Abstract:
:Irritable bowel syndrome (IBS), which is characterized by recurrent abdominal pain and disordered bowel habits, is one of the most common functional bowel disorders. IBS is a substantial burden on both patient health-related quality of life and healthcare costs. Several pathophysiologic mechanisms have been postulated for the occurrence of IBS, including altered gastrointestinal motility, visceral hypersensitivity, changes in gut permeability, immune activation, gut-brain dysregulation, central nervous system dysfunction, and changes in the gut microbiota. Of note, both qualitative and quantitative differences have been observed in the gut microbiota of a population with IBS versus a healthy population. Because of the substantial interest in the gut microbiota and its role as a therapeutic target in IBS, this article provides an overview of specific interventions with the potential to modulate the gut microbiota in IBS, including elimination diets, prebiotics, probiotics, synbiotics, and nonsystemic antibiotics. Although probiotics and synbiotics are generally well tolerated, differences in the composition and concentration of different bacterial species and inclusion or exclusion of prebiotic components varies widely across studies and has prevented strong recommendations on their use in IBS. For nonsystemic antibiotics, rifaximin is indicated in the United States for the treatment of IBS with diarrhea in adults and has been shown to be efficacious and well tolerated in well-designed clinical trials. Overall, more consistent evidence is needed regarding the efficacy and safety of elimination diets, prebiotics, probiotics, and synbiotics for the treatment of patients with IBS. Furthermore, additional well-designed studies are needed that examine alterations in the gut microbiota that occur with these interventions and their potential associations with clinical symptoms of IBS.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Harris LA,Baffy Ndoi
10.1080/00325481.2017.1383819subject
Has Abstractpub_date
2017-11-01 00:00:00pages
872-888issue
8eissn
0032-5481issn
1941-9260journal_volume
129pub_type
杂志文章,评审abstract::Patients with colon cancer involving regional lymph nodes (stage C disease) have a 5-year survival rate of only 30% to 40%, and the majority die of recurrent disease. Recent trials have shown increased survival rates with postoperative use of fluorouracil plus levamisole. The authors discuss these findings and the imp...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716390
更新日期:1990-10-01 00:00:00
abstract::Hypertension increases the risk of reinfarction and sudden death in post-myocardial infarction (MI) patients. The same s true of coexisting left ventricular hypertrophy. Fortunately, these two risk factors may be modified by pharmacotherapy. In this article, Dr Boden describes the complementary use of beta blockers an...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701448
更新日期:1992-09-01 00:00:00
abstract::During the last few years, the number, variety, and complexity of nuclear medical examinations that can be performed in children have increased impressively, due partly to recent accomplishments in radiopharmaceutical development and the availability of gamma scintillation cameras and computer systems for acquisition,...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11713991
更新日期:1975-03-01 00:00:00
abstract::Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia, yet because AF can often be intermittent or lacking in overt symptoms, its prevalence is underestimated, and it may be diagnosed only incidentally. Because AF is a potent ischemic stroke risk factor and stroke rates are similar for paroxysmal...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.03.2260
更新日期:2011-03-01 00:00:00
abstract::Preview Management of otitis media in children is a controversial matter: The basic questions of why, in whom, and how it should be treated are undergoing continual reassessment. In this article, Drs Shapiro and Bluestone provide answers to these and other questions, such as Why is treatment of acute otitis media just...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11945992
更新日期:1995-05-01 00:00:00
abstract::Although a great deal of investigation has led to some novel approaches in treating primary sclerosing cholangitis (PSC) and primary biliary cirrhosis (PBC), no method has been proven to definitively alter the long-term outcome of either disease. In addition, many of the medical regimens reviewed in this article have ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) are common functional bowel disorders. Patients with IBS-C or CIC often present with ≥ 1 comorbidity that coincides with either of these conditions. These comorbidities may make underappreciated contributions to the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.03.2640
更新日期:2013-03-01 00:00:00
abstract::The role of reflux in the development of esophagitis, stricture, and Barrett's esophagus is well recognized. However, reflux is not an infrequent cause of atypical chest pain, chronic pulmonary disorders, and pharyngeal and laryngeal changes. Increased insight into the pathogenesis of reflux and the relationship betwe...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::Carotid endarterectomy for carotid artery stenosis is valuable for some patients, but not all. Results of clinical trials in symptomatic and asymptomatic patients provide guidance on use of this common vascular procedure. The authors of this article describe the controversies and concerns with the procedure and give t...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.5.15.1093
更新日期:2000-05-15 00:00:00
abstract::The dose and dosing interval for leukotriene receptor antagonists montelukast and zafirlukast in adult asthmatic patients were determined by bronchoprovocation with exercise or leukotriene D4 inhalation. Subsequent dose-ranging studies confirmed that once-daily ingestion of a 10-mg dose of montelukast was effective an...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.09.15.2000.suppl7.40
更新日期:2000-09-15 00:00:00
abstract::Probably nothing in the field of medicine has changed as rapidly over the last decade as antiretroviral (ARV) therapy for HIV infection. New insights into pathogenesis, new tests for measuring virus levels in plasma, and availability of powerful new drugs have combined to transform the care of persons with HIV infecti...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1997.10.331
更新日期:1997-10-01 00:00:00
abstract::In developed countries, prevalence is increasing of malignancy-related secondary lymphedema, usually resulting from lymph node resection or irradiation. Untreated lymphedema usually increases over time, and the physical and psychological sequelae in even mild cases demand appropriate diagnosis and treatment. Patients ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.10.450
更新日期:1998-10-01 00:00:00
abstract::Chronic pain is considered one of the most prevalent causes of costly and disabling medical conditions. This review will define chronic pain and its categories and then will summarize the effectiveness and side effects associated with the use of various antidepressants, including the tricyclics, the selective serotoni...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1147925
更新日期:2016-01-01 00:00:00
abstract::Management of the acutely poisoned patient should start with decontamination of the skin and irrigation of the eyes, if necessary, and assessment of cardiorespiratory status, neurologic status, and pupils and eye movement. If a definable toxic syndrome is present, the specific "antidote" should be given. If no such sy...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716063
更新日期:1982-05-01 00:00:00
abstract:OBJECTIVES:There is limited and contradictory information regarding the role of serum ischemia-modified albumin (IMA) in obstructive sleep apnea (OSA). In this study we examine the effects of OSA and obesity on IMA and interleukin-6 (IL-6), and detect whether IMA and IL-6 may be potential biomarkers in OSA. METHODS:Fi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1203237
更新日期:2016-08-01 00:00:00
abstract::Primary care physicians have an important role in diagnosing and treating eye disorders--including dacryocystitis, blepharitis, and conjunctivitis--and in determining when ophthalmologic referral is needed. Fundus examination for diagnosis of glaucoma and diabetic eye complications should be a part of the routine exam...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::Cough in children, even in infants under 1 year of age, is a frequent problem in clinical practice. Many causes are possible and should be considered, but only a few are likely. In primary care, appropriate evaluation is based on skillful history taking. In an ostensibly healthy child or infant with recurrent episodes...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698430
更新日期:1983-09-01 00:00:00
abstract::The clinical history and physical examination remain the most important factors in determining the presence, anatomic location, and physiologic extent of arterial occlusive disease and the need for operation. The physician should refrain from ordering arteriography to confirm the diagnosis of arterial disease unless o...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714271
更新日期:1976-02-01 00:00:00
abstract::The term "autoimmune thyroid disease" encompasses all of the autoimmune thyroid conditions, including Hashimoto's thyroiditis, Graves' disease, most cases of silent thyroiditis, and postpartum thyroiditis. Extrathyroidal manifestations (e.g., ophthalmopathy, dermopathy) can occur in Graves' disease and, less commonly,...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2000.01.810
更新日期:2000-01-01 00:00:00
abstract::Maternal peripartum complications continue to be a significant problem in the United States, even among previously healthy women. The problems include peripartum bleeding, infection, hypertension, and thromboembolic disease. Primary care physicians are often called upon to treat these conditions. An awareness of the a...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::Several risks can be posed by travel, even when the stay is not protracted nor the destination exotic. Air travelers should consider the potential problems associated with decreased cabin pressure, hypoxia, and circadian dysrhythmia, problems that can contraindicate flying for some. Motion sickness can affect those tr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11698368
更新日期:1983-04-01 00:00:00
abstract::Preview New information emerges almost weekly about the relative importance of one factor or another in the development of coronary artery disease. Yet controversies continue over which factor deserves the most emphasis. Dr Elliott presents a broad and, at times, humorous look at research into cardiovascular risk fact...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945892
更新日期:1994-09-01 00:00:00
abstract::Treating rheumatoid arthritis can be very satisfying when patients participate fully in designing and implementing their therapeutic strategy. However, the strategy's success depends on early intervention and disease modification. Many patients do well when education, rest, diet, exercise, and drug therapy are incorpo...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.02.314
更新日期:1998-02-01 00:00:00
abstract::Febrile convulsions affect about 1 child in 30. Most of these children have a good outcome with no sequelae and do not require prophylactic medication. Differential diagnosis should include meningitis, epilepsy, hypoglycemia, and encephalopathies and other central nervous system disorders. Children with a high risk fo...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700905
更新日期:1991-04-01 00:00:00
abstract::Preview Back pain can be a symptom of any number of problems, most commonly mechanical, or structural, in nature. Among the nonmechanical causes is ankylosing spondylitis, an inflammatory disease that involves the spine and sometimes other joints and extra-articular organs. Dr Escalante explains how to differentiate t...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11945685
更新日期:1993-07-01 00:00:00
abstract::Careful attention to the practical aspects of oral anticoagulant therapy can improve patient compliance and lessen the risk of bleeding complications. A variety of risk factors for bleeding associated with oral anticoagulant therapy have been defined and should be assessed before initiating therapy. Recent investigati...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::Allergy is responsible for many problems in the pediatric age-group. At times the most difficult job for the physician is to determine if the patient is indeed allergic and, if so, to what. Allergy skin testing remains the first choice for diagnostic study. Treatment consists of avoiding the offending allergen if poss...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1984.11716317
更新日期:1984-05-01 00:00:00
abstract::Fluoroquinolone-resistant variants of pandemic clones Spain(23F)-1, Spain(6B)-2, Spain(9V)-3, and Spain(14)-5 have been seen in various regions of the United States and the world, leading to the speculation that fluoroquinolone resistance among US Streptococcus pneumoniae may increase because of clonal spread. Using l...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2008.09.suppl52.283
更新日期:2008-09-01 00:00:00
abstract::Readers are invited to submit questions relating to problem cases. Inquiries will be answered by qualified consultants and replies forwarded by mail promptly. Selected problems and solutions are published every month in this section. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1973.11713331
更新日期:1973-01-01 00:00:00
abstract::Glaucoma is a group of diseases leading to characteristic cupping and damage of the optic nerve head associated with progressive visual loss. The exact mechanism of damage is unknown, but current research is pointing toward a multifactorial disease process, in which elevated intraocular pressure is just one of the fac...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00