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If straining upon defecation can be avoided, previously disordered defecation is often no longer a problem. This may sometimes be accomplished by a fiber-rich diet, but dietary fiber is often neither successful nor well tolerated, and treatment with laxatives is indicated. The currently available laxatives are efficacious and safe, treatment is usually lifelong. One approach is to increase stool volume by macrogol, the other is to stimulate colonic motility (and to decrease water absorption) by the stimulant laxatives bisacodyl, picosulphate, or anthraquinones. Bisacodyl may also be given as a suppository which may be a good choice in disordered defecation. Much attention has been paid to biofeedback training which seems to improve pelvic floor dyssynergia in a high proportion of patients. However, establishing the diagnosis of pelvic floor dyssynergia is difficult in itself. Muscle relaxation training seems to be similarly effective as biofeedback training. [ABSTRACT FROM AUTHOR]

During a meeting in The Hague, The Netherlands, the IBiS Club evaluated the most important techniques that can be used in the investigation of irritable bowel syndrome, either in the context of scientific research or as a clinical diagnostic tool. In each of these, the relevance of findings made in irritable bowel syndrome was balanced against the applicability of the technique. The discussion of the group is summarized in this paper. Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Different food items are made responsible for irritable bowel syndrome (IBS) symptoms, but the physiopathology of IBS remains unclear. Aims: During a meeting in Nice, France, experts of the European Working Team of the IBiS Club discussed selected data regarding the relationships between alimentation, food items (including fibers) and IBS symptoms. Methods/Results: Food allergy remains a difficult diagnosis, but medical and general history, presence of general symptoms such as skin rash, and hypersensitivity tests may help in achieving a positive diagnosis. On the other hand, food intolerance is more confusing because of the subjectivity of the relationship between ingestion of certain foods and the appearance of clinical symptoms. Different food items which are commonly implicated in adverse reactions mimicking IBS were found to be stimulants for the gut, suggesting that patients with predominant diarrhea IBS have to be carefully questioned about consumption of different kinds of food (i.e., coffee, alcohol, chewing gum, soft drinks) and not only on lactose ingestion. Gas production is discussed on the basis of retention of intestinal gas as well as on malabsorption of fermentable substrates. The role of a large amount of this kind of substrate reaching the colon is suggested as a potential mechanism of IBS-type symptoms in overeating patients. Regarding the role of fiber in IBS, the expert group concluded that fibers are not inert substances and that they could trigger pain or bloating in some IBS patients. Conclusion: Despite numerous reviews on this subject, it is very difficult to give general dietary advice to IBS patients, but dieteticians may have a positive role in managing such patients.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

This report summarizes current concepts and information gathered to date about the rectum in the irritable bowel syndrome (IBS) that were presented at the 10th meeting of IBiS Club held in Leuven, Belgium. A working group of experts in the field of IBS discussed whether the rectum or the whole colon is the better site to test in IBS patients and provided suggestions for a number of areas where further advances are required.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Examines the potential pitfalls in the differential diagnosis of irritable bowel syndrome (IBS). Details on the post-inflammatory IBS; Information on antibiotic-associated diarrhea; Primary bile salt malabsorption.

Summarizes presentations and discussions about the psychosocial background of irritable bowel syndrome (IBS) patients and various options of psychotropic intervention. Sociocultural profile of people with IBS; Psychologic and psychiatric profile of the IBS patients; Influence of psychological factors on gut motility.