Talk:Irritable bowel syndrome

20-50% gastroenterology visits?

http://www.expresspharmaonline.com/20100115/market01.shtml

Why was this number deleted? —Preceding unsigned comment added by Hypernovic (talk • contribs) 22:25, 14 March 2010 (UTC)

Depression

I found a much more recent review article[1] which also cites the Ledochowski study. The interpretation is somewhat different:

"Fructose malabsorption has been associated with depression in young women with mood improvement following restriction of free fructose intake.68, 69 The mechanisms of these effects are poorly understood, but may involve low circulating levels of tryptophan, the precursor of serotonin.70 Such association is also consistent with the frequency of fatigue and lethargy in IBS."

"Other symptoms linked with fructose malabsorption, particularly mood and depression, have also been improved in patients following a ‘fructose-free’ diet. Thus, a 4-week exclusion diet in fructose malabsorbers has been shown to improve mood and depressive symptoms.69"

As far as I can see, major depression was not talked about by the Ledochowski study,[2] (source for the removed material), only an association with an increased Beck depression score. The Ledochowski study was also small (16 men, 34 women), with no blinding or controls. It only concludes, "Fructose malabsorption should be considered in patients with symptoms of depression and disturbances of tryptophan metabolism."

The material removed from the article was claiming much more than the Ledochowski study source. Ward20 (talk) 19:22, 10 April 2010 (UTC)

You need to be careful with studies like this because depression is highly susceptible to the placebo effect, and if there is no control then there is no way of knowing how much of the benefit is due to the placebo effect. Also the mechanism of fructose causing depression doesn't seem very plausible, so a lot of good evidence would be required before taking it seriously. --sciencewatcher (talk) 22:55, 10 April 2010 (UTC)

Agree. Editor Eloerc added more about fructose in the article then just the section that was removed [3]. Some material is obviously redundant and the rest should probably be examined for relevance and weight. Ward20 (talk) 23:20, 10 April 2010 (UTC)

Name change

Unsure why the name of this article was changed? Doc James (talk · contribs · email) 09:43, 11 April 2010 (UTC)

I explained on my talk page that I screwed up. There should be no redirect between these two articles, Irritable bowel syndrome and Irritable bowel disease. What I tried to do was remove the redirect and instead all I did was reverse the redirect. I tried to undo it but it didn't work. Would appreciate any help in removing the redirect completely. I've never done a redirect in all my time here so this would be a learning experience too. I read and read all I could about this but I guess I still didn't understand it. Sorry, --CrohnieGal^Talk 09:55, 11 April 2010 (UTC)

Well it looks like an editor found my error. This editor undid my move but there is still a problem with the IBD article being redirected to this article which it shouldn't be. Maybe the IBD article should be redirected to Inflammatory bowel disease or just left to stand on it's own? I don't know when the redirect was done and I don't know how to undo it. I still have it requested where you also commented. Thanks, --CrohnieGal^Talk 14:25, 11 April 2010 (UTC)

Is there even such a thing as 'irriable bowel disease'? I thought that was just people getting confused between IBS and IBD. Doing a quick search on google scholar seems to reveal that 'irritable bowel disease' is an occasionally used synonym for IBS, so I'd suggest either leaving the redirect so it points to IBS or just removing it entirely. It definitely shouldn't redirect to inflammatory bowel disease. --sciencewatcher (talk) 15:19, 11 April 2010 (UTC)

The initials IBD is commonly used for people with Inflammatory bowel disease like Crohn's disease or Ulcerative colitis. So it should redirect to that article or be deleted completely with anything in it that is salvagable put on the Inflammatory bowel disease article. I personally would like to see the redirect to there since a lot of people use the term IBD and it would take them to the correct article. IBD and IBS are not at all the same. Thanks, --CrohnieGal^Talk 15:50, 11 April 2010 (UTC)

Yes, IBD should definitely redirect to inflammatory bowel disease. However 'irritable bowel disease' should redirect to IBS, which I see it does. So I think everything is ok now. --sciencewatcher (talk) 17:33, 11 April 2010 (UTC)

Yes agree with sciencewatcher. Doc James (talk · contribs · email) 18:16, 11 April 2010 (UTC)

┌────────────────────────────────────────────────────────────────────────────────────────────────────┘ The problem with have the article Irritable bowel disease being redirected here is that it is incorrect. IBD stands for Inflammatory bowel disease which can be seen at that article. IBD and IBS are always confused as being the same thing which it is not. The main thing I can think of is that IBS never causes bleeding whereas IBD can. I think the redirect to this article should be removed and a redirect put to the Inflammatory bowel disease. Thanks, --CrohnieGal^Talk 16:48, 12 April 2010 (UTC)

Maybe a disambig page would be best which lists both and properly distinguishes them? Doc James (talk · contribs · email) 16:53, 12 April 2010 (UTC)

Crohnie, 'Irritable bowel disease' is not the same as 'Inflammatory bowel disease'. Just because they have the same first letters does not mean they are the same thing. 'Irritable bowel disease' is another term for IBS, although it seems to be infrequently used. If you redirected 'irritable bowel disease' to 'inflammatory bowel disease' that would be incorrect. I don't see the problem with IBD getting confused with IBS - as long as the IBD page lists 'inflammatory bowel disease' (which it does) and not 'irritable bowel disease' there should not be any confusion.

The only potential issue I can think of is people typing in 'irritable bowel disease' when they actually mean 'inflammatory bowel disease'. If that is an issue then maybe we should use Jmh649's suggestion to clearly distinguish between the two. --sciencewatcher (talk) 18:20, 12 April 2010 (UTC)

I agree with what Jmh649 and Sciencewatcher suggest. Thanks for all the input. I will not be doing anything since I do have a strong POV about this. I shouldn't be the one to make any changes like this. I'm sure you all understand. Thanks again, --CrohnieGal^Talk 18:50, 12 April 2010 (UTC)

Suppose I should have posted earlier here - per a discusson at WT:MED, I added disambiguation hat notes on 13th April.[4] David Ruben ^Talk 20:36, 25 April 2010 (UTC)

Thank you, yes that takes care of things nicely and puts my concerns to rest. Thanks again, --CrohnieGal^Talk 10:28, 26 April 2010 (UTC)

Fibromyalgia is not a psychiatric disease

This is biased information. Current thought on fibromyalgia is that it is an illness of central sensitization, an illness of the central nervous system.

Well there is some debate about that. The general consensus is that it probably is psychiatric, although it isn't classified as a psychiatric illness at present. However if you look at the reference for that statement in the article it actually lumps fibromyalgia in with 'nonpsychiatric conditions', so I think someone needs to take a closer look at that sentence and fix it. --sciencewatcher (talk) 15:18, 29 April 2010 (UTC)

Actually, on re-reading the article it does NOT say that fibromyalgia is psychiatric, but it isn't entirely clear. I'll just tweak it to make it more clear. --sciencewatcher (talk) 18:55, 29 April 2010 (UTC)

SarMarTay Suggestions 5-4-10 (Citations 1-26)

SarMarTay (talk) 16:47, 4 May 2010 (UTC)

In addition to these citation suggestions, I made minor text edits.

Irritable Bowel Syndrome:

1-(brief description of the disease) is a reliable source. This textbook can also be used:

Gastroenterology: an illustrated colour text By Graham P. Butcher

2-(bowel movement may relieve symptoms) is a primary literature article that should be replaced with a secondary source. Suggest deleting and replacing with [5]

For the second use of citation 2, the phrase "psychological interventions" is not supported by this source, so a separate source is required OR the wording can be changed to "...including dietary adjustments and medication." A secondary source that discusses psychological abnormalities and IBS is this textbook:

Gastroenterology: an illustrated colour text By Graham P. Butcher

3-(fructose malabsorption) is a primary literature article in German that should be replaced (See ref 4 comment).

4-(parasitic infections) is a dead link. I suggest deleting cites 3 and 4 and using a general reference such as a textbook or review for the entire sentence "Several conditions may present as IBS including celiac disease, Fructose malabsorption, mild infections, parasitic infections like giardiasis, several inflammatory bowel diseases, functional chronic constipation, and chronic functional abdominal pain." Citation 20 will work here, but "fructose" and "like giardiasis" should be removed.

5-(brain/body, gut flora or immune system) is a primary literature article that is not appropriate in this context (does not support the statement).

6-(brain/body, gut flora or immune system) is a primary literature review of IBS and gut flora and is relevent as of 2007. Citations for brain/body and immune system roles in IBS must be included here, too.

7-11-(IBS does not lead to other complications) are primary literature reviews that do not support the statement. I suggest replacing with a single secondary source such as[6].

12-15-(increased medical costs and absenteeism) are primary literature reviews that all basically come to similar conclusions. I suggest deleting all of these and replacing them with a single reference. I suggest citation 19 (The Burden of Illness of Irritable Bowel Syndrome: Current Challenges and Hope for the Future by DARRELL HULISZ, RPh, PharmD). Absenteeism is also in [7].

16-19-(prevalence and societal costs of IBS) are primary literature reviews that should also be deleted and replaced with citation 19.

Classification:

20-(types of IBS) is an appropriate primary literature review.

Symptoms:

21-23-(symptoms) are appropriate primary literature reviews [8] can also be added here.

Causes:

24-(infection increases IBS) is an appropriate primary literature review. However, the wording of the sentence "Post-infection, further risk factors are young age, prolonged fever, anxiety, and depression." is unclear. Are these additional factors that may lead to IBS, or are these symptoms due to IBS?

25-26-(brain/gut) are primary literature articles that are directly referred to in the text, so they should remain in the article.

SarMarTay (talk) 16:47, 4 May 2010 (UTC)

SarMarTay Suggestions 5-5-10 (Citations 27-42)

SarMarTay (talk) 16:31, 5 May 2010 (UTC)

-One or more citations are required for the "Immune reaction" section, preferably from secondary sources. This 2007 primary literature review discusses increased cytokine production in colons of IBS patients and will fit well here:

Role of infection in irritable bowel syndrome.[9]

27-28-(protozoa infection rates) are graphs that are not referred to in the text. 28 is a primary source and should be deleted. 27 (a review) can be cited later in the wiki after "Two of the protozoa investigated have a high prevalence in industrialized countries and infect the bowel, but little is known about them as they are recently emerged pathogens."

29-(Rifaximin) is a primary literature article that should be replaced with a secondary source. I am unable to find a non-primary source to support this section. Perhaps this should be moved to the Research or Treatment sections of this wiki.

30-(overgrowth of intestinal flora) is a primary literature article that should be replaced with a secondary source. I suggest using this 2009 primary literature review:

Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis. [10]

6-(protozoa and IBS) is an acceptable primary literature review.

31-32-(increase in protozoa infection in IBS patients) are primary literature articles that should be replaced with a secondary source. The following review discusses this topic with regards to Blastocystis, but it is not from a mainstream journal (a textbook or mainstream review cite is desired):

Blastocystis hominis and bowel diseases[11]

33-(blastocystis symptoms) is a primary literature article that should be replaced in this context with a secondary source. This CDC website will work:

http://www.cdc.gov/ncidod/dpd/parasites/blastocystishominis/factsht_blastocystis_hominis.htm

34-(blastocystis symptoms contested by some physicians) is a primary literature article that should be replaced with a secondary source. The CDC website will also work here:

http://www.cdc.gov/ncidod/dpd/parasites/blastocystishominis/factsht_blastocystis_hominis.htm

35-(London infection rates) is a primary literature article that is appropriate because it is directly cited. It is currently a dead link.

31-(Pakistan infection rates) is a primary literature article that is appropriate here because it is directly cited.

32-(Italy infection rates) is a primary literature article that is appropriate here because it is directly cited.

36-(fail to identify blast infection) is a primary literature article that should be replaced with a secondary source. I suggest:

http://www.cdc.gov/ncidod/dpd/parasites/blastocystishominis/factsht_blastocystis_hominis.htm#should

34,37-39-(blast may not respond to treatment) are primary literature articles that should be replaced by a single secondary source. Again, the CDC site is sufficient:

http://www.cdc.gov/ncidod/dpd/parasites/blastocystishominis/factsht_blastocystis_hominis.htm#should

-I suggest citing D. fragilis infection symptoms with:

http://www.cdc.gov/ncidod/dpd/parasites/dientamoeba/factsht_dientamoeba.htm#symptoms

27-(See above) is an appropriate primary literature review.

40-(fragilis resolves with antibiotics) is a primary literature article that should be replaced with a secondary source. I suggest using:

http://www.cdc.gov/ncidod/dpd/parasites/dientamoeba/factsht_dientamoeba.htm#medication

Later, 40 is used to cite "Researchers have noted that methods used clinically may fail to detect some Dientamoeba fragilis infections." I suggest using:

http://www.cdc.gov/ncidod/dpd/parasites/dientamoeba/factsht_dientamoeba.htm#diagnosis

41-(fragilis causes IBS-like symptoms and can be treated) is a primary literature article that is directly cited, so it is appropriate. This is currently a dead link.

42-(fragilis found in non-IBS patients) is a primary literature article that should be deleted. I don't think a source is necessary here.

SarMarTay (talk) 16:31, 5 May 2010 (UTC)

SarMarTay Suggestions 5-5-10 (Citations 43-59)

SarMarTay (talk) 18:39, 5 May 2010 (UTC)

Diagnosis:

43-(IBS is a diagnosis of exclusion, suggested screening) is an appropriate primary literature review. This information can also be found in the textbook:

Gastroenterology: an illustrated colour text By Graham P. Butcher

44-(compared criteria for diagnosis) is an appropriate primary literature review.

45-(assessment of IBS diagnosis) is an acceptable primary literature review.

46-(patients with hidden constipation) is a primary literature article that is directly referenced in the text and should remain. The rest of this paragraph is a summary of this paper, so I suggest citing 46 again at the end of the paragraph. There is no link for this citation.

47-51-(misdiagnosis as IBS when really other conditions) are primary literature articles that should be replaced with a single secondary reference. Cite 20 can be used except it does not specifically reference heliobacter pylori (a bacteria), though it does have bacteria listed.

52-(IBS Celiacs recommendation) is an appropriate primary literature opinion article.

53-(medications may cause IBS-like symptoms) is a primary literature article that should be replaced with a secondary source. I suggest using citation 20.

23-(%of comorbidity) is an appropriate primary literature review.

54-(comorbidities) is a primary literature article that is directly cited in the text so it is appropriate. However, I suggest changing the wording of the sentence to "Irritable Bowel Syndrome is associated with headache, fibromyalgia, chronic fatigue syndrome and depression." This statement can be supported by a number of sources, including citation 20 and

Gastroenterology: an illustrated colour text By Graham P. Butcher (textbook)

7-10-(IBS and IBD) are acceptable primary literature reviews.

11-(specific IBS/IBD study) is a primary research article that is acceptable b/c it is directly referenced in the text.

55-57-(IBS and unnecessary abdominal surgery) are primary literature articles that are acceptable b/c they are directly mentioned in the article. However, there are a number of secondary sources that describe increased abdominal surgeries in IBS patients, including citation 19.

58-(migraine, endometriosis, IBS link) is a primary literature article that is appropriate because it is directly cited in the text.

59-(link to other chronic disorders) is a mayo clinic link to a small description of Interstitial cystitis. The wiki description was copied and pasted from this website. This section should be deleted, reworded and the mayo clinic link can be used as a citation:

[12]

SarMarTay (talk) 18:39, 5 May 2010 (UTC)

SarMarTay Suggestions 5-5-10 (Citations 60-92)

SarMarTay (talk) 00:27, 6 May 2010 (UTC)

Management:

60-(overview of treatment success) is an appropriate primary literature review.

61-(restrictive diets) is an appropriate primary literature review.

62-(lactose-free diet) is a primary literature article that should be replaced with a secondary source. I recommend:

[13]

63-(fructose malabsorption) is a website that is currently a dead link.

64-65-(IgG diet) is a primary literature article that is acceptable b/c it is directly referenced in the text. The link to 65 is the same link as 64. I think 65 should be deleted anyway because the statement does not need a reference.

66-(gastrocolic response) is a primary literature article that should be replaced with a secondary source. I am unable to find a secondary source at this time.

67-75-(fiber data) are primary literature sources that are acceptable because they are directly referenced in the wiki text. I would also suggest including one or more general citations regarding fiber, including:

http://digestive.niddk.nih.gov/ddiseases/pubs/ibs/#help

76-79-(medication overview) are acceptable primary literature reviews.

80-(laxatives) is a primary literature article that should be replaced with a secondary source.

-The Lubiprostone section appears to have been copied from answers.com

-The Antispasmotics section appears to have been copied from cureirritablebowel.com

-The Tegaserod section appears to have been copied from mayoclinic.com —Preceding unsigned comment added by SarMarTay (talk • contribs) 02:49, 6 May 2010 (UTC)

81-(Zelnorm effectiveness) is a primary literature article that is appropriate because it is referenced in the wiki, though a secondary source is desired. I suggest:

Updates on treatment of irritable bowel syndrome.[14]

Also, this section describes the history of Zelnorm approval, which is not necessarily appropriate for this article. I suggest describing Zelnorm's effectiveness in one sentence with a link to a Zelnorm wiki that discusses the history of the medication. The suggested citation also hits on Zelnorm approval.

82-85-(SSRI effectiveness) are primary literature articles that should be replaced with a secondary source. I suggest:

Role of serotonin in gastrointestinal motility and irritable bowel syndrome.[15]

86-(antidepressant effectiveness) is a pay-only website and should be replaced with a secondary citation that is accessible to the general public. I suggest citation 87 or:

[16]

87-88-(antidepressant effectiveness) 87 is a review and acceptable (mentioned above). 88 is acceptable because it is a primary research article that is referenced in the text.

89-90-(rafiximin) 89 is a primary literature article that is acceptable because it is referenced in the wiki text. 90 is an acceptable review about gut flora in IBS patients.

91-(domperidone) is a primary literature article that should be replaced with a secondary source. There is no link to citation 91. I am unable to find a secondary reference.

92-(opiods) is a dead link to a textbook.

SarMarTay (talk) 00:27, 6 May 2010 (UTC)

SarMarTay Suggestions 5-5-10 (Citations 93-115)

SarMarTay (talk) 01:16, 6 May 2010 (UTC)

-Cites 93-95 (phsycological treatments) are primary literature sources that should be replaced with a single secondary source. Citation 67 will work or many textbooks discuss psycological treatments, including:

Gastroenterology: an illustrated colour text By Graham P. Butcher

96-(questionnaire on IBS) is an acceptable primary research article because it is referenced in the wiki text.

97 and 100-(probiotics) are acceptable primary research reviews.

98-(probiotics) is a primary research article and the data is discussed in citation 97.

99-(probiotics) is a press release and should be deleted. A citation is not required because the information is discussed in citation 97.

101-(probiotics) is a dead link to Mayo Clinic.

102-(peppermint oil) is a primary source that should be replaced with a secondary source. I suggest using the citation 60 review. Or, this information is discussed on websites and textboooks.

The section concerning peppermint oil usage to treat IBS suggests that all IBS sufferers should use peppermint oil. This statement is medical advice and should be deleted.

103-(iberogast) is a primary source that should be replaced with a secondary source.

-Cite 104 (acupuncture) is a primary research article that is acceptable because it is directly referenced in the wiki text. However, a secondary article is desired.

-Graph with % population with IBS is not cited in the text. It should be cited OR removed.

-Cites 105-110 (% population with IBS) and table are direct references from primary data and are sufficient as citations.

History:

-Cite 111 (first IBS symptoms reported) is a direct reference from primary literature and is sufficient.

Economics:

-Cites 112-113 (monetary costs of IBS) are direct references from primary literature and are sufficient.

Research:

-Cite 114 (fructose diet) is a direct reference and is sufficient in the Research section.

-Cite 115 (IgG diet) is a direct reference and is sufficient in the Research section.

SarMarTay (talk) 01:16, 6 May 2010 (UTC)

Can you condense and/or shorten some of this. It's gotten to the point where too long; didn't read gets applied. Also, you just need to sign at the end of your post not in the beginning nor in the subject line. Thanks in advance, --CrohnieGal^Talk 10:26, 6 May 2010 (UTC)

Agreed. If you want to help fix the references in the article, that is great - just go ahead and do it. No need to post a whole load of references here for us to look through. --sciencewatcher (talk) 14:26, 6 May 2010 (UTC)

I am concerned that reviews and meta-analysis's have been wrongly labeled as primary sources as well as other issues with this analysis of sources which I have addressed on the SarMarTays talk page. I reviewed some of the changes and flagging and saw lots of inappropriate flaggings and decided to boldly revert. Hopefully SarMar will understand my bold revert.--Literaturegeek | T@1k? 15:16, 8 May 2010 (UTC)

(outdent), I think I see one problem, SarMar is interpreting review articles as being primary sources because they are reviewing primary sources, presumably SarMar mistakenly thinks a secondary source is one that only reviews reviews or something. A secondary source comments and reviews or analyses primary source. As a result of this misinterpretation even a meta-analysis by Cochrane Review was labeled a primary source! Primary sources are not forbidden on wikipedia just simply used more cautiously and secondary sources given preference.--Literaturegeek | T@1k? 15:20, 8 May 2010 (UTC)

SarMarTay: You can easily see if something is a review by clicking on the "MeSH Terms" in pubmed and it will say "Review". --sciencewatcher (talk) 16:16, 8 May 2010 (UTC)

I think you'll find it's a bit more complicated than that. What Wikipedia declares to be a secondary source for our purposes is not always what an academic or professional would consider a secondary source. For that matter, what Wikipedia declares to be a secondary source depends on the context: The same article from a newspaper would considered a secondary source for the purpose of notability, but a primary source for the purpose of WP:NPOV. WhatamIdoing (talk) 04:41, 18 May 2010 (UTC)

I understand that, but for medical info in medical articles a secondary source is a high quality review. I'm just saying how you figure out the 'review' bit. Deciding if it is 'high quality' is another issue altogether. --sciencewatcher (talk) 14:45, 18 May 2010 (UTC)

Ref numbers

It is not always clear which version of the article SarMarTay's ref numbers pertain to, as some were added during the time period for the above comments. The starting point would have been this rev, bit it is possible that the subsequent changes to the article impacted the number/ref mapping. Please use caution.LeadSongDog come howl 17:11, 12 May 2010 (UTC)

Google Project

Hi guys,

Let me provide a little (possibly useful) context: Google's private foundation is supporting expansions of the Swahili Wikipedia, Spanish Wikipedia, and Arabic Wikipedia. (See this announcement.) Forty medicine- or health-related articles have been identified as targets, including this one. Basically, Google is having these articles reviewed and professionally translated -- and we want the translators looking at good, accurate, globally relevant articles.

The comments above represent one of the first reviews by an outside expert (an expert in medical writing, not an expert in Wikipedia's ways!). Other articles will be reviewed soon. You are not required to do anything at all, but I know all the regular editors on this page, and SarMarTay is fortunate to have been assigned an article with such a great, hard-working group. I hope that you will help identify and implement the best of the suggestions. Even small improvements are very much appreciated and will be very helpful to the other Wikipedias. Think of this as a great opportunity to pick a couple of the comments above that you think are most important, and to improve this article. This is such an important subject for our readers, and I'd really love to see it reach Good Article status.

As a suggestion for managing this long list, another page has been using templates from the {{done}} and {{notdone}} family to keep track of what needs doing, what is finished, what is confusing, and what suggestions have been rejected.

If you're curious, here's the rest of the target list. If you are interested in helping with the overall project, please consider adding Wikipedia:WikiProject Medicine/Google Project to your watchlist, improving any articles on the list, and/or contributing advice at the talk page. All editors are welcome. Also, if you have opinions about what does or doesn't work for you, please leave a note at the project's talk page. Thanks, WhatamIdoing (talk) 04:33, 18 May 2010 (UTC)

Yes, this is a good idea and hopefully people will take some of SarMayTay's suggestions and improve the article. This article is important because IBS is "one of the most common disorders seen by doctors" and "the most common condition seen by gastroenterologists" (according to a quick google search, although we don't have that info in the article anywhere). --sciencewatcher (talk) 15:05, 18 May 2010 (UTC)

Missing medication

I was surprised that the medication section did not include Pinaverium Bromide, marketed as dicetel. it is a colon muscle relaxant that I take, and is quite effective in my case. —Preceding unsigned comment added by 96.49.152.4 (talk) 06:36, 24 May 2010 (UTC)

Differential diagnosis

Most of the text under Differential diagnosis belongs under the main heading Diagnosis. I've added the main diseases eliminated in a thorough differential diagnosis. Anthony (talk) 18:08, 24 October 2010 (UTC)

PoV in alt med section

I mean: "Due to often unsatisfactory results from medical treatments for IBS". So treatment is apparently ineffective... Then "up to 50 percent of people turn to complementary alternative medicine." Is there are reason to include the percentage other to increase the perceived validity of AM ?

Then it continues: "Probiotics -can be- beneficial in the treatment of IBS" . Finally "There is good evidence of a beneficial effect of these capsules " . Good evidence? does not sound scientific at all, does it? —Preceding unsigned comment added by 190.103.73.109 (talk) 00:50, 15 December 2010 (UTC)

Looking through the first reference, it completely supports the first sentence of this section. Not only that, but it appears to be a pretty good review and it also matches my own perception of IBS. Also, the review states 'Peppermint oil and probiotics are supported by enough evidence to recommend their use' - so 'good evidence' is correct and scientific. I'm certainly not a fan of quackery (check my edits), but I don't see any problem with this section. --sciencewatcher (talk) 15:40, 15 December 2010 (UTC)

PLEASE HELP ME..

I'm at present 20 years old(male). I'm from south India. I have been suffering from alternating Diarrhea and Constipation over 2-3 years. I had undergone a colonoscopy last year and found to have ulcers in my intestine.He also told me to undergo certain tests. But due to lack of money I avoided them. Doctor asked me to avoid wheat products and to use his prescription for 3 months. I followed his advice and avoided the wheat products completely. From then onwards I still have the same problem but with severe. So I thought that it may take time to cure. But the problem continued over with small periods of mild attacks. Since I'm a college student I'm facing serious problems of lack of attendance during those mild attacks. From last three days this problem became very severe. The main thing is that I usually face this problem in the morning session only. The rest of the day is very cool for me. I can't understand the problem. Please help me in finding out my problem and aiding me in my diet. Please tell what food should I take to get relief from these problems. —Preceding unsigned comment added by 202.133.61.84 (talk) 15:09, 18 December 2010 (UTC)

I'm sorry but we can't give medical advice plus you should ask for medical advise on the net. Go back to your doctor and talk about this. Sorry,--CrohnieGal^Talk 15:16, 18 December 2010 (UTC)

SSRIs

There appears to be a contradiction of sorts in the Management: Medication section with regard to SSRIs. Under the Tricyclic antidepressants subheader it asserts that there is "little evidence of effectiveness of other antidepressant classes such as the SSRIs", but under the Serotonin agonists section, it states that "Selective serotonin reuptake inhibitor anti-depressants (SSRIs), because of their serotonergic effect, would seem to help IBS, especially patients who are constipation predominant. Initial crossover studies and randomized controlled trials support this role." The phrasing "would seem to help" suggests that perhaps there isn't sufficient evidence to say so with more confidence, but if there are studies that support this, isn't that some evidence? Perhaps this could be clarified? — Preceding unsigned comment added by Lzzzl (talk • contribs) 05:44, 18 March 2011 (UTC)

Those 2 reviews used in the first paragraph don't seem to be the most authoritative. The French one only has 1 citation, and the other one is written by a 2nd-year medical student and only has 27 citations. --sciencewatcher (talk) 14:54, 18 March 2011 (UTC)

Opening sentence

The opening sentence should not be "Irritable bowel syndrome is a diagnosis of exclusion". This is only a fancy way of saying what IBS is not. "Diagnosis of exclusion" probably belongs in the lead somewhere, probably in the second paragraph, but the opening should say what IBS is. 86.41.46.205 (talk) 08:20, 10 August 2011 (UTC)

Just a placeholder for "we don't have a clue"?

Isn't this "IBS" just a (pseudo-scientific) placeholder for "we don't have a clue"? The same goes for "functional symptom" (in which case, even if the source of disease is of psychological origin, there is still some gland (or what-have-you) acting up). --90.157.252.17 (talk) 06:39, 14 September 2011 (UTC)

If you read my insert about the FODMAP diet (below), it would your statement is no longer true (i would have agreed even a week ago). Everything that is now known was once a puzzle. Looks like IBS is being solved. — Preceding unsigned comment added by 90.193.233.44 (talk) 23:42, 1 December 2011 (UTC)

FODMAP diet

The Fodmap diet is especially beneficial for IBS sufferers. This contradicts some of the article. The relatively recent diet is based on molecular groups of natural compounds found in food, which ferment in the gut producing the gases and bowel movement symptoms. Will someone please add the fodmap diet to the article. here are some references:

http://fodmap.com/ http://foodhospital.channel4.com/conditions/irritable-bowel-syndrome/low-fodmap-diet

general supporting article: http://ibs.about.com/od/ibsfood/a/The-Fodmap-Diet-For-IBS.htm 90.193.233.44 (talk) 23:39, 1 December 2011 (UTC)

Thanks for your suggestion. The FODMAP diet does look interesting. The last link you provide gives a caution, however:

"Currently, all of the published work on the FODMAP theory for IBS is being done by a related group of researchers. Further studies must be conducted, at a variety of sites, to further test the theory's assumptions and to evaluate the effect of a low FODMAP diet in reducing IBS symptoms."

That suggests that while we might make brief mention of FODMAP, we need to also add the caution that these studies are from an interrelated group of researchers and there have not yet been studies to confirm these findings. Go ahead and add something along those lines, if you wish. Note that a citation from a reliable source is needed. If you would like help with that, please contact me on my talk page. Sunray (talk) 21:17, 4 December 2011 (UTC)