Interní Med. 2007; 9(12): 544-547

Irritable bowel syndrom

prof. MUDr. Milan Lukáš CSc

IV. interní klinika VFN a 1. LF UK, Praha

The funtional bowel disorders and especialy irritable bowel syndrome and functional large bowel dyspepsia are the final diagnosis in many of our patients. The irritable bowel syndrome is characterised by changes of bowel habits with abdominal dyscomfort or abdominal pain. The pathophysiology of irritable bowel syndrome is still not completely understood, but many factors are considered: a) abnormal motility pattern includes of the pathologic gastro-colic reflex; b) postinfective consequences in the large bowel mucosa; c) visceral hyperalgesia and increased perception of physiological or minor noxious stimuli; d) abnormal intestinal secretion with accumulation of fluid in the intestinal lumen. Regarding on predominant symptoms we can divided irritable bowel syndrome into three clinical groups: a) diarrheal type; b) contipated type c) mixed typ. Diagnosis of the disease is based on the typical clinical picture and absent of alarming symptoms. In younger patients is not necessary to perform some invasive investigation. In all patients with alarming symptoms colonoscopy is absolute indicated. Therapy of irritable bowel syndrome has to be complex and symptomatic. Dietary and life style arrangement are self-evidents. The drugs therapy include antidiarrheal agents (diphenyloxylate, loperamide, cholestyramine), bulking and salinic laxatives, tricyclic antidepressants and neuroleptics, musculotropic antispasmodics and at the future agonists of 5HT4 receptors.

Keywords: bowel dyspepsia, constipation, diarrhea, abdominal pain

Published: January 20, 2008  Show citation