashion that is dependent on the presence of methane gas: subanalysis of a double-blind randomized controlled study.  Dig Dis Sci. 2006;  51 1297-1301
  • 448 Houghton L A, Fell C, Whorwell P J et al. Effect of a second-generation alpha2delta ligand (pregabalin) on visceral sensation in hypersensitive patients with irritable bowel syndrome.  Gut. 2007;  56 1218-1225
  • 449 Liu J P, Yang M, Liu Y X et al. Herbal medicines for treatment of irritable bowel syndrome.  Cochrane Database Syst Rev. 2006;  1 CD004116
  • 450 Davis K, Philpott S, Kumar D et al. Randomised double-blind placebo-controlled trial of aloe vera for irritable bowel syndrome.  Int J Clin Pract. 2006;  60 1080-1086
  • 451 Mearin F, Balboa A, Badia X et al. Irritable bowel syndrome subtypes according to bowel habit: revisiting the alternating subtype.  Eur J Gastroenterol Hepatol. 2003;  15 165-172
  • 452 Drossman D A, Morris C B, Hu Y et al. A prospective assessment of bowel habit in irritable bowel syndrome in women: defining an alternator.  Gastroenterology. 2005;  128 580-589
  • 453 Efskind P S, Bernklev T, Vatn M H. A double-blind placebo-controlled trial with loperamide in irritable bowel syndrome.  Scand J Gastroenterol. 1996;  31 463-468
  • 454 Lavo B, Stenstam M, Nielsen A L. Loperamide in treatment of irritable bowel syndrome – a double-blind placebo controlled study.  Scand J Gastroenterol Suppl. 1987;  130 77-80
  • 455 Cann P A, Read N W, Holdsworth C D et al. Role of loperamide and placebo in management of irritable bowel syndrome (IBS).  Dig Dis Sci. 1984;  29 239-247
  • 456 Camilleri M, Chey W Y, Mayer E A et al. A randomized controlled clinical trial of the serotonin type 3 receptor antagonist alosetron in women with diarrhea-predominant irritable bowel syndrome.  Arch Intern Med. 2001;  161 1733-1740
  • 457 Camilleri M, Northcutt A R, Kong S et al. Efficacy and safety of alosetron in women with irritable bowel syndrome: a randomised, placebo-controlled trial.  Lancet. 2000;  355 1035-1040
  • 458 Camilleri M, Mayer E A, Drossman D A et al. Improvement in pain and bowel function in female irritable bowel patients with alosetron, a 5-HT3 receptor antagonist.  Aliment Pharmacol Ther. 1999;  13 1149-1159
  • 459 Chey W D, Chey W Y, Heath A T et al. Long-term safety and efficacy of alosetron in women with severe diarrhea-predominant irritable bowel syndrome.  Am J Gastroenterol. 2004;  99 2195-2203
  • 460 Wedlake L, A’Hern R, Russell D et al. Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome.  Aliment Pharmacol Ther. 2009;  30 707-717
  • 461 Poynard T, Regimbeau C, Benhamou Y. Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome.  Aliment Pharmacol Ther. 2001;  15 355-361
  • 462 Shi J, Tong Y, Shen J G et al. Effectiveness and safety of herbal medicines in the treatment of irritable bowel syndrome: a systematic review.  World J Gastroenterol. 2008;  14 454-462
  • 463 Kline R M, Kline J J, Di Palma J et al. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children.  J Pediatr. 2001;  138 125-128
  • 464 Huertas-Ceballos A, Logan S, Bennett C et al. Pharmacological interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood.  Cochrane Database Syst Rev. 2008;  1 CD003017
  • 465 Lesbros-Pantoflickova D, Michetti P, Fried M et al. Meta-analysis: The treatment of irritable bowel syndrome.  Aliment Pharmacol Ther. 2004;  20 1253-1269
  • 466 Jailwala J, Imperiale T F, Kroenke K. Pharmacologic treatment of the irritable bowel syndrome: a systematic review of randomized, controlled trials.  Ann Intern Med. 2000;  133 136-147
  • 467 Ramkumar D, Rao S S. Efficacy and safety of traditional medical therapies for chronic constipation: systematic review.  Am J Gastroenterol. 2005;  100 936-971
  • 468 Khoshoo V, Armstead C, Landry L. Effect of a laxative with and without tegaserod in adolescents with constipation predominant irritable bowel syndrome.  Aliment Pharmacol Ther. 2006;  23 191-196
  • 469 Tramonte S M, Brand M B, Mulrow C D et al. The treatment of chronic constipation in adults. A systematic review.  J Gen Intern Med. 1997;  12 15-24
  • 470 Medoff J, Katz S, Malik P et al. Open-label, dose-ranging pilot study of 4 weeks of low-dose therapy with sodium phosphate tablets in chronically constipated adults.  Clin Ther. 2004;  26 1479-1491
  • 471 Tack J, Outryve van M, Beyens G et al. Prucalopride (Resolor) in the treatment of severe chronic constipation in patients dissatisfied with laxatives.  Gut. 2009;  58 357-365
  • 472 Quigley E M, Vandeplassche L, Kerstens R et al. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation – a 12-week, randomized, double-blind, placebo-controlled study.  Aliment Pharmacol Ther. 2009;  29 315-328
  • 473 Camilleri M, Kerstens R, Rykx A et al. A placebo-controlled trial of prucalopride for severe chronic constipation.  N Engl J Med. 2008;  358 2344-2354
  • 474 Milo R. Use of the peripheral dopamine antagonist, domperidone, in the management of gastro-intestinal symptoms in patients with irritable bowel syndrome.  Curr Med Res Opin. 1980;  6 577-584
  • 475 Fielding J F. Domperidone treatment in the irritable bowel syndrome.  Digestion. 1982;  23 125-127
  • 476 Cann P A, Read N W, Holdsworth C D. Oral domperidone: double blind comparison with placebo in irritable bowel syndrome.  Gut. 1983;  24 1135-1140
  • 477 Drossman D A, Chey W D, Johanson J F et al. Clinical trial: lubiprostone in patients with constipation-associated irritable bowel syndrome – results of two randomized, placebo-controlled studies.  Aliment Pharmacol Ther. 2009;  29 329-341
  • 478 Johanson J F, Morton D, Geenen J et al. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of lubiprostone, a locally-acting type-2 chloride channel activator, in patients with chronic constipation.  Am J Gastroenterol. 2008;  103 170-177
  • 479 Johanson J F, Ueno R. Lubiprostone, a locally acting chloride channel activator, in adult patients with chronic constipation: a double-blind, placebo-controlled, dose-ranging study to evaluate efficacy and safety.  Aliment Pharmacol Ther. 2007;  25 1351-1361
  • 480 Pimentel M, Chow E J, Lin H C. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. A double-blind, randomized, placebo-controlled study.  Am J Gastroenterol. 2003;  98 412-419
  • 481 Sharara A I, Aoun E, Abdul-Baki H et al. A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence.  Am J Gastroenterol. 2006;  101 326-333
  • 482 Pimentel M, Park S, Mirocha J et al. The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial.  Ann Intern Med. 2006;  145 557-563
  • 483 Hoveyda N, Heneghan C, Mahtani K R et al. A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome.  BMC Gastroenterol. 2009;  9 15
  • 484 Nikfar S, Rahimi R, Rahimi F et al. Efficacy of probiotics in irritable bowel syndrome: a meta-analysis of randomized, controlled trials.  Dis Colon Rectum. 2008;  51 1775-1780
  • 485 Madisch A, Holtmann G, Plein K et al. Treatment of irritable bowel syndrome with herbal preparations: results of a double-blind, randomized, placebo-controlled, multi-centre trial.  Aliment Pharmacol Ther. 2004;  19 271-279
  • 486 Sallon S, Ben-Arye E, Davidson R et al. A novel treatment for constipation-predominant irritable bowel syndrome using Padma Lax, a Tibetan herbal formula.  Digestion. 2002;  65 161-171
  • 487 Bensoussan A, Talley N J, Hing M et al. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial.  JAMA. 1998;  280 1585-1589
  • 488 Pittler M H, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis.  Am J Gastroenterol. 1998;  93 1131-1135
  • 489 Dobrilla G, Imbimbo B P, Piazzi L et al. Longterm treatment of irritable bowel syndrome with cimetropium bromide: a double blind placebo controlled clinical trial.  Gut. 1990;  31 355-358
  • 490 Page J G, Dirnberger G M. Treatment of the irritable bowel syndrome with Bentyl (dicyclomine hydrochloride).  J Clin Gastroenterol. 1981;  3 153-156
  • 491 Lu C L, Chen C Y, Chang F Y et al. Effect of a calcium channel blocker and antispasmodic in diarrhoea-predominant irritable bowel syndrome.  J Gastroenterol Hepatol. 2000;  15 925-930
  • 492 Gilbody J S, Fletcher C P, Hughes I W et al. Comparison of two different formulations of mebeverine hydrochloride in irritable bowel syndrome.  Int J Clin Pract. 2000;  54 461-464
  • 493 Kruis W, Weinzierl M, Schussler P et al. Comparison of the therapeutic effect of wheat bran, mebeverine and placebo in patients with the irritable bowel syndrome.  Digestion. 1986;  34 196-201
  • 494 Vahedi H, Merat S, Rashidioon A et al. The effect of fluoxetine in patients with pain and constipation-predominant irritable bowel syndrome: a double-blind randomized-controlled study.  Aliment Pharmacol Ther. 2005;  22 381-385
  • 495 Simren M. Bloating and abdominal distention: not so poorly understood anymore!.  Gastroenterology. 2009;  136 1487-1490
  • 496 Accarino A, Perez F, Azpiroz F et al. Abdominal distention results from caudo-ventral redistribution of contents.  Gastroenterology. 2009;  136 1544-1551
  • 497 Serra J, Azpiroz F, Malagelada J R. Impaired transit and tolerance of intestinal gas in the irritable bowel syndrome.  Gut. 2001;  48 14-19
  • 498 Prior A, Whorwell P J. Double blind study of ispaghula in irritable bowel syndrome.  Gut. 1987;  28 1510-1513
  • 499 Battaglia G, Morselli-Labate A M, Camarri E et al. Otilonium bromide in irritable bowel syndrome: a double-blind, placebo-controlled, 15-week study.  Aliment Pharmacol Ther. 1998;  12 1003-1010
  • 500 Novick J, Miner P, Krause R et al. A randomized, double-blind, placebo-controlled trial of tegaserod in female patients suffering from irritable bowel syndrome with constipation.  Aliment Pharmacol Ther. 2002;  16 1877-1888
  • 501 Chang L, Ameen V Z, Dukes G E et al. A dose-ranging, phase II study of the efficacy and safety of alosetron in men with diarrhea-predominant IBS.  Am J Gastroenterol. 2005;  100 115-123
  • 502 Enck P, Zimmermann K, Menke G et al. A mixture of Escherichia coli (DSM 17 252) and Enterococcus faecalis (DSM 16 440) for treatment of the irritable bowel syndrome – a randomized controlled trial with primary care physicians.  Neurogastroenterol Motil. 2008;  20 1103-1109
  • 503 Kim H J, Camilleri M, McKinzie S et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome.  Aliment Pharmacol Ther. 2003;  17 895-904
  • 504 Caldarella M P, Serra J, Azpiroz F et al. Prokinetic effects in patients with intestinal gas retention.  Gastroenterology. 2002;  122 1748-1755
  • 505 Accarino A, Perez F, Azpiroz F et al. Intestinal gas and bloating: effect of prokinetic stimulation.  Am J Gastroenterol. 2008;  103 2036-2042
  • 506 Holtmann G, Gschossmann J, Mayr P et al. A randomized placebo-controlled trial of simethicone and cisapride for the treatment of patients with functional dyspepsia.  Aliment Pharmacol Ther. 2002;  16 1641-1648
  • 507 Kaplan M A, Prior M J, Ash R R et al. Loperamide-simethicone vs loperamide alone, simethicone alone, and placebo in the treatment of acute diarrhea with gas-related abdominal discomfort. A randomized controlled trial.  Arch Fam Med. 1999;  8 243-248
  • 508 Suarez F, Levitt M D, Adshead J et al. Pancreatic supplements reduce symptomatic response of healthy subjects to a high fat meal.  Dig Dis Sci. 1999;  44 1317-1321
  • 509 Tack J, Broekaert D, Fischler B et al. A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome.  Gut. 2006;  55 1095-1103
  • 510 Kuiken S D, Tytgat G N, Boeckxstaens G E. The selective serotonin reuptake inhibitor fluoxetine does not change rectal sensitivity and symptoms in patients with irritable bowel syndrome: a double blind, randomized, placebo-controlled study.  Clin Gastroenterol Hepatol. 2003;  1 219-228
  • 511 Boerner D, Eberhardt R, Metz K et al. Wirksamkeit und Verträglichkeit eines Antidepressivums beim Colon irritabile.  Therapiewoche. 1988;  38 201-208
  • 512 Candy D, Belsey J. Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction: a systematic review.  Arch Dis Child. 2009;  94 156-160
  • 513 Camilleri M, Vazquez-Roque M I, Burton D et al. Pharmacodynamic effects of a novel prokinetic 5-HT receptor agonist, ATI-7505, in humans.  Neurogastroenterol Motil. 2007;  19 30-38
  • 514 Manini M L, Camilleri M, Goldberg M et al. Effects of Velusetrag (TD-5108) on gastrointestinal transit and bowel function in health and pharmacokinetics in health and constipation.  Neurogastroenterol Motil. 2010;  22 42-49, e7-e8
  • 515 Fujita T, Yokota S, Sawada M et al. Effect of MKC-733, a 5-HT receptor partial agonist, on bowel motility and symptoms in subjects with constipation: an exploratory study.  J Clin Pharm Ther. 2005;  30 611-622
  • 516 Chial H J, Camilleri M, Burton D et al. Selective effects of serotonergic psychoactive agents on gastrointestinal functions in health.  Am J Physiol Gastrointest Liver Physiol. 2003;  284 G130-G137
  • 517 Bharucha A E, Ravi K, Zinsmeister A R. Comparison of selective M 3 and nonselective muscarinic receptor antagonists on gastrointestinal transit and bowel habits in humans.  Am J Physiol Gastrointest Liver Physiol. 2010;  299 G215-G219
  • 518 Camilleri M, Kim D Y, McKinzie S et al. A randomized, controlled exploratory study of clonidine in diarrhea-predominant irritable bowel syndrome.  Clin Gastroenterol Hepatol. 2003;  1 111-121
  • 519 Kelleher D L, Hicks K J, Cox D S et al. Randomized, double-blind, placebo (PLA)-controlled, crossover study to evaluate efficacy and safety of the beta 3-adrenergic receptor agonist solabegron (SOL) in patients with irritable bowel syndrome (IBS).  Neurogastroenterol Motil. 2008;  20 1-144
  • 520 Gonenne J, Camilleri M, Ferber I et al. Effect of alvimopan and codeine on gastrointestinal transit: a randomized controlled study.  Clin Gastroenterol Hepatol. 2005;  3 784-791
  • 521 Delvaux M, Beck A, Jacob J et al. Effect of asimadoline, a kappa opioid agonist, on pain induced by colonic distension in patients with irritable bowel syndrome.  Aliment Pharmacol Ther. 2004;  20 237-246
  • 522 Leventer S M, Raudibaugh K, Frissora C L et al. Clinical trial: dextofisopam in the treatment of patients with diarrhoea-predominant or alternating irritable bowel syndrome.  Aliment Pharmacol Ther. 2008;  27 197-206
  • 523 Lu W Z, Gwee K A, Moochhalla S et al. Melatonin improves bowel symptoms in female patients with irritable bowel syndrome: a double-blind placebo-controlled study.  Aliment Pharmacol Ther. 2005;  22 927-934
  • 524 Saad R, Chey W D. Lubiprostone for chronic idiopathic constipation and irritable bowel syndrome with constipation.  Expert Rev Gastroenterol Hepatol. 2008;  2 497-508
  • 525 Crutchley R D, Miller J, Garey K W. Crofelemer, a novel agent for treatment of secretory diarrhea.  Ann Pharmacother. 2010;  44 878-884
  • 526 Johnston J M, Kurtz C B, Drossman D A et al. Pilot study on the effect of linaclotide in patients with chronic constipation.  Am J Gastroenterol. 2009;  104 125-132
  • 527 Andresen V, Camilleri M, Busciglio I A et al. Effect of 5 days linaclotide on transit and bowel function in females with constipation-predominant irritable bowel syndrome.  Gastroenterology. 2007;  133 761-768
  • 528 Rao A S, Wong B S, Camilleri M et al. Chenodeoxycholate in Females With Irritable Bowel Syndrome-Constipation: A Pharmacodynamic and Pharmacogenetic Analysis.  Gastroenterology. 2010;  139 1549-1558, 1558 e1
  • 529 Corinaldesi R, Stanghellini V, Cremon C et al. Effect of mesalazine on mucosal immune biomarkers in irritable bowel syndrome: a randomized controlled proof-of-concept study.  Aliment Pharmacol Ther. 2009;  30 245-252
  • 530 Klooker T K, Braak B, Koopman K E et al. The mast cell stabiliser ketotifen decreases visceral hypersensitivity and improves intestinal symptoms in patients with irritable bowel syndrome.  Gut. 2010;  59 1213-1221

1 In Zusammenarbeit mit Deutsche Gesellschaft für Innere Medizin (DGIM), Berufsverband Niedergelassener Gastroenterologen Deutschlands (bng), Gesellschaft für Pädiatrische Gastroenterologie und Ernährung (GPGE), Deutsche Gesellschaft für Ernährungsmedizin (DGEM), Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV), Deutsche Gesellschaft für Allgemein- und Familienmedizin (DEGAM), Deutsche Gesellschaft zum Studium des Schmerzes (DGSS), Deutsche Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation (DGVM), Deutsche Gesellschaft für Psychosomatische Medizin und Ärztliche Psychotherapie (DGPM), Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit (DTG), Deutsche Gesellschaft für Naturheilkunde, Deutsche Reizdarmselbsthilfe e. V. (Patientenorganisation).

6 2 Eine Symptomdauer > 2 – 3 Wochen, aber < 3 Monate rechtfertigt noch nicht die Diagnose eines Reizdarmsyndroms [9]. Dennoch gelten die Empfehlungen zum Management (Diagnostik, Therapie) des Reizdarmsyndroms auch für diese Patienten, denn auch diese Patienten bedürfen einer diagnostischen Abklärung und können therapeutisch nicht vertröstet werden. Eine Symptomdauer < 2 – 3 Wochen ist hingegen nicht Gegenstand der aktuellen Leitlinien.

13 3 Da sich eine Diabetes-Erkrankung bei Kindern in der Regel als akutes Krankheitsbild äußert, hat die Blutzuckerbestimmung bei chronischen Beschwerden eher einen geringen Stellenwert.

14 4 Anmerkung: Der Evidenzgrad A gründet sich auf positive Metaanalysen zum Einsatz von Probiotika beim RDS. Allerdings wurden in den Studien, die in den Metaanalysen getestet wurden, z. T. unterschiedliche Probiotikastämme untersucht, was erklärt, dass die Studienlage für einzelne Probiotikastämme weniger eindeutig ist, wie die Tab. 5-1 zeigt.

16 5 Erläuterung zur Definition: Probiotika sind lebende Mikroorganismen (in der Regel Bakterien oder Pilze), die, in ausreichenden Mengen oral aufgenommen, einen gesundheitsfördernden Einfluss auf den Wirtsorganismus haben können. Präbiotika sind hingegen nicht verdaubare Lebensmittelbestandteile, die ihren Wirt günstig beeinflussen, indem sie das Wachstum und/oder die Aktivität einer oder mehrerer Bakterienarten im Dickdarm gezielt anregen und somit die Gesundheit des Wirtes verbessern.

17 Unwohlsein meint ein unangenehmes Empfinden, welches nicht als Schmerz beschrieben wird. Bei pathophysiologischer Forschung und in klinischen Studien sollte eine aktuell bestehende Schmerz/Unwohlseins-Frequenz von mindestens 2 Tagen pro Woche als Einschlusskriterium gewählt werden.

18 7 Die Kriterien müssen erfüllt sein für die vergangenen 3 Monate, und die Symptome müssen mindestens 6 Monate vor Diagnosestellung begonnen haben.

Prof. Dr. Peter Layer

Medizinische Klinik, Israelitisches Krankenhaus

Orchideenstieg 14

22297 Hamburg

Phone: ++ 49/40/51 12 50 01

Fax: ++ 49/40/51 12 50 09

Email: layer@ik-h.de