Interní Med. 2009; 11(7): 332-335
The functional bowel disorders including the irritable bowel syndrome are the final diagnosis in significant proportion of gastroenterological
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. Recently, it has been proved that in 20–30 %
of patients with irritable bowel syndrome the infectious gastroenteritis preceded the clinical manifestation of the bowel functional
disoorder. The bacterial infections (campylobacteriosis, shigelosis and salmonelosis) are considered as the most important causes for
irritable bowel syndrome development. The gastrointestinal infections might induced the abnormal motility pattern which includes
the pathologic gastro-colic reflex and a visceral hyperalgesia. It has been stressed, that coincidental psychiatric illness eg depression or
anxiety and panic neurosis are very important permisive factors for irritable bowel syndrome development.
Therapy of irritable bowel syndrome has to be complex, and symptomatic. Dietary and life style arrangement are very important. The
drug therapy include antidiarrheal agents (diphenyloxylate, loperamide, cholestyramine), tricyclic antidepressants, neuroleptics, and
also musculotropic antispasmodics. Especially in the postinfectious irritable bowel syndrome the long therm therapy with cholestiramine
has been shown as a effective therapy.
Published: September 1, 2009 Show citation