Survey-Based Analysis of the Clinical Treatment Status of Irritable Bowel Syndrome in Korea

Koo Hoon Sup,Son Hui Chang,이홍섭,Goong Hyeon Jeong,김주석,김기배,Kwon Yong Hwan,김재학,신현덕,Shin Ji Eun,지삼룡 대한의학회 2023 Journal of Korean medical science Vol.38 No.16

Background: The quality-of-life of patients with irritable bowel syndrome is low; incorrect diagnosis/treatment causes economic burden and inappropriate consumption of medical resources. This survey-based study aimed to analyze the current status of irritable bowel syndrome treatment to examine differences in doctors’ perceptions of the disease, and treatment patterns. Methods: From October 2019 to February 2020, the irritable bowel syndrome and Intestinal Function Research Study Group of the Korean Society of Neurogastroenterology and Motility conducted a survey on doctors working in primary, secondary, and tertiary healthcare institutions. The questionnaire included 37 items and was completed anonymously using the NAVER platform (a web-based platform), e-mails, and written forms. Results: A total of 272 doctors responded; respondents reported using the Rome IV diagnostic criteria (amended in 2016) for diagnosing and treating irritable bowel syndrome. Several differences were noted between the primary, secondary, and tertiary physicians’ groups. The rate of colonoscopy was high in tertiary healthcare institutions. During a colonoscopy, the necessity of random biopsy was higher among physicians who worked at tertiary institutions. ‘The patient did not adhere to the diet’ as a reason for ineffectiveness using low-fermentable oligo-, di-, and mono-saccharides, and polyols diet treatment was higher among physicians in primary/secondary institutions, and ‘There are individual differences in terms of effectiveness’ was higher among physicians in tertiary institutions. In irritable bowel syndrome constipation predominant subtype, the use of serotonin type 3 receptor antagonist (ramosetron) and probiotics was higher in primary/secondary institutions, while serotonin type 4 receptor agonist was used more in tertiary institutions. In irritable bowel syndrome diarrhea predominant subtype, the use of antispasmodics was higher in primary/secondary institutions, while the use of serotonin type 3 receptor antagonist (ramosetron) was higher in tertiary institutions. Conclusion: Notable differences were observed between physicians in primary/secondary and tertiary institiutions regarding the rate of colonoscopy, necessity of random biopsy, the reason for the ineffectiveness of low-fermentable oligo-, di-, and mono-saccharides, and polyols diet, and use of drug therapy in irritable bowel syndrome. In South Korea, irritable bowel syndrome is diagnosed and treated according to the Rome IV diagnostic criteria, revised in 2016.

과민성(過敏性) 대장증후군(大腸症候群)에 대한 문헌적(文獻的) 고찰(考察)

조윤성,정종안,홍광해,정경아,Cho, Yoon-Sung,Jung, Jong-An,Hong, Gwang-Hae,Jeong, Kyoung-Ah 대한한의학방제학회 2006 大韓韓醫學方劑學會誌 Vol.14 No.2

Objective & Methods : Irritable Bowel Syndrome is occurred frequently in daily life. Nevertheless. medical treatment of the Irritable Bowel Syndrome is almost dependent on western cure, but that cure is not effective enough. So we chose the oriental medicine textbook that were dealing with the oriental concept and the treatment of Irritable Bowel Syndrome. we got these results. Results were as follows : 1. Irritable Bowel Syndrome is characterised by recurrent or chronic abdominal pain, with distension, disturbed defecation and psychic problems without organic lesions. 2. The etiology of Irritable Bowel Syndrome include stress. disharmony of liver and spleen, the coldness of spleen and kidney and the lack of qi or yin, etc. 3. The oriental treatments of Irritable Bowel Syndrome are warming spleen and kidney, easing liver and stopping diarrhea. 4. The internal medication of Irritable Bowel Syndrome was the most used 11 times Tongsayobang(痛瀉要方) and 10 times Yijungtang(理中湯). 5. The most many used herb were Atractylodjs macrocephalae rhjzoma(白朮), Gjnseng Radix (人蔘), Cjnnamomj Cortex(肉桂), Polyporus(猪笭), etc.

과민대장증후군 환자를 소시호탕 합 작약감초탕 및 침 치료로 호전시킨 1례 : 증례보고

최치호,권승원,Choi, Chiho,Kwon, Seungwon 대한한방내과학회 2022 大韓韓方內科學會誌 Vol.43 No.5

Objectives: Irritable bowel syndrome is a functional disorder of the gastrointestinal tract marked by chronic abdominal pain and altered bowel habits. Irritable bowel syndrome is experienced by 11% of the global population. Although antidepressants and antispasmodic agents are currently used as therapeutic methods, they have side effects, so safer treatment agents are needed. Hence, I report the case of an outpatient who suffers from irritable bowel syndrome. Methods: The patient visited a public health center 14 times over four weeks and was treated with acupuncture and herbal medicine (Sosiho-tang and Jakyakgamcho-tang). Treatment progress was assessed using the Irritable Bowel Syndrome Severity Scoring System. Results: After 28 days of treatment, the Irritable Bowel Syndrome Severity Scoring System score decreased from 410 to 30 points without adverse events. The patient was highly satisfied. Conclusion: Sosiho-tang and Jakyakgamcho-tang with acupuncture might become recommended therapeutic options for irritable bowel syndrome patients.

체질량지수로 평가한 비만 및 허리둘레로 평가한 복부비만과 과민대장증후군의 연관성

이동영(Dong Young Lee),이정규(Jeong Gyu Lee),김영주(Young Joo Kim),이상엽(Sangyeop Lee),김윤진(Yun jin Kim) 대한임상노인의학회 2009 대한임상노인의학회지 Vol.10 No.2

Background: Irritable bowel syndrome is a functional bowel disease including chronic abdominal discomfort and abdominal pain which is relevant to changing of defecation feature. Irritable bowel syndrome's pathway is yet to be solved perfectly. Generally speaking, obesity affects gastrointestinal symptoms such as abdominal pain, nausea, vomiting, diarrhea and constipation. Therefore, there could be a relationship between obesity and irritable bowel syndrome. This research would like to figure out the corelation of obesity and irritable bowel syndrome and corelation of waist circumference which never been studied. Methods: The study group was from 90 colonoscopic exam patients of Health Promotion Center of Pusan national university. Among 90 of them, 19 were excluded because they had organic factor. Totally 71 patients' waist circumference were measured and researched on the corelation of Irritable bowel syndrome by using Rome II standard. Results: In women, the incident rate of obesity group (BMI≥25) and normal weight group (18.5≤BMI<25) were 60% and 9.5%, so that, the obesity group's incident rate was significantly increased in statistics. Relative risk of normal weight group without central obesity (M<90 cm, F<85 cm and 18.5≤BMI<25) compare with normal weight group with central obesity (M≥90 cm, F≥85 cm and 18.5≤BMI<25) was 4.23. Relative risk of obesity group with central obesity (M≥90 cm, F≥85 cm and BMI≥25) was 4.14. Conclusion: This research presented the corelation of irritable bowel syndrome and BMI in women and incident rate of patient with central obesity was significantly increased compare to normal weight group without central obesity. 연구배경: 과민대장증후군은 기질적 원인 없이 만성 복부 불쾌감이나 복통이 있으며 증상이 배변 양상의 변화와 관련되는 기능적 위장관 질환이다. 아직까지 과민대장증후군의 기전은 정확히 밝혀져 있지 않다. 비만은 복통, 구역, 구토, 설사, 변비 등 위장관 증상에 영향을 미친다. 본 연구는 비만 및 복부비만과 과민대장증후군의 연관성에 대해 알아보았다. 방법: 부산 소재의 3차 의료기관 외래와 건강증진센터를 방문하여 결장내시경 검사를 시행한 90명을 대상으로 하였다. 90명 중 기질적 원인을 가진 19명을 배제한 71명을 대상으로 체질량지수(body mass index, BMI)와 허리둘레(abdominal circumference, AC)를 측정하였고 로마 II 기준 사용하여 과민대장증후군과의 연관성을 조사하였다. 결과: 여성에서 비만(BMI≥25)군과 정상(18.5≤BMI<25)군을 비교시에 과민대장증후군의 유병률은 각각 60%, 9.5%로 유의하게 비만군에서 높게 나타났다. 정상(허리둘레; 남<90, 여<85 cm and 18.5≤BMI<25)군에 비해 복부비만(허리둘레; 남≥90, 여≥85 cm and 18.5≤BMI<25)군에서 오즈비(odds ratio)가 4.23이었으며, 복부비만 및 비만을 동시에 가진(허리둘레; 남≥90, 여≥85 cm and BMI≥25)군에서는 4.14로 나타났다. 결론: 본 연구결과 여성에서 과민대장증후군과 체질량지수와의 연관성이 있었고, 복부비만이 있을 경우 복부 비만이 없으며 체질량 지수가 정상인 경우보다 과민대장증후군의 위험도가 크게 나타났다.

대학생의 과민대장증후군 중증도 예측모형

박빈희(Park, Bin-Hee),이경숙(Lee, Kyung-Sook) 한국기초간호학회 2020 Journal of korean biological nursing science Vol.22 No.2

Purpose: The purpose of this study was to build and verify a structural model that could predict the severity of irritable bowel syndrome in university students. Methods: Participants were 205 students enrolled in college with irritable bowel syndrome using the irritable bowel syndrome module of the ROME IV Adult Questionnaire. The data were collected using online questionnaires in April- May 2019. The data were analyzed using the SPSS WIN 25.0 and AMOS 20.0 programs. Results: 1) The symptom severity that participants experienced were mild (14.6%), moderate (45.4%), and severe (40%). 2) Fit indices of the model were x2=79.66 (df=52, p=.009), CFI=.94, TLI=.96, RMSEA=.05, RMR=1.59, GFI=.94, and TLI=.96.3). The severity of irritable bowel syndrome was influenced directly by anxiety and sleep, and indirectly by family history, perfectionism, social support, coping, and stress. The severity of irritable bowel syndrome was indirectly affected by the following: family history through anxiety; perfectionism through stress, anxiety, and sleep; social support through coping, stress, anxiety, and sleep; coping through stress and anxiety; and stress through anxiety and sleep. Conclusion: Based on the results of this study, a nursing intervention is needed to reduce the anxiety and stress and improve the quality of sleep to improve the health of the college students and manage the symptoms of patients with irritable bowel syndrome.

Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place

( Rafiz Abdul Rani ),( Raja Affendi Raja Ali ),( Yeong Yeh Lee ) 대한장연구학회 2016 Intestinal Research Vol.14 No.4

Irritable bowel syndrome (IBS), a common gastrointestinal disorder involving the gut-brain axis, and inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder, are both increasing in incidence and prevalence in Asia. Both have significant overlap in terms of symptoms, pathophysiology, and treatment, suggesting the possibility of IBS and IBD being a single disease entity albeit at opposite ends of the spectrum. We examined the similarities and differences in IBS and IBD, and offer new thoughts and approaches to the disease paradigm. (Intest Res 2016;14:297-304)

과민성 장증후군의 한방치료 증례논문 분석

이연월 ( Lee Yeon Weol ),유화승 ( Yoo Hwa Seung ),조종관 ( Cho Chong Kwan ) 대전대학교 한의학연구소 2016 혜화의학회지 Vol.25 No.1

Objectives : The purpose of this study was to present the clinical guidelines for Korean medical treatment of Irritable Bowel Syndrome Methods : Reports for Korean medical treatment of Irritable Bowel Syndrome were collected, analyzed and summarized from the Electronic journal search since 2000. Results : In Korean medicine treatment of irritable bowel syndrome used herbs, acupuncture, moxibustion, herbal acupuncture, and auricular acupuncture. Herb medicines were administered according to the patient`s case by a prescription of considering physical condition and symptoms. Acupuncture and moxibustion therapies stimulate the median points of LR(足厥陰肝經), ST(足陽明胃經), LI(手陽明大腸經), SI(手太陽 小腸經). The assessment items for Korean medical treatment of Irritable Bowel Syndrome were abdominal symptoms, defecation, autonomic nervous system changes, stress, Live blood condition and mental health. Conclusions : Through continued research need to develop better treatment strategies for Korean treatment of Irritable Bowel Syndrome.

과민성 대장 증후근의 감별 - 감별진단을 위한 대장 생리 검사의 의의 -

나용호(Yong Ho Nah),유준형(June Hyung Lyou),유광현(Kwang Hyen You),최석채(Suck Chei Choi) 대한내과학회 1996 대한내과학회지 Vol.51 No.2

N/A Objectives: Irritable bowel syndrome (IBS) is a diagnosis of exclusion. There are no gold standard test that can yield a positive diagnosis. There has been considerable debate concerning the amount of investigation necessary to exclude organic disease. Certain diagnostic test should be performed routinely, whereas others ore selected on the basis of specific symptoms. The aim of this study was to determine the diagnostic value of the physiology test ot the bowel to exclude the organic disease in the suspected irritable bowel syndrome. Methods: 60 patients (M;34, F;26; mean age 46 years, range 18-67) with irritable bowel syndrome based on Manning criteria (negative colonoscopy, barium enema, biochemical tests, and stool examinadtions) were evaluated by hydrogen breath test, colon transit study, anorectal manometry, and defecography. Results: Based on these study, patients were categorized as having; no abnormalities, 27 patients; lactose intolerance, 16 patients among 24 diarrhea- predominant group, pelvic floor disorders (rectocele, rectal intussusception, anismus, descending perineal syndrome), 14 patients, and colonic inertia, 3 patients among 36 constipation-predominant group. Conclusion: Over 50% patients with the suspected irritable bowel syndrome have other organic or functionally disturbed disease. In addition to the routine studies, it is desirable to perform at least hydrogen breath test, colon transit study, anorectal manometry, and defecography.

과민성 대장증후군에서 Fenoverine(Fexadine^(�))과 Spabutine의 치료효과에 대한 비교연구

유종선,양대현,윤종만,윤정한 최신의학사 1993 最新醫學 Vol.36 No.5

Targeting Histamine Receptors in Irritable Bowel Syndrome: A Critical Appraisal

( Adam Fabisiak ),( Jakub Wlodarczyk ),( Natalia Fabisiak ),( Martin Storr ),( Jakub Fichna ) 대한소화기기능성질환·운동학회 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.3

Irritable bowel syndrome is a group of functional gastrointestinal disorders with not yet fully clarified etiology. Recent evidence suggesting that mast cells may play a central role in the pathogenesis of irritable bowel syndrome paves the way for agents targeting histamine receptors as a potential therapeutic option in clinical treatment. In this review, the role of histamine and histamine receptors is debated. Moreover, the clinical evidence of anti-histamine therapeutics in irritable bowel syndrome is discussed. (J Neurogastroenterol Motil 2017;23:341-348)