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Rather, IBD refers to "inflammatory bowel disease" in which patients have an underlying mucosal inflammation.2 IBD includes both ulcerative colitis and Crohn disease, whereas the abbreviation IBS refers to irritable bowel syndrome, a functional bowel disorder characterized by recurrent abdominal pain at least 1 day/week for the past 3 months and is related to defecation or associated with a change in stool frequency or form.3 To further complicate the definitions, research has indicated an overlap between both IBD and IBS, such that some individuals with IBD have co-occurring IBS (known as IBD-IBS).4,5 Although the acronyms are similar and patients can have overlapping disease, it is important to be clear on the meaning: IBD as inflammatory bowel disease and IBS as irritable bowel syndrome. It is possible that the heading "dermatological manifestations of irritable bowel disease" was supposed to be inflammatory bowel disease as the paragraph speaks to cutaneous manifestations of inflammatory bowel disease. We read with interest the recent article entitled "Faecal calprotectin in dermatology practice" by Premjeyanth I et al i ., published recently in I Clinical and Experimental Dermatology i .1 In this paper, the authors discussed the potential use of faecal calprotectin in assessing for bowel diseases in dermatology practice. [Extracted from the article]

Bloating is a frequent complaint of women with irritable bowel syndrome (IBS). We compared retrospective and daily diary gastrointestinal and psychological distress symptoms in 183 women ages 18-48 in three IBS subgroups: Minimal-Bloating, Mild-Bloating, Moderate-Severe-Bloating. More women with moderate to severe levels of bloating reported a history of hard stools, straining to have a stool, a history of depressive disorders, and more severe daily symptoms of depression and anxiety as compared to women with minimal or mild bloating symptoms. Appraising the level of symptom severity and psychological distress is vital to the selection of appropriate treatment options. [ABSTRACT FROM AUTHOR]

Chronic constipation is among the most common lower gastrointestinal (GI) motility disorders seen in clinical practice. Managing patients with chronic constipation presents numerous challenges, including overcoming communication barriers associated with open discussion of bowel habits and other sensitive GI-related symptoms. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome is a common and often unpredictable disorder with an increased incidence among women. It is characterized by abdominal pain associated with constipation-diarrhea. Recent research, current theories about etiology and pathophysiology, diagnosis, management, and overlapping conditions such as interstitial cystitis and chronic pelvic pain are discussed. [ABSTRACT FROM AUTHOR]

Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syndrome (IBS) using laboratory tests of function (ie, expiratory/inspiratory ratio, Valsalva, posture changes, and cold pressor) and spectral and nonspectral measures of heart rate variability (HRV). Women with (N = 103) and without IBS (N = 49) were recruited, interviewed, then completed a laboratory assessment and wore a 24-hr Holter monitor Analysis using the entire sample showed little difference between IBS and control women and between subgroups with IBS on either laboratory measures or 24-hr HRV measures. However, analysis restricted to those women with severe IBS symptoms showed quite pronounced differences between two IBS subgroups on 24-hr HRV measures. Parasympathetic tone was significantly lower and ANS balance was significantly higher in the constipation-predominant compared to the diarrhea-predominant group. Subgroups of women with IBS do differ in ANS function as measured by 24-hr HRV; however, these differences are only apparent among women with severe symptoms. These findings point out the importance of considering symptom severity when interpreting studies of IBS. [ABSTRACT FROM AUTHOR]

Women seek healthcare and are diagnosed more frequently with chronic somatic and visceral pain conditions relative to men. These conditions tend not to be life-threatening disorders, but rather ones that decrease people's quality of life, impinge on work and recreational activities, and increase healthcare resource utilization. With increased awareness of basic gender differences in biology and responsiveness to therapies, there has been renewed interest in factors which may account for the gender disparity in chronic visceral pain conditions. Basic and clinical evidence primarily from patients with irritable bowel syndrome has provided initial insights into visceral pain sensitivity, perception, and responsitivity. [ABSTRACT FROM AUTHOR]

This analysis evaluated the association between sleep disturbance and gastrointestinal symptoms in women with and without irritable bowel syndrome (IBS), and examined the role of psychological distress in this relationship. Women with IBS (N = 82) reported considerably higher levels of sleep disturbance compared to controls (N = 35), using both retrospective seven-day recall and daily diary recall for two menstrual cycles (P < 0.05 on 8 of 10 measures). We used daily diary data to estimate the association between sleep disturbance and gastrointestinal symptoms, both across women (ie, whether women with high average sleep disturbance have higher average gastrointestinal symptoms) and within woman (ie, whether poorer than average sleep on one night is associated with higher than average gastrointestinal symptoms the following day). The regression coefficients for the across-women effect are large and highly significant in both groups (IBS, β ± se = 0.46 ± 0.08, P < 0.001; controls, 0.57 ± 0.13, P < 0.001). The regression coefficients for the within-woman effect are considerably smaller and statistically significant only in the IBS group (IBS, 0.06 ± 0.02, P = 0.006; control, 0.01 ± 0.03, P = 0.691). These regression coefficients showed little change when daily psychological distress or stress was controlled for, the one exception being the coefficient for the across-women effect in the IBS group, which decreased substantially but still remained highly significant. Because it is possible that gastrointestinal symptoms could, in fact, cause poor sleep, we also fitted the temporally reversed model to evaluate the association between gastrointestinal symptoms on one day and sleep disturbance that night. The within-woman regression coefficients were nonsignificant in both the IBS and control groups. In conclusion, these results are consistent with the hypothesis that poor sleep leads to higher gastrointestinal symptoms on the following day among women with IBS. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purposes of this study were to: (a) compare women with three premenstrual symptom patterns (LS - low severity, PMS - premenstrual syndrome, PMM - premenstrual magnification symptom patterns) with respect to perceived stressors and levels of cortisol and catecholamines measured in urine daily across one menstrual cycle; and (b) examine intra-individual correlation between the measures of perceived stressors, cortisol and catecholamines, and the premenstrual symptoms of emotional turmoil and fluid retention. DESIGN: Three-group comparative. SETTING: Home interviews. POPULATION: Women were recruited through advertisements in local newspapers seeking women with either low symptom severity or premenstrual symptoms. A total of 1,149 women between the ages of 18 and 45 responded to newspaper advertisements. INTERVENTIONS: A total of 522 women were interviewed in their homes, and kept the Washington Women's Health Diary (WWHD) , a 90-day daily health diary, for two to three cycles. Each woman was assigned to a symptom severity pattern group. Women meeting the criteria for the PMS, PMM, or LS group for at least two cycles were eligible to participate in an intensive study over one entire menstrual cycle. Participation included the laboratory measurement of autonomic responses, daily collection of urine samples for hormonal assays, and completion of a daily health diary that included measures of symptoms and perceived stress. A total of 118 women agreed to participate in and began the intensive study cycle. At the end of the study cycle each woman was reclassified according to her daily symptom ratings during that study cycle into one of the symptom severity groups. MAIN OUTCOME MEASURE(S): Group and menstrual cycle phase differences in perceived stress were consistent with findings of others who have reported that women with PMS experience higher premenses than postmenses stress levels and significantly higher levels than women with LS symptoms. There is evidence of positive time-lagged relationships between perceived stress and stress arousal indicators (cortisol and norepinephrine) across groups of women with LS, PMS, and PMM symptom patterns. There also is evidence of a unique cross-correlation between perceived stress and epinephrine only for women with PMS. Cortisol, epinephrine, and norepinephrine, in turn, all correlated positively with turmoil and fluid retention symptoms across all groups. The single exception is the lack of cross-correlation between epinephrine and turmoil for women with PMS. Perceived stress was positively correlated with symptoms across the groups. RESULTS/CONCLUSIONS: Taken together, these findings prompt further investigation of the relationships between indicators of physiologic arousal, perceived stress, the autonomic nervous system and the HPS axis hormones, and symptoms, with separate consideration of women with the PMS and PMM symptom patterns. Future studies should distinguish women with PMS versus PMM symptom patterns. Failure to do so is likely to perpetuate mixed results and mask different social and physiologic mechanisms responsible for the symptom patterns. [CINAHL abstract] [ABSTRACT FROM AUTHOR]

A system of magnetic field goniometry was developed for measuring the frequency of stomach contractions. This technique uses a handheld, electronic compass to measure the angular change in direction of a magnetic field generated by a small, ingested magnet. Measurements of gastric mechanical activity made by goniometry were validated with simultaneous measurements using manometry and electrogastrography. The agreement between these different modalities was excellent. In this pilot study, magnetic field goniometry provided an easy, minimally invasive, and accurate method to measure the frequency of gastric contractions. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to assess relationships among ovarian steroids, stress arousal indicators (cortisol, catecholamines), perceived stress, and symptoms (turmoil and fluid retention) during the luteal phase of the menstrual cycle. A second purpose was to compare the patterns of these relationships for women with premenstrual syndrome (PMS) versus a premenstrual magnification (PMM) symptom pattern. DESIGN: Three-group comparative design. SETTING: Home interviews. POPULATION: Participants were recruited through advertisements in local newspapers seeking women with either low symptom severity or premenstrual symptoms. A total of 522 women met the criteria for PMS, PMM, or LS. INTERVENTIONS: Women screened for an LS (low symptom severity), PMS (premenstrual syndrome), and PMM (premenstrual magnification) symptom pattern provided daily urine samples for hormone analysis. They also rated their symptoms and stress levels daily for the entire 90-day study cycle in a health diary. Of the 522 women, 342 returned a completed diary for at least two consecutive cycles. Each women was assigned to a symptom severity pattern group based on a scoring system developed from a study of symptom patterns in a community-based sample of women. A total of 118 women agreed to participate in and began the intensive study period, through one menstrual cycle, with 100% completing it. Participation included the laboratory measurement of autonomic responses and daily collection of urine samples for hormonal assays. Factor analysis of the 57 symptoms included in the Washington Women's Health Diary (WWHD) revealed five factors, with the first two accounting for a large proportion of the variance and frequently cited by women with premenstrual symptoms. Factor 1, labeled Emotional Turmoil, included hostility, depression, anger, feeling out control [sic], etc. Assays of estradiol, pregnanediol, cortisol, epinephrine, and norepinephrine were performed from a urinalysis. Perceived stress was assessed daily using two indicators included in the WWHD. MAIN OUTCOME MEASURE(S): These findings support a complex set of relationships among ovarian hormones, perceived stress, stress arousal indicators, and symptoms that differ for women with the PMS and the PMM symptom patterns. Analyses of data for women with the LS and PMM symptom patterns revealed that lower luteal phase levels of norepinephrine, higher premenses global stress ratings, and the estradiol beta were significant predictors of premenstrual turmoil. Group differences in levels of the ovarian steroids, stress arousal indicators, perceived stress, and symptoms were analyzed using one-way ANOVA by group. RESULTS/CONCLUSIONS: Taken together, these findings suggest that perceived stress and cortisol play an important role in symptoms for women with a PMS symptom pattern. For women with a PMM symptom pattern, emotional turmoil and fluid retention symptoms are mediated by higher perceived stress, lower norepinephrine and higher epinephrine levels, and persistence of somewhat higher estradiol levels during the luteal phase. Replication studies with larger and more diverse samples of women are needed. [ABSTRACT FROM AUTHOR]

Autonomic nervous system function was assessed in women with and without irritable bowel syndrome using frequency domain measures of heart rate variability. Women were interviewed and placed into the irritable bowel syndrome (N = 25) group based on history of diagnosis and self-report of current gastrointestinal symptoms. Women in the control group denied a history of chronic gastrointestinal symptoms (N = 15). Women were followed for one menstrual cycle with a symptom diary, and during mid-luteal phase they wore a Holter 24-hr electrocardiograph monitor. Women with irritable bowel syndrome demonstrated significantly lower vagal tone as measured by the high frequency spectrum relative to control women. In addition, women with irritable bowel syndrome had a flattened 24-hr pattern of heart rate variability, with significantly lower levels of vagal tone during sleep. These results suggest that systemic sympathovagal balance may be shifted in a subset of women with irritable bowel syndrome. [ABSTRACT FROM AUTHOR]