Page numbers in bold refer to figures or tables.
abdomen, 67
abdominal distention, 3, 5, 6, 7, 8, 15, 16–17, 30, 90, 149, 257
abdominal pain, 3, 5, 6, 7, 8, 10, 12–14, 16–17, 32–33, 234–53
case study of, 234–36
in Crohn’s disease, 162
discrete clustered contractions and, 22
duration and frequency of, 86–88
medications for, 9, 120, 237–53, 239, 324
new treatments for, 324
recurrent, of childhood, 303–6, 315
significance of, 89–90
in ulcerative colitis, 164
visceral hypersensitivity and, 25, 26, 30. See also pain sensitivity
acetaminophen, 6, 128, 154, 237, 239, 240, 253
acetylcholine, 229, 240, 242, 244
acid reflux, 36, 57, 82, 92, 137, 183, 248, 319
in children, 304–5
acupuncture, 131, 144, 239, 249, 275, 276, 277–78, 282, 321
acute conditions, 170
agrimony, 223
air, swallowing of, 75–76, 90, 149, 257
alcohol, 31, 84, 128, 131, 143, 170, 183, 277, 290
drug interactions with, 184, 240, 242, 273
Aleve. See ibuprofen
Align. See Bifidobacterium infantis
allopathic medicine, 43, 275, 277, 280
alosetron, 223, 231–32, 233, 253, 259
alvimopan, 324
Ambien. See zolpidem
Amerge, 128
Amitiza. See lubiprostone
amitriptyline, 209, 223, 239, 246, 315
anal canal, 65, 67, 71, 108, 111
analgesics. See pain medications
anal sphincter: external, 69, 74
anatomy of GI tract, 64–65, 67
anemia, 7, 9, 91, 93, 105, 121, 310
causes of, 102
in inflammatory bowel disease, 162, 164
anesthesia, 110
for children, 311
anesthetic injections, in fibromyalgia, 126–27
anismus. See pelvic floor dyssynergia
anorectal manometry (ARM), 78, 100, 115–16, 118, 312
ANS (autonomic nervous system), 20
antibiotics, 7, 91, 254–56, 270–74, 325, 326, 327
contraindications to, 273
dosing of, 271–72
drug interactions with, 273
duration of treatment with, 272
for gas and bloating, 257, 258–59, 259, 262
for IBS symptoms, 112, 115, 144, 227–28, 233, 263, 270–74, 325, 326
for infectious gastroenteritis, 44
for small intestine bacterial overgrowth, 152, 155–56, 258–59
anticholinergic agents: for abdominal pain, 239, 240, 243, 244
side effects of, 209, 231, 245
antidepressants: for abdominal pain, 9, 120, 239, 245–48, 252, 253
for children, 315
in chronic fatigue syndrome, 125
constipation induced by, 43, 209, 246
for diarrhea, 223, 230–31, 285
for fibromyalgia, 127
for interstitial cystitis, 131
antiflatulents, 259
anti-inflammatory agents: for abdominal pain, 6, 237, 240, 253
in chronic fatigue syndrome, 125
constipation induced by, 209
for fibromyalgia, 126
for interstitial cystitis, 131
for temporomandibular joint syndrome, 129
anti-Parkinsonian agents, 209
antipsychotics, 209
antispasmodic agents, 239, 240–45, 252, 253, 284
anxiety, 11, 27, 39–41, 42, 83, 144–45
in children, 308
medications for, 145
ARM (anorectal manometry), 78, 100, 115–16, 118, 312
ascites, 94
aspirin, 43, 128, 237, 238–40, 253, 296
A3309, 216
inflammatory bowel disease, 160, 162–63
autonomic nervous system (ANS), 20–22, 21, 22
autosomal dominant disorders, 35
autosomal recessive disorders, 36
Bacillus coagulans, 225
bacteria: in colon, 149–50
in small intestine, 149–56. See also small intestine bacterial overgrowth barium, 113, 311
barium enema, 25, 95, 101, 116, 120
Beano, 260–61
behavior, illness, in children, 309
behavioral therapies, 125, 286, 288–89, 292, 321, 322
Benadryl. See diphenhydramine
Benefiber. See guar gum
Bentyl. See dicyclomine
benzodiazepines, 243
beta blockers, 128
Bifidobacterium, 225, 258, 265
Bifidobacterium infantis, 227, 258, 265, 266, 268, 325
Bifidobacterium lactis, 265, 266
bilberry, 223
biopsies, 106–8, 109, 111, 154, 158, 235, 285
in Hirschsprung’s disease, 312
bismuth subsalicylate, 223, 224–25, 314
blackberry, 223
bleeding, gastrointestinal, 8–9, 91
after endoscopy, 112
blind research study, 333
bloating, 3, 5, 6, 7, 8, 12, 14, 15, 16, 17, 30, 32, 90, 149
case example of, 254–56
due to small intestine bacterial overgrowth, 150, 152, 153–54
medication-induced, 43
sorbitol-induced, 43, 142–43, 148
treatment of, 257–58
blood tests, 33, 95, 96, 100, 101, 101–4, 121, 154, 176, 235–36, 284, 296
for inflammatory bowel disease, 158, 162, 164
bowel activity: in children, 306
in IBS, 12–13, 14, 17, 30, 88, 89–90
bowel training, 74, 205–6, 314
in IBS, 28–30, 29, 39–40, 136, 189, 286, 287, 318
stress/emotional effects on, 18, 39–41, 55
brain influences on gut, 27–28
breath test, 115, 140, 259, 262
for lactose intolerance, 190
for small intestine bacterial overgrowth, 151–52, 153, 155, 156
buckthorn, 207
Bufferin. See aspirin
caffeine, 8, 32, 128, 131, 143, 183, 233, 286, 314
calcium channel blockers, 128, 209
calcium polycarbophil, 203, 207, 223
CAM. See complementary and alternative medicine
cancer, 7, 83, 91, 97, 98, 267
IBS and risk of, 8, 49, 57, 59, 61, 62, 298
pain due to, 238, 239, 290. See also specific types
Carafate. See sucralfate
carbonated drinks, 75, 131, 139, 143, 149, 191, 197, 199, 257
carbon dioxide, intestinal, 74–75, 149, 150, 212, 220, 256–57
case studies, 5–9, 11–12, 32–34, 47–48, 84–85, 120–22, 143–46, 157–60, 175–77, 234–36, 254–56, 284–86
castor oil, 212
CBC (complete blood count), 7, 101, 101–2, 105, 117, 118, 124, 154, 158, 164, 176, 254, 284, 305, 310
CBT (cognitive behavioral therapy), 125, 286, 288–89, 292, 321, 322
cecum, 65
Celexa. See citalopram
celiac disease, 6, 7, 41, 52, 91, 121, 135, 140–41, 144, 147, 148, 154, 175, 194
diagnosis of, 93, 96, 97, 101, 101, 140–41, 154, 254, 284, 304
central nervous system (CNS), 20, 21, 27–28, 35
brain-gut axis, 18–20, 19, 28–30, 29
brain influences on gut, 27–28
CFS. See chronic fatigue syndrome
children and IBS, 303–16
diagnosis of, 309–12
vs. encopresis, 312–13
etiology of, 308–9
vs. Hirschsprung’s disease, 312
parenting behavior and, 38–39, 42, 308–9
recurrent abdominal pain and, 303–6
Rome criteria for, 306, 311–12
and “watchful waiting,”
Chinese rhubarb, 207
chlordiazepoxide + clidinium, 239, 243, 259
chromosomes, 35–36
chronic conditions, 5, 7, 8, 17, 60–61, 62, 81, 83, 96, 98, 119, 170, 286
chronic fatigue syndrome (CFS), 121, 122–25, 123
diagnosis of, 124
epidemiology of, 122
etiology of, 123–24
management of, 124–25
natural history of, 124
symptoms of, 122–23
chronic pelvic pain (CPP), 129–30
Chronulac. See lactulose
chyme, 68
cinquefoil, 223
citalopram, 247
Citrucel. See methylcellulose
in children, 313–14
phases of, 328
placebo-controlled, 225, 329, 330, 332, 333
Clostridium butyricum, 225
Clostridium difficile colitis, 259, 269, 273–74
CNS. See central nervous system
cognitive behavioral therapy (CBT), 125, 286, 288–89, 292
Colace. See docusate sodium
colchicine, 207
Clostridium difficile, 259, 269, 273–74. See also ulcerative colitis
abnormal function of, 71–73
gas in, 76–77
laxative-induced discoloration of, 210
normal function of, 69–70
perforation of, 112
colonoscopy, 9, 15, 25, 44, 95, 96, 98, 100, 101, 101, 106–7, 120, 144, 154, 156, 235, 284–85, 296
compared with flexible sigmoidoscopy, 107–9, 108
in Crohn’s disease, 162
in inflammatory bowel disease, 107, 110–11, 158–60, 162, 164, 165, 311
preparation for, 107, 110, 209
recommendations for, 62, 105, 110, 117, 118
stool transplantation during, 269–70
in ulcerative colitis, 164–65
colorectal cancer, 8–9, 55, 61, 62, 73, 84, 89, 91, 98, 105, 157, 171, 175, 319
Crohn’s disease and, 163
screening for, 62, 104–5, 107, 110, 117
ulcerative colitis and, 165
complementary and alternative medicine (CAM), 275–82, 284
aromatherapy, 278
biofeedback, 279
herbal remedies, 279–80, 281, 282, 325
homeopathy, 280
manipulation therapies, 281
naturopathy, 281–82
new treatments, 325–26
research studies on, 321
widespread use of, 275–76, 282, 325
complete blood count (CBC), 7, 101, 101–2, 105, 117, 118, 124, 154, 158, 164, 176, 254, 284, 305, 310
computed tomography (CT) scan, 25, 44, 95, 98, 100, 101, 104, 112–13, 117, 120, 124, 126, 144, 156, 235, 236, 296, 327
conscious sedation, 110, 111, 311
constipation, 3, 4, 5, 10, 12, 13, 14, 16, 30, 198
alternating with diarrhea, 5, 12, 14, 17, 89, 171, 194, 196, 222, 228, 246, 265, 306, 316, 328
bowel training for, 205–6
in children, 306–7
diet and, 200
and exercise, 204–5
fiber intake and, 200–204, 201–2, 216
in Hirschsprung’s disease, 312
and lifestyle changes, 198–205
medication-induced, 43, 208, 209, 246, 250
medications for, 43, 48, 120, 206–17, 207, 252–53, 323–24
new treatments for, 323–24
normal transit, 72–73
treatment of, in children, 314
constitutional symptoms, 91
contraceptives, oral, 154, 184, 273
contractions, discrete clustered, 22
coping skills, 39, 42, 45, 60, 308
corticotropin-releasing factor (CRF), 322
CPP (chronic pelvic pain), 129–30
cramps. See abdominal pain
C-reactive protein (CRP), 103, 159
Creon. See pancreatic enzymes
CRF (corticotropin-releasing factor), 322
Crohn’s disease, 4, 62, 73, 82, 94, 97, 110, 222, 269
diagnostic tests for, 158–60, 162
vs. IBS, 157–65
pathophysiology of, 161–62
symptoms of, 162
treatment of, 162–63, 165. See also inflammatory bowel disease
cross-sectional study, 331
CRP (C-reactive protein), 103, 159
CT (computed tomography) scan, 25, 44, 95, 98, 100, 101, 104, 112–13, 117, 120, 124, 126, 144, 156, 235, 236, 296, 327
cystoscopy, 130–31
Cytotec. See misoprostol
dairy products, 135, 176, 191, 255
abstinence from, 6, 12, 146, 154, 155, 189–91, 197, 219, 256
consequences of avoidance of, 191
diarrhea and, 219
lactose intolerance and, 138–39, 189–91
milk challenge test, 189–90
probiotics in, 225. See also lactose intolerance
deep breathing, 186
defecation, 13, 14, 68–69. See also evacuation
definition of IBS, 5, 15–17, 30
deodorized tincture of opium (DTO), 223, 229
deoxyribonucleic acid (DNA), 35
depression: in children, 307, 308, 313
chronic fatigue syndrome and, 125
herbal remedies for, 280
IBS and, 27, 39–41, 42, 83, 145, 170, 235–37, 286–87, 292
medications for, 145, 230, 236, 245–47, 252, 292
psychiatric treatment of, 291–92
descending perineum syndrome, 74
desipramine, 9, 209, 223, 239, 246
desvenlafaxine, 247
dextofisopam, 324
diagnosis of IBS, 4, 7–8, 11–12, 81–98, 117–18
accuracy of, 97–98
in children, 309–12
components of, 81–82
delayed, 83
early, 97
vs. inflammatory bowel disease, 82, 97, 98, 157–65, 321, 328
Manning criteria for, 16
and patient history, 7, 81–82, 84–92, 170–71
physical examination, 81–82, 92–95, 170, 171
Rome criteria for, 16–17, 86, 87, 98, 118, 306, 311–12
diagnostic tests, 15, 81–82, 91, 95–96, 99–118, 101
anorectal manometry, 115–16
breath test, 115, 140, 151–52, 153, 155, 156, 259
for children, 310–11
for Crohn’s disease, 158–60, 162
defecography, 116
laboratory, 101–4
for lactose intolerance, 189–90
radiologic, 112–14
recommendations for, 117–18
research studies on, 321
for small intestine bacterial overgrowth, 151–55, 153f, 156
for ulcerative colitis, 164–65
ultrasound, 114–15
diarrhea, 3, 5, 7, 8, 10, 12, 13, 14, 16, 32–33, 218–19
alternating with constipation, 5, 12, 14, 17, 89, 171, 194, 196, 222, 228, 246, 265, 306, 316, 328
in children, 306–7
medications for, 8, 12, 218–33, 222–33, 223, 253, 324
new treatments for, 324
treatment of, in children, 314–15
in ulcerative colitis, 164
diary of symptoms, 41, 60, 172–77, 173–74, 189
dicyclomine, 209, 223, 239, 241, 242, 244, 259
diet, 9, 33, 41–43, 46, 134–48, 188–97, 286
for bloating, 257
caffeine in, 8, 32, 128, 131, 143, 183, 219, 221, 233, 286, 314
for children, 314
constipation and, 200
eating habits and, 196–97
elimination, 146, 148, 154, 155, 256
before endoscopy, 107
food allergies and sensitivities, 136–38, 139, 140, 143–48
fructose intolerance, 139–40, 191–92
gas, bloating and, 255–56, 262
gluten-free, 140–41, 148, 154, 155, 193, 194–95, 197
IBS development and, 134–35
in interstitial cystitis, 131
intestinal gas and, 75, 76, 77, 78
introducing foods into, 145–47, 189
lactose intolerance, 138–39, 189–91
low-FODMAP, 8, 142, 155, 192–94, 197, 221, 322
migraine and, 128
research on role in IBS, 322–23, 326
resources on, 338
small intestine bacterial over-growth and, 155, 156
wheat products in, 6, 93, 140, 175, 197, 311
differential diagnosis of IBS, 96, 97
intestinal gas and, 74–78
digestive system. See gastrointestinal tract
digital rectal examination, 94–95, 107
Dilantin. See phenytoin
diltiazem, 209
diphenhydramine, 184
diphenoxylate-atropine, 209, 223, 228–29, 235, 237, 285
distention. See abdominal distention
diuretics, 209
diverticula/diverticulitis, 55, 107, 150
DMSO, 131
DNA (deoxyribonucleic acid), 35
doctor-patient interviews, 84–92, 170–71
bringing question list to, 87, 172, 294, 297
frequency of, 119
tips for improving efficiency of, 87, 293–99
docusate sodium, 207; and casanthrol, 207; and sennoside, 207
Donnatal. See phenobarbital + atropine + hyoscyamine + scopolamine
double-blind research study, 333
doxepin, 239
doxylamine, 184
DTO (deodorized tincture of opium), 223, 229
Dulcolax. See bisacodyl
duloxetine, 252
duodenum, 65
dyspareunia, 129
dysphagia, 310
eating habits, 196–97. See also diet
EBV (Epstein-Barr virus), 123
E. coli Nissle 1917, 225
education: for patients, 11, 172, 295
for physicians, 169–70, 319–20
Effexor. See venlafaxine
EGD (esophagogastroduodenoscopy), 235, 311. See also upper endoscopy
Elavil. See amitriptyline
electrolytes, 103–4
elimination diet, 146, 148, 154, 155, 256
Elmiron. See pentosan polysulfate
embarrassment, 48, 74, 84, 116, 254, 295
emotional factors, 237, 286, 291–92, 308
influence on brain-gut axis, 28, 40, 55, 318
emotional health, 170, 178, 278, 287–89, 291–92
encopresis, 312–13
endoscope, 106
colonoscopy, 106–7, 110–11, 111
in Crohn’s disease, 162
flexible sigmoidoscopy, 106, 107–9, 108
risks of, 112
in ulcerative colitis, 164–65
upper, 95, 106, 112, 117, 141, 144, 151, 154, 156, 235, 305, 311
enemas, 210–12
energy drinks, 76, 139, 193, 219
enteric nervous system (ENS), 21–22, 22, 34
Enterococcus faecium, 225
environmental factors, 37–39, 307
enzyme replacements, 6, 259, 260–61
epidemiology: of chronic fatigue syndrome, 122
of fibromyalgia, 125
of IBS, 3–4, 10, 38, 47–57, 49, 51, 53, 54, 56
of migraine headaches, 127
of TMJ syndrome, 128
of ulcerative colitis, 160, 163
epinephrine pen (EpiPen), 138
Epstein-Barr virus (EBV), 123
Equalactin. See calcium polycarbophil
eructation, 75
erythrocyte sedimentation rate (ESR), 96, 101, 103, 117, 118, 125–26, 158, 162, 176, 284, 310–11
escitalopram, 247
esophageal sphincter: lower, 64–65, 76, 248
esophagogastroduodenoscopy (EGD), 235, 311. See also upper endoscopy
cancer of, 91
x-ray studies of, 106, 113, 311
ESR (erythrocyte sedimentation rate), 96, 101, 103, 117, 118, 125–26, 158, 162, 176, 284, 310–11
estrogen, 57
eszopiclone, 185
ethnicity. See race/ethnicity
abuse and, 44–45
in children, 308–9
diet and, 41–43
environmental influences on, 37–39
genetics and, 34–37
infections and, 43–44
medications and, 43
stress and, 39–41
treatment and, 169
evacuation, 68–69
in encopresis, 312–13
incomplete, 14, 16, 17, 30, 68, 74, 89, 116, 120, 198, 215
pelvic floor changes during, 72
Excedrin. See aspirin
exclusion criteria for research study, 331
exclusion diet, 146–47, 148, 314
exercise, 286
in chronic fatigue syndrome, 124–25
for constipation, 204–5
in fibromyalgia, 126
for sleep problems, 183
for stress reduction, 185
Ex-Lax. See senna
experimental studies, 330
fad diets, 196
family histories, 33, 34, 35–37, 48, 84, 91, 144, 170
fecal blood, 8–9, 91, 104–5, 164
fecal incontinence, 15, 70, 115, 222, 224, 288, 312–13
vs. encopresis, 312–13
fecal microbiota transplantation (FMT), 269–70
fecal urgency, 5, 6, 7, 8, 12, 13, 14, 30, 32–33
fiber, 6, 8, 48, 90, 142, 148, 154, 318
for children, 314
for constipation, 203–4, 207, 216
soluble and insoluble, 200
diagnosis of, 125–26
epidemiology of, 125
symptoms of, 125
5-HT3 antagonists, 223, 231, 239
Flagyl. See metronidazole
flares of IBS, 40–41, 60, 62, 132, 284, 286, 287, 289
flatulence. See gas, intestinal
flatus, 75
flexible sigmoidoscopy, 96, 100, 105, 106
in Hirschsprung’s disease, 312
insufflation for, 109
recommendations for, 117
risks of, 112
in ulcerative colitis, 164
Flora-Q, 258
fluoxetine, 247
FMT (fecal microbiota transplantation), 269–70
food allergies, 41, 82, 84, 97, 134, 139, 143–48, 188, 323
elimination/ exclusion diets for, 146–47, 148
vs. food sensitivities, 136–38, 147–48, 323
to wheat products, 6, 93, 140, 175, 197, 311. See also celiac disease frangula, 207
Freelax. See magnesium hydroxide
fructose, 148, 192, 212, 219–20, 233, 255
avoidance of, 8, 154, 155, 191, 197, 220, 256, 314
fructose intolerance, 41, 73, 76, 77, 78, 90, 97, 135, 136, 139–40, 143, 147, 148, 189, 191–92, 255, 260, 262, 328
diagnosis of, 115, 140, 191–92, 197
diarrhea and, 219–20
fruits and fruit juices, 48, 178, 183, 196, 255
fiber in, 142, 200, 201–2, 256
fructose in, 76, 135, 139, 191, 193, 197, 219–20, 255, 256
functional bowel disorders, 16, 39, 40, 73, 92, 98, 140, 196
abuse history and, 45
future issues, 317–26
new treatments, 323–26
physician education, 319–20
public awareness, 318–19
research, 320–22
gallbladder, 12, 63, 114, 236, 237
garlic, 280
gas, intestinal, 5, 12, 14, 15, 30, 74–78, 149
amount of, 75, 76–77, 90, 149, 256
case example of, 254–56
dietary fiber and, 142
in lower GI tract, 76–77
and small intestine bacterial overgrowth, 150
in upper GI tract, 75–76
gastrocolic reflex, 14–15, 24, 90, 196, 206, 244
gastroenteritis, infectious, 33–34, 43–44, 97, 153, 226, 321
gastroenterologists, 7, 10, 92, 99, 106, 296
gastroesophageal reflux disease (GERD), 36. See also acid reflux gastrointestinal (GI) tract, 63–64
contractions in, 18, 19, 22, 24
gas in, 74–78
layers of, 23
in normal digestion, 65–68
visceral hypersensitivity in, 25, 26, 30, 44, 95, 119, 129, 136, 189, 287, 307
Gas-X. See simethicone
genetic factors: in Crohn’s disease, 161
in IBS, 34–37, 42, 45, 46, 308
medications and, 323
in ulcerative colitis, 163
Gentlax. See bisacodyl
GERD (gastroesophageal reflux disease), 36. See also acid reflux
gingko, 280
GI tract. See gastrointestinal tract glucose, 138, 193
gluten: dietary avoidance of, 140–41, 148, 154, 155, 193, 194–95, 197
intolerance to, 73, 97, 135, 141, 147, 148
sensitivity to, 135, 140–41, 148, 149.See also celiac disease
Glycolax. See polyethylene glycol
gut: brain influences on, 27–28
microflora of, 149–50, 155, 163, 227, 257, 258, 263, 264, 269–70, 273, 326
motility in, 19, 20–23, 29, 307. See also brain-gut axis
Hct (hematocrit), 102
hematocrit (Hct), 102
heme-occult test, 104–5
hemoglobin (Hgb), 102
heparin, 131
herbal remedies, 275, 276, 279–80
for abdominal pain, 239, 248–49
for chronic fatigue syndrome, 125
precautions for use of, 280, 281, 282, 325
side effects of, 279–80
for sleep problems, 184
heredity. See genetic factors
Hgb (hemoglobin), 102
Hirschsprung’s disease, 312
history taking, 7, 81–82, 84–92, 170–71
for children, 309
homeopathy, 43, 199, 275, 276, 280
melatonin, 183–84
thyroid stimulating, 101, 102–3, 117, 118, 176
hydrogen, intestinal, 74–75, 149, 151–52, 212, 256–57
hydrogen breath test, 115, 151–52, 153, 155, 156, 190, 259, 262
hyoscyamine, 209, 223, 239, 242, 259, 285
hypnotherapy, 276, 280, 289–91, 292, 321
hypothesis for research study, 330
IBD. See inflammatory bowel disease
IBS. See irritable bowel syndrome
ibuprofen, 128, 129, 131, 209, 237, 240
IC (interstitial cystitis), 97, 122, 129, 130–31, 132, 318, 321
ileocecal valve, 65
Imitrex, 128
immune hypersensitivity, 44
immune system, 63
celiac disease and, 141
chronic fatigue syndrome and, 122–23
emotions and, 40
exercise effects on, 204
food allergies and, 137–38, 141, 147, 148
gluten sensitivity and, 140
gut microbiota and, 150, 257, 264
inflammatory bowel disease and, 160, 161, 162–63
small intestine bacterial overgrowth and, 150
Imodium. See loperamide
incidence of IBS, 3, 47, 50, 51, 52, 54, 57, 160
inclusion criteria for research study, 331
incomplete evacuation, 14, 16, 17, 30, 68, 74, 89, 116, 120, 198, 215
incontinence: fecal, 15, 70, 115, 222, 224, 288, 312–13
urinary, 70
infections: blood tests for, 101–2, 103
chronic fatigue syndrome and, 123
Crohn’s disease and, 161
gastrointestinal, 7, 33–34, 42, 43–44, 97, 153–55, 164, 226, 321
inflammatory bowel disease (IBD), 4, 7, 9, 62, 73, 91, 121, 154, 175, 222, 298
colonoscopy in, 107, 110–11, 158–60, 162, 164, 165, 311
diagnosis of, 93, 94, 102, 106
vs. IBS, 82, 97, 98, 157–65, 321, 328
inflammatory colitis, 4
interstitial cystitis (IC), 97, 122, 129, 130–31, 132, 318, 321
interventions in research studies, 332
intussusception, 74
irritable bowel syndrome (IBS): historical descriptions of, 4–5
vs. inflammatory bowel disease, 157–65
Manning criteria for, 16
misconceptions about, 3–4, 10, 30, 47–48, 157
other medical disorders and, 119–33
irritable colon, 15
jambolan, 223
jaundice, 92
JNJ-27018966, 324
kidney function tests, 103–4
Kristalose. See lactulose
laboratory tests, 118
blood, 101–4
bringing list to doctor’s appointment, 294, 296
in chronic fatigue syndrome, 124
in fibromyalgia, 125–26
in IBS, 6, 7, 15, 82, 91, 95–96, 101, 101–6
recommendations for, 117
research on, 321
stool, 104–6
lactase, 138–39, 190–91, 193, 260
Lactobacillus GG, 258
Lactobacillus plantarum 299V, 258, 265
Lactococcus, 225
lactoferrin in stool, 106
lactose, 138
lactose intolerance, 5–6, 41, 90, 135, 136, 138–39, 176, 189–91, 197, 254, 255, 260, 262, 304
diagnosis of, 101, 115, 189–90, 192
diarrhea and, 219
lactulose breath test, 115, 151, 152
lady’s mantle, 223
large intestine. See colon
L-dopa, 209
LES (lower esophageal sphincter), 64–65, 76, 248
leukocytes, fecal, 96, 105–6, 117, 284, 305
LevBid/Levsin. See hyoscyamine
Lexapro. See escitalopram
LFTs (liver function tests), 104
Librax. See chlordiazepoxide + clidinium
lifestyle modifications, 178–87
for constipation, 198–205
for sleep problems, 181–85
linaclotide, 207, 214–15, 217, 253, 259
Linzess. See linaclotide
liver function tests (LFTs), 104
Lomotil. See diphenoxylate-atropine
longitudinal study, 331
loperamide, 8, 12, 154, 158, 159, 160, 209, 222–24, 223, 228, 229, 233, 284, 286, 314
Lotronex. See alosetron
lower esophageal sphincter (LES), 64–65, 76, 248
low-FODMAP diet, 8, 142, 155, 192–94, 197, 221, 322
lubiprostone, 207, 213–14, 216–17, 252–53, 259
Lunesta. See eszopiclone
Lyrica. See pregabalin
magnesium citrate, 48, 207, 208
magnesium sulfate, 208
magnetic resonance (MR) defecography, 100, 116
manipulation therapy, 276, 281
manna, 207
Manning criteria, 16
massage therapy, 281
Maxalt, 128
medical disorders and IBS, 119–33, 321
chronic fatigue syndrome, 122–25
chronic pelvic pain, 129–30
links between visceral and somatic pain, 131–32
migraine, 127–28
TMJ syndrome, 128–29
urinary problems, 130–31
medications, 33, 120–21, 284–85
for abdominal pain, 9, 120, 234–53, 239, 324
for anxiety, 145
bringing list to doctor’s appointment, 294, 296–97
for children, 313–15
for chronic fatigue syndrome, 125
for constipation, 43, 48, 120, 206–17, 207, 252–53, 323–24
for depression, 145
development of new, 323–24, 326
for diarrhea, 8, 12, 218–33, 223, 253, 324
for fibromyalgia, 127
for food allergies, 138
for gas and bloating, 258–62, 259
genetic factors and, 323
for global IBS symptoms, 252–53, 262
for interstitial cystitis, 131
for pain, 43
probiotics and, 266
side effects of, 43
for sleep, 183–85
symptoms mimicking IBS, 43
for TMJ syndrome, 129
for ulcerative colitis, 165. See also over-the-counter medications
melanosis coli, 210
melatonin, 183–84
menopause, 57
Metamucil. See psyllium
methane, intestinal, 74–75, 149, 151–52, 256–57
methscopolamine, 239
methylcellulose, 202, 203, 207, 223
metronidazole, 273
microflora/microbiota, 149–50, 155, 163, 227, 257, 258, 263, 264, 273, 326
antibiotic effects of, 270–71
fecal transplantation of, 269–70. See also small intestine bacterial over-growth
Midrin, 128
migraine headaches, 43, 58, 121, 122, 127–28
milk challenge test, 189–90
milk of magnesia, 48, 207, 208, 216
Miralax. See polyethylene glycol
misconceptions, 3–4, 10, 30, 47–48, 157
misoprostol, 207
motility, gut: abnormal, 20–23
in children, 407
before and after a meal, 22, 24
measurement of, 22
Motrin. See ibuprofen
MR (magnetic resonance) defecography, 100, 116
mucosa, 23
mucus, 5, 14, 16, 17, 30, 90, 158, 159, 164, 306–7
myalgia, 91, 123, 240. See also fibromyalgia
myenteric plexus, 23
Mylicon. See simethicone
narcotics, 43, 209, 236, 249–50, 253, 324
of chronic fatigue syndrome, 124
of IBS, 8, 11, 33, 50, 58–61, 171
nausea, 306
assessment of, 93
Neurontin. See gabapentin
nitrogen, intestinal, 74–75, 149, 256–57
nonsteroidal anti-inflammatory drugs (NSAIDs), 209, 240
Norpramin. See desipramine
NSAIDs (nonsteroidal anti-inflammatory drugs), 209, 240
NuLev. See hyoscyamine
O&P (ova and parasites) study, 106, 117, 284, 305
observational study, 330
opioid receptor antagonists, 324
oral contraceptives, 154, 184, 273
organ systems, 63
osmotic agents, 207, 208–9, 212, 216
ova and parasites (O&P) study, 106, 117, 284, 305
ovarian cancer, 7, 9, 154, 235, 254
overactive bladder, 130
over-the-counter (OTC) medications, 3, 6, 10, 48, 120
for abdominal pain, 237–40
for constipation, 208–12
for diarrhea, 222–27
enzyme replacements, 260–61
for gas and bloating, 255, 258, 262
for sleep, 183–84
oxycodone, 209
oxygen, intestinal, 74–75, 149, 256–57
pain medications, 253
narcotic, 43, 209, 236, 249–50, 253, 324
over-the-counter, 238–40
tramadol, 251
pain sensitivity, 25–27, 26, 29, 119–20, 238. See also visceral hypersensitivity Pamelor. See nortriptyline
Pamine. See methscopolamine
pancolitis, 164
Pancrease. See pancreatic enzymes
pancreatic enzymes, 68, 78, 261
panic disorder, 287–88
parasympathetic nervous system, 21, 22, 30
pathophysiology of IBS, 18–30, 45, 189, 321
in children, 307. See also physiology of IBS patient resources, 335–38
Paxil. See paroxetine
PEG (polyethylene glycol), 120, 207, 209, 212, 314
pelvic floor, 70
changes in, during evacuation, 72
normal function of, 70
retraining of, 78
pelvic floor dyssynergia, 72, 74
pelvic pain, chronic, 129–30
pentosan polysulfate, 131
peppermint oil, 239, 248, 278, 280, 315
Pepto-Bismol. See bismuth subsalicylate
Percocet. See narcotics
Peri-Colace. See docusate sodium: and casanthrol
peripheral nervous system, 20, 21
peristalsis, 20, 23, 43, 44, 64, 66, 68, 77, 88, 94, 114, 213
pets, 186
PET (positron emission tomography) scan, 27, 127, 290
pharmacogenomics, 323
Phazyme. See simethicone
phenobarbital, 209
phenobarbital + atropine + hyoscyamine + scopolamine, 236, 239, 243–44, 259
physical examination, 121
in chronic fatigue syndrome, 124
in IBS, 81–82, 92–95, 170, 171
for migraine headache, 128
physician education, 319–20
physiology of IBS, 18–30, 34–35, 45, 189
brain-gut axis, 18–20, 19, 28–30, 29, 39–40
brain influences on gut, 27–28
in children, 307
visceral hypersensitivity, 25, 26, 30, 44, 95, 119, 129, 136, 189, 287, 307
vs. alosetron, 231
vs. CAM therapies, 276
vs. citalopram, 247
vs. dextofisopam, 324
vs. herbal remedies, 232, 249, 280
vs. linaclotide, 215
vs. lubiprostone, 213–14
placebo-controlled studies, 225, 329, 330, 332, 333
plecanitide, 323
polyethylene glycol (PEG), 120, 207, 209, 212, 314
polymyalgia rheumatica, 126
polyps, 105, 107, 108, 108, 109, 111, 111, 112
positron emission tomography (PET) scan, 27, 127, 290
postinfectious IBS, 44, 154–55, 226, 321
postprandial discomfort, 14, 90
prebiotics, 269
prevalence: of anxiety disorders, 287
of celiac disease, 101, 140, 141
of chronic fatigue syndrome, 122
of colorectal cancer, 117
of fibromyalgia, 125
of lactose intolerance, 139
of migraine headaches, 127
of TMJ syndrome, 128
prevalence of IBS, 3, 36, 38–39, 50–55, 53, 56, 122, 319, 331
by race/ethnicity, 4, 10, 38, 49, 55
by sex, 55–57
by socioeconomic status, 55
worldwide, 4, 10, 38, 47, 49, 53–56
Pristiq. See desvenlafaxine
probiotics, 154, 233, 263–68, 276–77, 325, 326
amount to take, 265–66
choice of, 265
contraindications to, 267
duration of treatment with, 266
efficacy of, 265
for gas and bloating, 256, 257, 258, 259, 259, 262
prebiotics and, 269
safety of, 266–67
sources for purchase of, 225, 267–68
stool transplantation and, 269–70
progesterone, 57
prospective study, 331
Prozac. See fluoxetine
psychiatric therapy, 291–92
psychological elements of IBS, 283, 286–88
cognitive behavioral therapy for, 125, 286, 288–89, 292, 321, 322. See also anxiety
depression
psyllium, 200, 203, 204, 207, 223
public awareness, 318–19
pylorus, 65
questions for doctor, 87, 172, 294, 297
Questran. See cholestyramine
race/ethnicity: chronic fatigue syndrome and, 122
colon cancer screening and, 62, 105, 110, 118
genetic disorders and, 36
inflammatory bowel disease and, 161, 163
lactose intolerance and, 139
radiologic studies, 102, 112–14
in children, 311
in chronic fatigue syndrome, 124
defecography, 116
in fibromyalgia, 126
in IBS, 16, 25, 27, 40, 77, 87, 95, 98, 101, 144, 154, 159
in inflammatory bowel disease, 162
in TMJ syndrome, 128
upper GI series, 95, 113, 159, 311
ramelteon, 185
randomized trial, 332
RAP (recurrent abdominal pain of childhood), 304–6, 315
rectal examination, 94–95, 107
rectum, 65, 67, 69, 70, 71, 108, 111
perforation of, 211
recurrent abdominal pain of childhood (RAP), 304–6, 315
red flags, 33, 100, 309. See also warning signs
reflexology, 281
relaxation techniques, 275
research on IBS, 320–21
research studies, 59–61, 327–33
basic science, 318, 320, 326, 327
in children, 313–14
phases of, 328
placebo-controlled, 225, 329, 330, 332, 333
resources for patients, 335–38
retrospective study, 331
“review of systems,”
rigid sigmoidoscopy, 18
Robinul. See glycopyrrolate
Rolfing, 281
Rome criteria, 16–17, 86, 87, 98, 118
validity of, in children, 306, 311–12
Rozerem. See ramelteon
Saccharomyces boulardii, 225
Saccharomyces cerevisiae, 225
salivary glands, 63
saw palmetto, 280
selective serotonin reuptake inhibitors (SSRIs), 145, 239, 246–48
Senokot. See senna Senokot-S. See docusate sodium: and sennoside
sensory afferent neurons, 28
sensory alterations, 25–27, 26
serotonin norepinephrine reuptake inhibitors (SNRIs), 247, 252
sex and IBS, 55–57
shiatsu, 281
SIBO. See small intestine bacterial overgrowth
sigmoidoscope, 106, 107–9, 108. See also flexible sigmoidoscopy
signs, warning, 33, 100, 117, 118, 250, 305, 309–10, 311
Sinequan. See doxepin
sitz marker study, 101, 113–14
Sjogren’s syndrome, 126
SLE (systemic lupus erythematosus), 124, 126
sleep medications, 185
sleep problems: caffeine and, 221
in chronic fatigue syndrome, 122–25
in fibromyalgia, 125
in IBS, 7, 9, 88, 122, 158, 181–85, 186
management of, 182–85
small intestine, 67
anatomy of, 65
digestion in, 66–68
gas in, 75–76
small intestine bacterial overgrowth (SIBO), 149–56
case example of, 153–55
causes of, 150
diagnosis of, 151–55, 153, 156, 259
smoking/tobacco, 76, 84, 161, 163, 277, 290
smooth muscle, 13, 20, 23, 24, 109, 130, 132
in Hirschsprung’s disease, 312
medications for relaxation of, 235, 236, 239, 240–45, 253
peppermint oil for relaxation of, 248
during pregnancy, 57
smooth muscle antispasmodics, 239, 240–45, 252, 253, 284
SNRIs (serotonin norepinephrine reup-take inhibitors), 247, 252
social environment, 38–39
socioeconomic status, 38, 55, 308
somatic nervous system, 20, 21
somatization disorder, 42, 247, 287, 292
Sonata. See zaleplon
sorbitol, 43, 73, 142–43, 148, 193, 233
for constipation, 207, 209, 212, 213
sports drinks, 76, 135, 139, 191, 197, 199, 219, 255
SSRIs (selective serotonin reuptake inhibitors), 145, 239, 246–48
St. John’s wort, 280
steroids, 162
digestion in, 66
functions of, 65
gas in, 75–76
stool, 68
evacuation of, 68–69
lactoferrin in, 106
leukocytes in, 96, 105–6, 117, 284, 305
transplantation of, 269–70
withholding of, 313. See also straining at stool
stool softeners, 208
stool studies, 100, 102, 104–6, 118, 154, 176, 284–85, 321
straining at stool, 5, 14, 17, 30, 47, 68, 74, 89, 94–95, 116, 120, 142, 198, 200, 215, 252, 312
Streptococcus salivarium, 225
Streptococcus thermophilus, 225
stress, 322
chronic fatigue syndrome and, 123
effects on brain-gut axis, 18, 28, 39–41, 55
IBS and, 4, 5, 6, 7, 18, 32–34, 39–41, 42, 158, 176
pain perception and, 27
reduction of, 160, 185–86, 187
subjects, research, 331
submucosal plexus, 23
sucralfate, 209
sucralose, 193
support groups, 319
suppositories, 210–12
surgery: contraindicated in IBS, 161, 163, 165, 172, 237, 320, 321
for Hirschsprung’s disease, 312
for inflammatory bowel disease, 163, 165
for interstitial cystitis, 131
role in development of IBS, 27, 134, 297
for small intestine bacterial over-growth, 150
Swiss-Kriss. See senna
sympathetic nervous system, 21, 22, 28–30
symptoms of IBS, 3, 4–8, 10, 12–17, 30, 32–34, 120
bringing list to doctor’s appointment, 87, 294, 295
causes of, 18–28
constitutional, 91
diary of, 41, 60, 172–77, 173–74, 189
diet and, 188–89
flares of, 40–41, 60, 62, 132, 284, 286, 287, 289
history taking for, 7, 81–82, 84–92
long-term, 60–61
medication-induced, 43
pattern of, 13
resolution of, 54, 55, 60, 61, 62, 124, 135, 169, 213, 256, 310
syndrome, 15
systemic lupus erythematosus (SLE), 124, 126
TCAs. See tricyclic antidepressants
tegaserod, 250
Tegretol. See carbamazepine temporomandibular joint (TMJ) syndrome, 121, 128–29
thoracic cavity, 67
Thorazine, 209
thyroid disorders, 73, 91, 96, 99, 100, 103, 124
thyroid stimulating hormone (TSH), 101, 102–3, 117, 118, 176
thyroid tests, 101, 124, 125, 145, 236, 284
TMJ (temporomandibular joint) syndrome, 121, 128–29
Tofranil. See imipramine
toxic megacolon, 222
traveler’s diarrhea, 33, 44, 271
treatment plan, 172, 294, 296, 298–99
for abdominal pain, 234–53, 239
complementary and alternative, 275–82
for constipation, 198–217, 207
for Crohn’s disease, 162–63, 165
for depression, 291–92
before diagnostic tests, 100
for fibromyalgia, 127
for gas and bloating, 254–62
getting started with, 169–72
IBS diary and, 172–77, 173–74, 189
individualized, 171–72
for interstitial cystitis, 131
for lactose intolerance, 189–91, 197
lifestyle changes, 178–87, 198–205
principles of, 172
for psychological elements of IBS, 287–92
for sleep problems, 184–85
for small intestine bacterial overgrowth, 155–56
sub-type-specific, 171
for TMJ syndrome, 129
for ulcerative colitis, 165
tricyclic antidepressants (TCAs): for abdominal pain, 9, 120, 239, 245–46, 252, 253
for children, 315
constipation induced by, 43, 209, 246
for interstitial cystitis, 131
side effects of, 230–31, 245–46
trigger point therapy, 127, 281
TSH (thyroid stimulating hormone), 101, 102–3, 117, 118, 176
twin studies: of Crohn’s disease, 161
of
of ulcerative colitis, 163
Tylenol. See acetaminophen
ulcerative colitis (UC), 4, 7, 15, 62, 73, 82, 97, 110, 157–58, 160–61, 163–65, 222, 269
diagnosis of, 164–65
extra-intestinal, 164
pathophysiology of, 163–64
stool studies in, 106
symptoms of, 164
treatment of, 165. See also inflammatory bowel disease
Ultram. See tramadol
ultrasound, 95, 98, 104, 114–15, 117, 120, 154, 235, 236, 255, 296, 305
unabsorbed sugars, 207, 212–13
unstable colon or colitis, 4, 15
upper endoscopy, 95, 106, 112, 117, 141, 144, 235, 305, 311
in small intestine bacterial overgrowth, 151, 154, 156
upper esophageal sphincter, 64, 76
upper gastrointestinal (GI) series, 95, 113, 159, 311
urgency, fecal, 5, 6, 7, 8, 12, 13, 14, 30, 32–33, 90
urinalysis, 82, 121, 130, 305, 311
urinary problems, 70, 121, 130–31, 184, 242
uzara, 223
valerian, 184
valproate, 128
valsalva maneuver, 69
variables in research studies, 330–31
vegetables, 48, 135, 143, 178, 193, 196, 197, 255, 261
venlafaxine, 247
Vicodin. See narcotics
Viokase. See pancreatic enzymes
visceral hypersensitivity, 25, 26, 30, 44, 95, 119–20, 129, 136, 189, 238, 287
in children, 307
somatic pain and, 131–32
volunteering, 186
warning signs, 33, 100, 117, 118, 250
weight loss, 91, 144, 235, 310
wheat allergy, 6, 93, 140, 175, 197, 311. See also celiac disease
women and IBS, 8, 10, 48, 55–57
worldwide prevalence of IBS, 4, 10, 38, 47, 49, 53–56
Xifaxan. See rifaximin
x-rays. See radiologic studies
xylitol, 193
yogurt, probiotics in, 225, 258, 266, 268
zaleplon, 185
Zoloft. See sertraline
zolpidem, 185
Zomig, 128
zygote, 37