irritable bowel syndrome (redirected from Rome II Conference)

Irritable Bowel Syndrome 

Definition

Irritable bowel syndrome (IBS) is a common intestinal condition characterized by abdominal pain and cramps; changes in bowel movements (diarrhea, constipation, or both); gassiness; bloating; nausea; and other symptoms. There is no cure for IBS. Much about the condition remains unknown or poorly understood; however, dietary changes, drugs, and psychological treatment are often able to eliminate or substantially reduce its symptoms.

Description

IBS is the name people use today for a condition that was once called—among other things—colitis, mucous colitis, spastic colon, nervous colon, spastic bowel, and functional bowel disorder. Some of these names reflected the now outdated belief that IBS is a purely psychological disorder, a product of the patient's imagination. Although modern medicine recognizes that stress can trigger IBS attacks, medical specialists agree that IBS is a genuine physical disorder—or group of disorders—with specific identifiable characteristics.

No one knows for sure how many Americans suffer from IBS. Surveys indicate a range of 10-20%, with perhaps as many as 30% of Americans experiencing IBS at some point in their lives. IBS normally makes its first appearance during young adulthood, and in half of all cases symptoms begin before age 35. Women with IBS outnumber men by two to one, for reasons that are not yet understood. IBS is responsible for more time lost from work and school than any medical problem other than the common cold. It accounts for a substantial proportion of the patients seen by specialists in diseases of the digestive system (gastroenterologists). Yet only half-possibly as few as 15%—of IBS sufferers ever consult a doctor.

Causes and symptoms

Symptoms

The symptoms of IBS tend to rise and fall in intensity rather than growing steadily worse over time. They always include abdominal pain, which may be relieved by defecation; diarrhea or constipation; or diarrhea alternating with constipation. Other symptoms—which vary from person to person—include cramps; gassiness; bloating; nausea; a powerful and uncontrollable urge to defecate (urgency); passage of a sticky fluid (mucus) during bowel movements; or the feeling after finishing a bowel movement that the bowels are still not completely empty. The accepted diagnostic criteria—known as the Rome criteria—require at least three months of continuous or recurrent symptoms before IBS can be confirmed. According to Christine B. Dalton and Douglas A. Drossman in the American Family Physician, an estimated 70% of IBS cases can be described as "mild;" 25% as "moderate;" and 5% as "severe." In mild cases the symptoms are slight. As a general rule, they are not present all the time and do not interfere with work and other normal activities. Moderate IBS occasionally disrupts normal activities and may cause some psychological problems. People with severe IBS often find living a normal life impossible and experience crippling psychological problems as a result. For some the physical pain is constant and intense.

Causes

Researchers remain unsure about the cause or causes of IBS. It is called a functional disorder because it is thought to result from changes in the activity of the major part of the large intestine (the colon). After food is digested by the stomach and small intestine, the undigested material passes in liquid form into the colon, which absorbs water and salts. This process may take several days. In a healthy person the colon is quiet during most of that period except after meals, when its muscles contract in a series of wavelike movements called peristalsis. Peristalsis helps absorption by bringing the undigested material into contact with the colon wall. It also pushes undigested material that has been converted into solid or semisolid feces toward the rectum, where it remains until defecation. In IBS, however, the normal rhythm and intensity of peristalsis is disrupted. Sometimes there is too little peristalsis, which can slow the passage of undigested material through the colon and cause constipation. Sometimes there is too much, which has the opposite effect and causes diarrhea. A Johns Hopkins University study found that healthy volunteers experienced 6-8 contractions of the colon each day, compared with up to 25 contractions a day for volunteers suffering from IBS with diarrhea, and an almost complete absence of contractions among constipated IBS volunteers. In addition to differences in the number of contractions, many of the IBS volunteers experienced powerful spasmodic contractions affecting a larger-than-normal area of the colon—"like having a Charlie horse in the gut," according to one of the investigators.

DIET. Some kinds of food and drink appear to play a key role in triggering IBS attacks. Food and drink that healthy people can ingest without any trouble may disrupt peristalsis in IBS patients, which probably explains why IBS attacks often occur shortly after meals. Chocolate, milk products, caffeine (in coffee, tea, colas, and other drinks), and large quantities of alcohol are some of the chief culprits. Other kinds of food have also been identified as problems, however, and the pattern of what can and cannot be tolerated is different for each person. Characteristically, IBS symptoms rarely occur at night and disrupt the patient's sleep.

STRESS. Stress is an important factor in IBS because of the close nervous system connections between the brain and the intestines. Although researchers do not yet understand all of the links between changes in the nervous system and IBS, they point out the similarities between mild digestive upsets and IBS. Just as healthy people can feel nauseated or have an upset stomach when under stress, people with IBS react the same way, but to a greater degree. Finally, IBS symptoms sometimes intensify during menstruation, which suggests that female reproductive hormones are another trigger.

Diagnosis

Diagnosing IBS is a fairly complex task because the disorder does not produce changes that can be identified during a physical examination or by laboratory tests. When IBS is suspected, the doctor (who can be either a family doctor or a specialist) needs to determine whether the patient's symptoms satisfy the Rome criteria. The doctor must rule out other conditions that resemble IBS, such as Crohn's disease and ulcerative colitis. These disorders are ruled out by questioning the patient about his or her physical and mental health (the medical history), performing a physical examination, and ordering laboratory tests. Normally the patient is asked to provide a stool sample that can be tested for blood and intestinal parasites. In some cases x rays or an internal examination of the colon using a flexible instrument inserted through the anus (a sigmoidoscope or colonoscope) is necessary. The doctor also may ask the patient to try a lactose-free diet for two or three weeks to see whether lactose intolerance is causing the symptoms.

Treatment

Dietary changes, sometimes supplemented by drugs or psychotherapy, are considered the key to successful treatment. The following approach, offered by Dalton and Drossman, is typical of the advice found in the medical literature on IBS. The authors tie their approach to the severity of the patient's symptoms:

Mild symptoms

Dalton and Drossman recommend a low-fat, high-fiber diet. Problem-causing substances such as lactose, caffeine, beans, cabbage, cucumbers, broccoli, fatty foods, alcohol, and medications should be identified and avoided. Bran or 15-25 grams a day of an over-the-counter psyllium laxative (Metamucil or Fiberall) may also help both constipation and diarrhea. The patient can still have milk or milk products if lactose intolerance is not a problem. People with irregular bowel habits—particularly constipated patients—may be helped by establishing set times for meals and bathroom visits.

Moderate symptoms

The advice given by Dalton and Drossman in mild cases applies here as well. They also suggest that patients keep a diary of symptoms for two or three weeks, covering daily activities including meals, and emotional responses to events. The doctor can then review the diary with the patient to identify possible problem areas.

Although a high-fiber diet remains the standard treatment for constipated patients, such laxatives as lactulose (Chronulac) or sorbitol may be prescribed. Loperamide (Imodium) and cholestyramine (Questran) are suggested for diarrhea. Abdominal pain after meals can be reduced by taking antispasmodic drugs such as hyoscyamine (Anaspaz, Cystospaz, or Levsin) or dicyclomine (Bemote, Bentyl, or Di-Spaz) before eating.

Dalton and Drossman also suggest psychological counseling or behavioral therapy for some patients to reduce anxiety and to learn to cope with the pain and other symptoms of IBS. Relaxation therapy, hypnosis, biofeedback, and cognitive-behavioral therapy are examples of behavioral therapy.

Severe symptoms

When IBS produces constant pain that interferes with everyday life, antidepressant drugs can help by blocking pain transmission from the nervous system. Dalton and Drossman also underscore the importance of an ongoing and supportive doctor-patient relationship.

Alternative treatment

Alternative and mainstream approaches to IBS treatment overlap to a certain extent. Like mainstream doctors, alternative practitioners advise a high-fiber diet to reduce digestive system irritation. They also suggest avoiding alcohol, caffeine, and fatty, gassy, or spicy foods. Recommended stress management techniques include yoga, meditation, hypnosis, biofeedback, and reflexology. Reflexology is a technique of foot massage that is thought to relieve diarrhea, constipation, and other IBS symptoms.

Alternative medicine also emphasizes such herbal remedies as ginger (Zingiber officinale), buckthorn (Rhamnus purshiana), and enteric-coated peppermint oil. Enteric coating prevents digestion until the peppermint oil reaches the small intestine, thus avoiding irritation of the upper part of the digestive tract. Chamomile (Matricaria recutita), valerian (Valeriana officinalis), rosemary (Rosemarinus officinalis), lemon balm (Melissa officinalis), and other herbs are recommended for their antispasmodic properties. The list of alternative treatments for IBS is in fact quite long. It includes aromatherapy, homeopathy, hydrotherapy, juice therapy, acupuncture, chiropractic, osteopathy, naturopathic medicine, and Chinese traditional herbal medicine.

Prognosis

IBS is not a life-threatening condition. It does not cause intestinal bleeding or inflammation, nor does it cause other bowel diseases or cancer. Although IBS can last a lifetime, in up to 30% of cases the symptoms eventually disappear. Even if the symptoms cannot be eliminated, with appropriate treatment they can usually be brought under control to the point where IBS becomes merely an occasional inconvenience. Treatment requires a long-term commitment, however; six months or more may be needed before the patient notices substantial improvement.

Resources

Organizations

International Foundation for Functional Gastrointestinal Disorders. P.O. Box 17864, Milwaukee, WI 53217. (888) 964-2001. http://www.iffgd.org.

National Digestive Diseases Information Clearinghouse. 2 Information Way, Bethesda, MD 20892-3570. (800) 891-5389. http://www.niddk.nih.gov/health/digest/nddic.htm.

Key terms

Anus — The opening at the lower end of the rectum.

Crohn's disease — A disease characterized by inflammation of the intestines. Its early symptoms may resemble those of IBS.

Defecation — Passage of feces through the anus.

Feces — Undigested food and other waste that is eliminated through the anus. Feces are also called fecal matter or stools.

Lactose — A sugar found in milk and milk products. Some people are lactose intolerant, meaning they have trouble digesting lactose. Lactose intolerance can produce symptoms resembling those of IBS.

Peristalsis — The periodic waves of muscular contractions that move food through the intestines during the process of digestion.

Ulcerative colitis — A disease that inflames and causes breaks (ulcers) in the colon and rectum, which are parts of the large intestine.

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syndrome /syn·drome/ (sin´drōm) a set of symptoms occurring together; the sum of signs of any morbid state; a symptom complex. See also entries under disease.

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Aarskog syndrome , Aarskog-Scott syndrome a hereditary X-linked condition characterized by ocular hypertelorism, anteverted nostrils, broad upper lip, peculiar scrotal “shawl” above the penis, and small hands.

acquired immune deficiency syndrome , acquired immunodeficiency syndrome an epidemic, transmissible retroviral disease caused by infection with the human immunodeficiency virus, manifested in severe cases as profound depression of cell-mediated immunity, and affecting certain recognized risk groups. Diagnosis is by the presence of a disease indicative of a defect in cell-mediated immunity (e.g., life-threatening opportunistic infection) in the absence of any known causes of underlying immunodeficiency or of any other host defense defects reported to be associated with that disease (e.g., iatrogenic immunosuppression).

acute coronary syndrome  a classification encompassing clinical presentations ranging from unstable angina through non, sometimes also including Q wave infarction.

acute radiation syndrome  a syndrome caused by exposure to a whole body dose of over 1 gray of ionizing radiation; symptoms, whose severity and time of onset depend on the size of the dose, include erythema, nausea and vomiting, fatigue, diarrhea, petechiae, bleeding from the mucous membranes, hematologic changes, gastrointestinal hemorrhage, epilation, hypotension, tachycardia, and dehydration; death may occur within hours or weeks of exposure.

acute respiratory distress syndrome  (ARDS) fulminant pulmonary interstitial and alveolar edema, which usually develops within a few days after the initiating trauma, thought to result from alveolar injury that has led to increased capillary permeability.

acute retinal necrosis syndrome  necrotizing retinitis with uveitis and other retinal pathology, severe loss of vision, and often retinal detachment; of viral etiology.

Adams-Stokes syndrome  episodic cardiac arrest and syncope due to failure of normal and escape pacemakers, with or without ventricular fibrillation; the principal manifestation of severe heart attack.

addisonian syndrome  the complex of symptoms resulting from adrenocortical insufficiency; see Addison's disease, under disease.

Adie's syndrome  tonic pupil associated with absence or diminution of certain tendon reflexes.

adrenogenital syndrome  a group of syndromes in which inappropriate virilism or feminization results from disorders of adrenal function that also affect gonadal steroidogenesis.

adult respiratory distress syndrome  (ARDS) acute respiratory distress s.

AEC syndrome  Hay-Wells s.

afferent loop syndrome  chronic partial obstruction of the proximal loop (duodenum and jejunum) after gastrojejunostomy, resulting in duodenal distention, pain, and nausea following ingestion of food.

Ahumada-del Castillo syndrome  galactorrhea-amenorrhea syndrome with low gonadotropin secretion.

akinetic-rigid syndrome  muscular rigidity with varying degrees of slowness of movement; seen in parkinsonism and disorders of the basal ganglia.

Alagille syndrome  inherited neonatal jaundice, cholestasis with peripheral pulmonic stenosis, unusual facies, and ocular, vertebral, and nervous system abnormalities, due to paucity or absence of intrahepatic bile ducts.

Albright's syndrome , Albright-McCune-Sternberg syndrome polyostotic fibrous dysplasia, patchy dermal pigmentation, and endocrine dysfunction.

Aldrich's syndrome  Wiskott-Aldrich s.

Allgrove's syndrome  inherited glucocorticoid deficiency with achalasia and alacrima.

Alport's syndrome  a hereditary disorder marked by progressive nerve deafness, progressive pyelonephritis or glomerulonephritis, and occasionally ocular defects.

Alström syndrome  a hereditary syndrome of retinitis pigmentosa with nystagmus and early loss of central vision, deafness, obesity, and diabetes mellitus.

amnestic syndrome  a mental disorder characterized by impairment of memory occurring in a normal state of consciousness; the most common cause is thiamine deficiency associated with alcohol abuse.

amniotic band syndrome  see under sequence.

Angelman's syndrome  happy puppet s.

angular gyrus syndrome  a syndrome resulting from an infarction or other lesion of the angular gyrus on the dominant side, often characterized by alexia or agraphia.

ankyloblepharon–ectodermal dysplasia–clefting syndrome  Hay-Wells s.

anorexia-cachexia syndrome  a systemic response to cancer occurring as a result of a poorly understood relationship between anorexia and cachexia, manifested by malnutrition, weight loss, muscular weakness, acidosis, and toxemia.

anterior cord syndrome  anterior spinal artery s.

anterior interosseous syndrome  a complex of symptoms caused by a lesion of the anterior interosseous nerve, usually resulting from a fracture or laceration.

anterior spinal artery syndrome  localized injury to the anterior portion of the spinal cord, characterized by complete paralysis and hypalgesia and hypesthesia to the level of the lesion, but with relative preservation of posterior column sensations of touch, position, and vibration.

Apert's syndrome  acrocephalosyndactyly, type I; an autosomal dominant disorder characterized by acrocephaly and syndactyly, often with other skeletal deformities and mental retardation.

Asherman's syndrome  persistent amenorrhea and secondary sterility due to intrauterine adhesions and synechiae, usually as a result of uterine curettage.

Asperger's syndrome  a pervasive developmental disorder resembling autistic disorder, being characterized by severe impairment of social interactions and by restricted interests and behaviors; however, patients are not delayed in development of language, cognitive function, and self-help skills.

Barrett's syndrome  peptic ulcer of the lower esophagus, often with stricture, due to the presence of columnar-lined epithelium, which may contain functional mucous cells, parietal cells, or chief cells, in the esophagus instead of normal squamous cell epithelium.

Bartter syndrome  a hereditary form of hyperaldosteronism secondary to hypertrophy and hyperplasia of the juxtaglomerular cells, with normal blood pressure and hypokalemic alkalosis in the absence of edema, increased concentration of renin, angiotensin II, and bradykinin; usually occurring in children.

basal cell nevus syndrome  an autosomal dominant syndrome characterized by the development in early life of numerous basal cell carcinomas, in association with abnormalities of the skin, bone, nervous system, eyes, and reproductive tract.

Bassen-Kornzweig syndrome  abetalipoproteinemia.

battered-child syndrome  multiple traumatic lesions of the bones and soft tissues of children, often accompanied by subdural hematomas, willfully inflicted by an adult.

Beckwith-Wiedemann syndrome  an inherited disorder characterized by exomphalos, macroglossia, and gigantism, often associated with visceromegaly, adrenocortical cytomegaly, and dysplasia of the renal medulla.

Behçet's syndrome  severe uveitis and retinal vasculitis, optic atrophy, and aphtha-like lesions of the mouth and genitalia, often with other signs and symptoms suggesting a diffuse vasculitis; it most often affects young males.

Bernard-Soulier syndrome  a hereditary coagulation disorder marked by mild thrombocytopenia, giant and morphologically abnormal platelets, hemorrhagic tendency, prolonged bleeding time, and purpura.

Bing-Neel syndrome  the central nervous system manifestations of Waldenström's macroglobulinemia, possibly including encephalopathy, hemorrhage, stroke, convulsions, delirium, and coma.

Birt-Hogg-Dubé syndrome  an inherited disorder of proliferation of ectodermal and mesodermal components of the pilar system, occurring as multiple trichodiscomas, acrochordons, and fibrofolliculomas on the head, chest, back, and upper limbs.

Blackfan-Diamond syndrome  congenital hypoplastic anemia.

blue toe syndrome  skin necrosis and ischemic gangrene manifest as a blue color of the toes, resulting from arterial occlusion, usually caused by emboli, thrombi, or injury.

Boerhaave's syndrome  spontaneous rupture of the esophagus.

Börjeson's syndrome , Börjeson-Forssman-Lehmann syndrome a hereditary syndrome, transmitted as an X-linked recessive trait, characterized by severe mental retardation, epilepsy, hypogonadism, hypometabolism, marked obesity, swelling of the subcutaneous tissues of the face, and large ears.

bowel bypass syndrome  a syndrome of dermatosis and arthritis occurring some time after jejunoileal bypass, probably caused by immune reponse to bacterial overgrowth in the bypassed bowel.

Bradbury-Eggleston syndrome  a progressive syndrome of postural hypotension without tachycardia but with visual disturbances, impotence, hypohidrosis, lowered metabolic rate, dizziness, syncope, and slow pulse; due to impaired peripheral vasoconstriction.

bradycardia-tachycardia syndrome , brady-tachy syndrome a clinical manifestation of the sick sinus syndrome characterized by alternating periods of bradycardia and tachycardia.

Brown-Séquard syndrome  ipsilateral paralysis and loss of discriminatory and joint sensation, and contralateral loss of pain and temperature sensation; due to damage to one half of the spinal cord.

Brown-Vialetto-van Laere syndrome  an inherited syndrome of progressive bulbar palsy with any of several cranial nerve disorders.

Budd-Chiari syndrome  symptomatic obstruction or occlusion of the hepatic veins, causing hepatomegaly, abdominal pain and tenderness, intractable ascites, mild jaundice, and eventually portal hypertension and liver failure.

Caffey's syndrome , Caffey-Silverman syndrome infantile cortical hyperostosis.

Canada-Cronkhite syndrome  Cronkhite-Canada s.

capillary leak syndrome  extravasation of plasma fluid and proteins into the extravascular space, resulting in sometimes fatal hypotension and reduced organ perfusion; an adverse effect of interleukin-2 therapy.

carcinoid syndrome  a symptom complex associated with carcinoid tumors, marked by attacks of cyanotic flushing of the skin and watery diarrhea, bronchoconstrictive attacks, sudden drops in blood pressure, edema, and ascites. Symptoms are caused by tumor secretion of serotonin, prostaglandins, and other biologically active substances.

carotid sinus syndrome  syncope sometimes associated with convulsions due to overactivity of the carotid sinus reflex when pressure is applied to one or both carotid sinuses.

carpal tunnel syndrome  pain and burning or tingling paresthesias in the fingers and hand, sometimes extending to the elbow, due to compression of the median nerve in the carpal tunnel.

Median nerve entrapped in carpal tunnel in carpal tunnel syndrome.

Carpenter's syndrome  acrocephalopolysyndactyly, type II; an autosomal recessive disorder characterized by acrocephaly, polysyndactyly, brachydactyly, mild obesity, mental retardation, hypogonadism, and other anomalies.

central cord syndrome  injury to the central part of the cervical spinal cord resulting in disproportionately more weakness or paralysis in the upper limbs than in the lower; pathological change is caused by hemorrhage or edema.

cerebrocostomandibular syndrome  an inherited syndrome of severe micrognathia and costovertebral abnormalities, with palatal defects, prenatal and postnatal growth deficiencies, and mental retardation.

cerebrohepatorenal syndrome  a hereditary disorder, transmitted as an autosomal recessive trait, characterized by craniofacial abnormalities, hypotonia, hepatomegaly, polycystic kidneys, jaundice, and death in early infancy.

cervical rib syndrome  thoracic outlet syndrome caused by a cervical rib.

Cestan's syndrome , Cestan-Chenais syndrome an association of contralateral hemiplegia, contralateral hemianesthesia, ipsilateral lateropulsion and hemiasynergia, Horner's syndrome, and ipsilateral laryngoplegia, due to scattered lesions of the pyramid, sensory tract, inferior cerebellar peduncle, nucleus ambiguus, and oculopupillary center.

Charcot's syndrome 

1. amyotrophic lateral sclerosis.

2. intermittent claudication.

Charcot-Marie syndrome  Charcot-Marie-Tooth disease.

CHARGE syndrome  see under association.

Chédiak-Higashi syndrome  a lethal, progressive, autosomal recessive, systemic disorder associated with oculocutaneous albinism, massive leukocyte inclusions (giant lysosomes), histiocytic infiltration of multiple body organs, development of pancytopenia, hepatosplenomegaly, recurrent or persistent bacterial infections, and a possible predisposition to development of malignant lymphoma.

Chinese restaurant syndrome  transient arterial dilatation due to ingestion of monosodium glutamate, which is sometimes used liberally in seasoning Chinese food, marked by throbbing head, lightheadedness, tightness of the jaw, neck, and shoulders, and backache.

Chotzen's syndrome  acrocephalosyndactyly, type III; an autosomal dominant disorder characterized by acrocephaly and syndactyly in which the latter is mild and by hypertelorism, ptosis, and sometimes mental retardation.

Christ-Siemens-Touraine syndrome  anhidrotic ectodermal dysplasia.

chronic fatigue syndrome  persistent debilitating fatigue of recent onset, with greatly reduced physical activity and some combination of muscle weakness, sore throat, mild fever, tender lymph nodes, headaches, and depression, not attributable to any other known causes; it is of controversial etiology.

Churg-Strauss syndrome  allergic granulomatous angiitis; a systemic form of necrotizing vasculitis in which there is prominent lung involvement.

chylomicronemia syndrome  familial hyperchylomicronemia.

Coffin-Lowry syndrome  an X-linked syndrome of incapability of speech, severe mental deficiency, and muscle, ligament, and skeletal abnormalities.

Coffin-Siris syndrome  hypoplasia of the fifth fingers and toenails associated with growth and mental deficiencies, coarse facies, mild microcephaly, hypotonia, lax joints, and mild hirsutism.

compartmental syndrome  a condition in which increased tissue pressure in a confined anatomic space causes decreased blood flow leading to ischemia and dysfunction of contained myoneural elements, marked by pain, muscle weakness, sensory loss, and palpable tenseness in the involved compartment; ischemia can lead to necrosis resulting in permanent impairment of function.

congenital rubella syndrome  transplacental infection of the fetus with rubella, usually in the first trimester of pregnancy, as a consequence of maternal infection, resulting in various developmental anomalies in the newborn infant.

Conn's syndrome  primary aldosteronism.

cri du chat syndrome  a hereditary congenital syndrome characterized by hypertelorism, microcephaly, severe mental deficiency, and a plaintive catlike cry, due to deletion of the short arm of chromosome 5.

Crigler-Najjar syndrome  an autosomal recessive form of nonhemolytic jaundice due to absence of the hepatic enzyme glucuronide transferase, marked by excessive amounts of unconjugated bilirubin in the blood, kernicterus, and severe central nervous system disorders.

syndrome of crocodile tears  spontaneous lacrimation occurring parallel with the normal salivation of eating, and associated with facial paralysis; it seems to be due to straying of regenerating nerve fibers, some of those destined for the salivary glands going to the lacrimal glands.

Cronkhite-Canada syndrome  familial polyposis of the gastrointestinal tract associated with ectodermal defects such as alopecia and onychodystrophy.

Crow-Fukase syndrome  POEMS s.

crush syndrome  the edema, oliguria, and other symptoms of renal failure that follow crushing of a part, especially a large muscle mass; see lower nephron nephrosis, under nephrosis.

Cruveilhier-Baumgarten syndrome  cirrhosis with portal hypertension associated with congenital patency of the umbilical and paraumbilical veins.

Cushing's syndrome  a condition, more commonly seen in females, due to hyperadrenocorticism resulting from neoplasms of the adrenal cortex or anterior lobe of the pituitary; or to prolonged excessive intake of glucocorticoids for therapeutic purposes (iatrogenic Cushing's s. or Cushing's s. medicamentosus). The symptoms may include adiposity of the face, neck, and trunk, kyphosis caused by softening of the spine, amenorrhea, hypertrichosis (in females), impotence (in males), dusky complexion with purple markings, hypertension, polycythemia, pain in the abdomen and back, and muscular weakness.

Da Costa syndrome  neurocirculatory asthenia.

Dandy-Walker syndrome  congenital hydrocephalus due to obstruction of the foramina of Magendie and Luschka.

Dejean's syndrome  orbital floor s.

de Lange's syndrome  a congenital syndrome of mental retardation, short stature (Amsterdam dwarf), flat spadelike hands, and other anomalies.

dialysis dysequilibrium syndrome  symptoms such as headache, nausea, muscle cramps, nervous irritability, drowsiness, and convulsions during or after overly rapid hemodialysis or peritoneal dialysis, resulting from an osmotic shift of water into the brain.

disconnection syndrome  any neurologic disorder caused by an interruption in impulse transmission along cerebral fiber pathways.

Down syndrome  mongoloid features, short phalanges, widened space between the first and second toes and fingers, and moderate to severe mental retardation; associated with a chromosomal abnormality, usually trisomy of chromosome 21.

Drash syndrome  an inherited syndrome of Wilms' tumor with glomerulopathy and male pseudohermaphroditism.

Dubin-Johnson syndrome  hereditary chronic nonhemolytic jaundice thought to be due to defective excretion of conjugated bilirubin and certain other organic anions by the liver; a brown, coarsely granular pigment in hepatic cells is pathognomonic.

dumping syndrome  nausea, weakness, sweating, palpitation, syncope, often a sensation of warmth, and sometimes diarrhea, occurring after ingestion of food in patients who have undergone partial gastrectomy.

dyscontrol syndrome  a pattern of episodic abnormal and often violent and uncontrollable social behavior with little or no provocation; it may have an organic cause or be associated with abuse of a psychoactive substance.

dysmaturity syndrome  postmaturity s.

Eaton-Lambert syndrome  a myasthenia-like syndrome in which the weakness usually affects the limbs and ocular and bulbar muscles are spared; often associated with oat-cell carcinoma of the lung.

EEC syndrome  ectrodactyly–ectodermal dysplasia–clefting s.; an inherited congenital syndrome involving both ectodermal and mesodermal tissues, characterized by ectodermal dysplasia with hypopigmentation of skin and hair, and other hair, nail, tooth, lip, and palate abnormalities.

Ehlers-Danlos syndrome  a group of inherited disorders of connective tissue, varying in clinical and biochemical evidence, in mode of inheritance, and in severity from mild to lethal; major manifestations include hyperextensible skin and joints, easy bruisability, friability of tissues, bleeding, poor wound healing, subcutaneous nodules, and cardiovascular, orthopedic, intestinal, and ocular defects.

Eisenmenger's syndrome  ventricular septal defect with pulmonary hypertension and cyanosis due to right-to-left (reversed) shunt of blood. Sometimes defined as pulmonary hypertension (pulmonary vascular disease) and cyanosis with the shunt being at the atrial, ventricular, or great vessel area.

EMG syndrome  Beckwith-Wiedemann s.

Escobar syndrome  multiple pterygium s.

excited skin syndrome  nonspecific cutaneous hyperirritability of the back, sometimes occurring when multiple positive reactions are elicited in patch test screening of a battery of substances.

exomphalos-macroglossia-gigantism syndrome  Beckwith-Wiedemann s.

extrapyramidal syndrome  any of a group of clinical disorders considered to be due to malfunction in the extrapyramidal system and marked by abnormal involuntary movements; included are parkinsonism, athetosis, and chorea.

Faber's syndrome  hypochromic anemia.

Fanconi syndrome 

1. a rare hereditary disorder, transmitted as an autosomal recessive trait, characterized by pancytopenia, hypoplasia of the bone marrow, and patchy brown discoloration of the skin due to the deposition of melanin, and associated with multiple congenital anomalies of the musculoskeletal and genitourinary systems.

2. a general term for a group of diseases marked by dysfunction of the proximal renal tubules, with generalized hyperaminoaciduria, renal glycosuria, hyperphosphaturia, and bicarbonate and water loss; the most common cause is cystinosis, but it is also associated with other genetic diseases and occurs in idiopathic and acquired forms.

Farber syndrome , Farber-Uzman syndrome Farber's disease.

Felty's syndrome  a syndrome of splenomegaly with chronic rheumatoid arthritis and leukopenia; there are usually pigmented spots on the skin of the lower extremities, and sometimes there is other evidence of hypersplenism such as anemia or thrombocytopenia.

fetal alcohol syndrome  a syndrome of altered prenatal growth and morphogenesis, occurring in infants born of women who were chronically alcoholic during pregnancy; it includes maxillary hypoplasia, prominence of the forehead and mandible, short palpebral fissures, microophthalmia, epicanthal folds, severe growth retardation, mental retardation, and microcephaly.

fetal hydantoin syndrome  poor growth and development with craniofacial and skeletal abnormalities, produced by prenatal exposure to hydantoin analogues, including phenytoin.

floppy infant syndrome  abnormal posture in an infant suspended prone, the limbs and head hanging down; due to any of numerous conditions, particularly perinatal injury to the brain or spinal cord, spinal muscular atrophy, and various genetic disorders.

Foix-Alajouanine syndrome  a fatal necrotizing myelopathy characterized by necrosis of the gray matter of the spinal cord, thickening of the walls of the spinal vessels, and abnormal spinal fluid.

Franceschetti syndrome  the complete form of mandibulofacial dysostosis.

galactorrhea-amenorrhea syndrome  amenorrhea and galactorrhea, sometimes associated with increased levels of prolactin.

Ganser syndrome  the giving of approximate answers to questions, commonly associated with amnesia, disorientation, perceptual disturbances, fugue, and conversion symptoms.

Garcin's syndrome  unilateral paralysis of most or all of the cranial nerves due to a tumor at the base of the skull or in the nasopharynx.

Gardner's syndrome  familial polyposis of the colon associated with osseous and soft tissue tumors.

gay bowel syndrome  an assortment of sexually transmitted bowel and rectal diseases affecting homosexual males and others who engage in anal intercourse, caused by a wide variety of infectious agents.

general adaptation syndrome  the total of all nonspecific reactions of the body to prolonged systemic stress, comprising alarm, resistance, and exhaustion.

Gerstmann-Sträussler syndrome , Gerstmann-Sträussler-Scheinker syndrome a group of rare prion diseases of autosomal dominant inheritance, having the common characteristics of cognitive and motor disturbances, ending in death, and the presence of multicentric amyloid plaques in the brain.

Gianotti-Crosti syndrome  monomorphous, usually nonpruritic, dusky or coppery red, flat-topped, firm papules forming a symmetrical eruption on the face, buttocks, and limbs, including the palms and soles, with malaise and low-grade fever; seen in young children and associated with viral infection.

Gilles de la Tourette's syndrome  a childhood-onset syndrome comprising both multiple motor and one or more vocal tics, often associated with obsessions, compulsions, hyperactivity, distractibility, and impulsivity; it may diminish or even remit in adolescence or adulthood.

Goodpasture's syndrome  glomerulonephritis with pulmonary hemorrhage and circulating antibodies against basement membranes, usually seen in young men and with a course of rapidly progressing renal failure, with hemoptysis, pulmonary infiltrates, and dyspnea.

Gradenigo's syndrome  sixth nerve palsy and unilateral headache in suppurative disease of the middle ear, due to involvement of the abducens and trigeminal nerves by direct spread of the infection.

gray syndrome  a potentially fatal condition seen in neonates, particularly premature infants, due to a reaction to chloramphenicol, characterized by an ashen gray cyanosis, listlessness, weakness, and hypotension.

Guillain-Barré syndrome  acute idiopathic polyneuritis.

Gunn's syndrome  unilateral ptosis of the eyelid, with movements of the affected eyelid associated with those of the jaw.

Hamman-Rich syndrome  the acute form of idiopathic pulmonary fibrosis.

Hand-Schüller-Christian syndrome  see under disease.

hantavirus pulmonary syndrome  a sometimes fatal febrile illness caused by a hantavirus, characterized by variable respiratory symptoms followed by acute respiratory distress, sometimes progressing to respiratory failure.

happy puppet syndrome  an inherited syndrome of jerky puppetlike movements, frequent laughter, mental and motor retardation, peculiar open-mouthed facies, and seizures.

Harada syndrome  Vogt-Koyanagi-Harada s.

Hay-Wells syndrome  an inherited syndrome of ectodermal dysplasia, cleft lip and palate, and adhesions of the margins of the eyelids, accompanied by tooth, skin, and hair abnormalities.

HELLP syndrome  h emolysis, e levated l iver enzymes, and l ow p latelet count occurring in association with pre-eclampsia.

Helweg-Larsen's syndrome  an inherited syndrome of anhidrosis present from birth and labyrinthitis occurring late in life.

hemolytic uremic syndrome  a form of thrombotic microangiopathy with renal failure, hemolytic anemia, and severe thrombocytopenia and purpura.

Herrmann's syndrome  an inherited syndrome initially characterized by photomyogenic seizures and progressive deafness, with later development of diabetes mellitus, nephropathy, and mental deterioration.

HHH syndrome  hyperornithinemia-hyperammonemia-homocitrullinuria s.

Hinman syndrome  a psychogenic disorder seen in children, imitating a neurogenic bladder, consisting of detrusor-sphincter dyssynergia without evidence of neural lesion.

Horner syndrome , Horner-Bernard syndrome sinking in of the eyeball, ptosis of the upper lid, slight elevation of the lower lid, miosis, narrowing of the palpebral fissure, and anhidrosis and flushing of the affected side of the face; due to a brain stem lesion on the ipsilateral side that interrupts descending sympathetic nerves.

Hughes-Stovin syndrome  thrombosis of the pulmonary arteries and peripheral veins, characterized by headache, fever, cough, papilledema, and hemoptysis.

Hurler's syndrome  an inherited mucopolysaccharidosis due to deficiency of the enzyme α-l-iduronidase, characterized by gargoyle-like facies, dwarfism, severe somatic and skeletal changes, severe mental retardation, cloudy corneas, deafness, cardiovascular defects, hepatosplenomegaly, joint contractures, and death in childhood.

Hutchinson-Gilford syndrome  progeria.

hypereosinophilic syndrome  any of several diseases characterized by a massive increase in the number of eosinophils in the blood and bone marrow, with infiltration of other organs. Symptoms vary from mild to the often fatal outcome of eosinophilic leukemia.

hyperkinetic syndrome  former name for attention-deficit.

hyperornithinemia-hyperammonemia-homocitrullinuria syndrome  an inherited disorder characterized by elevated levels of ornithine, postprandial hyperammonemia and homocitrullinuria, and aversion to protein ingestion; believed to result from a defect in the transport of ornithine into the mitochondria, which disturbs the cycle of ureagenesis.

hyperventilation syndrome  a complex of symptoms that accompany hypocapnia caused by hyperventilation, including palpitations, shortness of breath, lightheadedness or giddiness, profuse perspiration, tingling sensations in the fingertips, face, or toes, and vasomotor collapse and loss of consciousness if prolonged.

hypoplastic left heart syndrome  congenital hypoplasia or atresia of the left ventricle, aortic or mitral valve, and ascending aorta, with respiratory distress, cardiac failure, and death in infancy.

impingement syndrome  progressive pathologic changes resulting from the impingement of the acromion, coracoacromial ligament, coracoid process, or acromioclavicular joint on the rotator cuff.

syndrome of inappropriate antidiuretic hormone  (SIADH) persistent hyponatremia, inappropriately elevated urine osmolality, caused by release of vasopressin (antidiuretic hormone) without discernible stimulus.

irritable bowel syndrome , irritable colon syndrome a chronic noninflammatory disease with a psychophysiologic basis, characterized by abdominal pain, diarrhea or constipation or both, and no detectable pathologic change.

Isaacs' syndrome , Isaacs-Mertens syndrome progressive muscle stiffness and spasms, with continuous muscle fiber activity similar to that seen with neuromyotonia.

Jacod's syndrome  chronic arthritis after rheumatic fever, with fibrous changes in the joint capsules leading to deformities that may resemble rheumatoid arthritis but lack bone erosion.

Jarcho-Levin syndrome  an inherited disorder of multiple vertebral defects, short thorax, rib abnormalities, camptodactyly, syndactyly, and sometimes urogenital abnormalities, usually fatal in infancy.

Joubert's syndrome  inherited, usually fatal, partial to complete agenesis of the cerebellar vermis, with hypotonia, episodic hyperpnea, mental retardation, and abnormal eye movements.

Kartagener's syndrome  a hereditary syndrome consisting of dextrocardia, bronchiectasis, and sinusitis.

Kimmelstiel-Wilson syndrome  intercapillary glomerulosclerosis in which the lesions are nodular.

King syndrome  a form of malignant hyperthermia accompanied by characteristic physical abnormalities.

Klinefelter's syndrome  smallness of testes with fibrosis and hyalinization of seminiferous tubules, variable degrees of masculinization, azoospermia, and infertility, and increased urinary gonadotropins. It is associated typically with an XXY chromosome complement although variants include XXYY, XXXY, XXXXY, and various mosaic patterns.

Klippel-Feil syndrome  shortness of the neck due to reduction in the number of cervical vertebrae or the fusion of multiple hemivertebrae into one osseous mass, with limitation of neck motion and low hairline.

Korsakoff's syndrome  a syndrome of anterograde and retrograde amnesia with confabulation associated with alcoholic or nonalcoholic polyneuritis, currently used synonymously with the term amnestic syndrome or, more narrowly, to refer to the amnestic component of the Wernicke-Korsakoff syndrome.

Kugelberg-Welander syndrome  an inherited juvenile form of muscular atrophy due to lesions on the anterior horns of the spinal cord, beginning with the proximal muscles of the lower limbs and pelvic girdle and progressing to the distal muscles.

LAMB syndrome  a syndrome of familial myomas with cutaneous, cardiac, and endocrine involvement, manifested as l entigines, a trial m yxoma, and b lue nevi.

Landau-Kleffner syndrome  an epileptic syndrome of childhood with partial or generalized seizures, psychomotor abnormalities, and aphasia progressing to mutism.

Launois' syndrome  pituitary gigantism.

Laurence-Moon syndrome  an autosomal recessive disorder characterized by mental retardation, pigmentary retinopathy, hypogonadism, and spastic paraplegia.

lazy leukocyte syndrome  a syndrome in children, marked by recurrent low-grade infections with a defect in neutrophil chemotaxis and deficient random mobility of neutrophils.

Lemieux-Neemeh syndrome  an inherited syndrome of Charcot-Marie-Tooth disease with progressive deafness.

Leriche syndrome  lower limb fatigue on exercising, lack of femoral pulse, impotence, and often pale, cold lower limbs, usually seen in males due to obstruction of the terminal aorta.

Lesch-Nyhan syndrome  an X-linked disorder of purine metabolism with physical and mental retardation, compulsive self-mutilation of fingers and lips by biting, choreoathetosis, spastic cerebral palsy, and impaired renal function, and by extremely excessive purine synthesis and consequently hyperuricemia and excessive urinary secretion of uric acid.

Li-Fraumeni syndrome  a familial syndrome of early breast carcinoma associated with soft tissue sarcomas and other tumors.

locked-in syndrome  quadriplegia and mutism with intact consciousness and preservation of some eye movements; usually due to a vascular lesion of the anterior pons.

long QT syndrome  prolongation of the Q–T interval combined with torsades de pointes and manifest in several forms, either acquired or congenital, the latter with or without deafness; it may lead to serious arrhythmia and sudden death.

Lowe syndrome , Lowe-Terrey-MacLachlan syndrome oculocerebrorenal s.

Lown-Ganong-Levine syndrome  a preexcitation syndrome of electrocardiographic abnormality characterized by a short P–R interval with a normal QRS complex, accompanied by atrial tachycardia.

Lutembacher's syndrome  atrial septal defect with mitral stenosis (usually rheumatic).

lymphadenopathy syndrome  unexplained lymphadenopathy for 3 or more months at extrainguinal sites, revealing on biopsy nonspecific lymphoid hyperplasia, possibly a prodrome of acquired immunodeficiency syndrome.

Maffucci's syndrome  enchondromatosis with multiple cutaneous or visceral hemangiomas.

malabsorption syndrome  a group of disorders marked by subnormal absorption of dietary constituents, and thus excessive loss of nutrients in the stool, which may be due to a digestive defect, a mucosal abnormality, or lymphatic obstruction.

male Turner's syndrome  Noonan's s.

Marfan syndrome  a hereditary syndrome of abnormal length of limbs, especially fingers and toes, with subluxation of the lens, cardiovascular abnormalities, and other defects.

Marie-Bamberger syndrome  hypertrophic pulmonary osteoarthropathy.

maternal deprivation syndrome  failure to thrive with severe growth retardation, unresponsiveness to the environment, depression, retarded mental and emotional development, and behavioral problems resulting from loss, absence, or neglect of the mother or other primary caregiver.

Meckel's syndrome  an autosomal recessive syndrome, with sloping forehead, posterior meningoencephalocele, polydactyly, polycystic kidneys, and death in the perinatal period.

meconium aspiration syndrome  the respiratory complications resulting from the passage and aspiration of meconium prior to or during delivery.

median cleft facial syndrome  a hereditary form of defective midline development of the head and face, including ocular hypertelorism, occult cleft nose and maxilla, and sometimes mental retardation or other defects.

megacystis-megaureter syndrome  chronic ureteral dilatation (megaureter) associated with hypotonia and dilatation of the bladder (megacystis) and gaping of ureteral orifices, permitting vesicoureteral reflux of urine, and resulting in chronic pyelonephritis.

megacystis-microcolon–intestinal hypoperistalsis syndrome  (MMIHS) enlarged bladder (megacystis), small colon with decreased or absent peristalsis (microcolon and intestinal hypoperistalsis), and the same abdominal muscle defect as occurs in prune-belly syndrome.

Meige syndrome 

1. Milroy's disease.

2. dystonia of facial and oromandibular muscles with blepharospasm, grimacing mouth movements, and protrusion of the tongue.

MELAS syndrome  a maternally-inherited syndrome of m itochondrial e ncephalopathy, l actic a cidosis, and s troke-like episodes.

Menkes' syndrome  an X-linked recessive disorder of copper absorption marked by severe cerebral degeneration and arterial changes resulting in death in infancy and by sparse, brittle scalp hair.

Meretoja's syndrome  a type of familial amyloid polyneuropathy.

MERRF syndrome  a maternally-inherited syndrome of m yoclonus with e pilepsy and with r agged r ed f ibers.

metabolic syndrome  a combination including at least three of the following: abdominal obesity, hypertriglyceridemia, low level of high-density lipoproteins, hypertension, and high fasting glucose level.

methionine malabsorption syndrome  an inborn aminoacidopathy marked by white hair, mental retardation, convulsions, attacks of hyperpnea, and urine with an odor like an oasthouse (for drying hops) due to alpha-hydroxybutyric acid formed by bacterial action on the unabsorbed methionine.

middle lobe syndrome  lobar atelectasis in the right middle lobe of the lung, with chronic pneumonitis.

Mikulicz's syndrome  chronic bilateral hypertrophy of the lacrimal, parotid, and salivary glands, associated with chronic lymphocytic infiltration; it may be associated with other diseases.

milk-alkali syndrome  hypercalcemia without hypercalciuria or hypophosphatemia and with only mild alkalosis and other symptoms attributed to ingestion of milk and absorbable alkali for long periods.

Milkman syndrome  a generalized bone disease marked by multiple transparent stripes of absorption in the long and flat bones.

Miller syndrome  an inherited syndrome of extensive facial and limb defects, sometimes accompanied by heart defects and hearing loss.

mitral valve prolapse syndrome  prolapse of the mitral valve, often with regurgitation; a common, usually benign, often asymptomatic condition characterized by midsystolic clicks and late systolic murmurs on auscultation.

Möbius' syndrome  agenesis or aplasia of cranial nerve motor nuclei in congenital bilateral facial palsy, with unilateral or bilateral paralysis of abductors of the eye and sometimes cranial nerve involvement and limb anomalies.

Mohr syndrome  an autosomal recessive disorder characterized by brachydactyly, clinodactyly, polydactyly, syndactyly, and bilateral hallucal polysyndactyly; by cranial, facial, lingual, palatal, and mandibular anomalies; and by episodic neuromuscular disturbances.

Morquio's syndrome  two biochemically distinct but clinically nearly indistinguishable forms of mucopolysaccharidosis, marked by genu valgum, pigeon breast, progressive flattening of the vertebral bodies, short neck and trunk, progressive deafness, mild corneal clouding, and excretion of keratan sulfate in the urine.

mucocutaneous lymph node syndrome  Kawasaki disease.

multiple endocrine deficiency syndrome , multiple glandular deficiency syndrome failure of any combination of endocrine glands, often accompanied by nonendocrine autoimmune abnormalities.

multiple pterygium syndrome  an inherited syndrome characterized by pterygia of the neck, axillae, and popliteal, antecubital, and intercrural areas, accompanied by facial, skeletal, and genital abnormalites.

Munchausen syndrome  a subtype of factitious disorder; habitual seeking of hospital treatment for apparent acute illness, the patient giving a plausible and dramatic history, all of which is false.

Munchausen syndrome by proxy  see factitious disorder by proxy, under disorder.

MVP syndrome  mitral valve prolapse s.

myelodysplastic syndrome  any of a group of related bone marrow disorders of varying duration preceding the development of overt acute myelogenous leukemia; characterized by abnormal hematopoietic stem cells, anemia, neutropenia, and thrombocytopenia.

myeloproliferative syndromes  see under disorder.

NAME syndrome  a syndrome of familial myxomas with cutaneous, cardiac, and endocrine involvement, manifested as n evi, a trial m yxoma, and neurofibroma e phelides.

Negri-Jacod syndrome  Jacod's s.

Nelson's syndrome  the development of an ACTH-producing pituitary tumor after bilateral adrenalectomy in Cushing's syndrome; it is characterized by aggressive growth of the tumor and hyperpigmentation of the skin.

nephrotic syndrome  any of a group of diseases involving defective kidney glomeruli, with massive proteinuria, lipiduria with edema, hypoalbuminemia, and hyperlipidemia.

nerve compression syndrome  entrapment neuropathy.

Noack syndrome  Pfeiffer's s.

nonstaphylococcal scalded skin syndrome  toxic epidermal necrolysis.

Noonan syndrome  webbed neck, ptosis, hypogonadism, and short stature, i.e., the phenotype of Turner's syndrome without the gonadal dysgenesis.

obesity-hypoventilation syndrome  pickwickian syndrome; a syndrome of obesity, somnolence, hypoventilation, and erythrocytosis.

occipital horn syndrome  the X-linked recessive form of cutis laxa.

oculocerebrorenal syndrome  an X-linked disorder marked by vitamin D–refractory rickets, hydrophthalmia, congenital glaucoma and cataracts, mental retardation, and renal tubule dysfunction as evidenced by hypophosphatemia, acidosis, and aminoaciduria.

oculodentodigital syndrome , ODD syndrome oculodentodigital dysplasia.

OFD syndrome  oral-facial-digital s.

Omenn's syndrome  histiocytic medullary reticulosis.

Opitz syndrome , Opitz-Frias syndrome a familial syndrome consisting of hypertelorism and hernias, and in males also characterized by hypospadias, cryptorchidism, and bifid scrotum. Cardiac, laryngotracheal, pulmonary, anal, and renal abnormalities may also be present.

oral-facial-digital syndrome  any of a group of congenital syndromes characterized by oral, facial, and digital anomalies. Type I, a male-lethal X-linked dominant disorder, is characterized by camptodactyly, polydactyly, and syndactyly; by cranial, facial, lingual, and dental anomalies; and by mental retardation, familial trembling, alopecia, and seborrhea of the face and milia; type II is Mohr s.; type III, an autosomal recessive disorder, characterized by postaxial hexadactyly, by ocular, lingual, and dental anomalies, and by profound mental retardation.

orbital floor syndrome  exophthalmos, diplopia, and anesthesia in the areas innervated by the trigeminal nerve, occurring with a lesion in the floor of the orbit.

organic anxiety syndrome  a term used in a former system of classification, denoting an organic mental syndrome marked by prominent, recurrent panic attacks or generalized anxiety caused by a specific organic factor and not associated with delirium.

organic brain syndrome  organic mental s.

organic delusional syndrome  a term used in a former system of classification, denoting an organic mental syndrome marked by delusions caused by a specific organic factor and not associated with delirium.

organic mental syndrome  former term for a constellation of psychological or behavioral signs and symptoms associated with brain dysfunction of unknown or unspecified etiology and grouped according to symptoms rather than etiology. See also under disorder.

organic mood syndrome  a term used in a former system of classification, denoting an organic mental syndrome marked by manic or depressive mood disturbance caused by a specific organic factor and not associated with delirium.

organic personality syndrome  a term used in a former system of classification, denoting an organic mental syndrome characterized by a marked change in behavior or personality, caused by a specific organic factor and not associated with delirium or dementia.

orofaciodigital syndrome  oral-facial-digital s.

Ortner syndrome  laryngeal paralysis associated with heart disease, due to compression of the recurrent laryngeal nerve between the aorta and a dilated pulmonary artery.

ovarian hyperstimulation syndrome  mild to severe ovarian enlargement with exudation of fluid and protein, leading to ascites, pleural or pericardial effusion, azotemia, oliguria, and thromboembolism in women undergoing ovulation induction.

ovarian vein syndrome  obstruction of the ureter due to compression by an enlarged or varicose ovarian vein; typically the vein becomes enlarged during pregnancy.

overlap syndrome  any of a group of connective tissue disorders that either combine scleroderma with polymyositis or systemic lupus erythematosus or combine systemic lupus erythematosus with rheumatoid arthritis or polymyositis.

overwear syndrome  extreme photophobia, pain, and lacrimation associated with contact lenses, particularly non–gas permeable hard lenses, usually caused by wearing them excessively.

pacemaker syndrome  vertigo, syncope, and hypotension, often accompanied by dyspnea, cough, nausea, peripheral edema, and palpitations, all exacerbated or caused by pacemakers that stimulate the ventricle and therefore do not maintain normal atrioventricular synchrony.

pacemaker twiddler's syndrome  twiddler's syndrome in a patient with an artificial cardiac pacemaker.

painful bruising syndrome  occurrence of one or more spontaneous, chronic recurring painful ecchymoses without antecedent trauma or after insufficient trauma; sometimes precipitated by emotional stress. Because certain patients exhibit autoerythrocyte sensitization in which intradermal injection of their own erythrocytes produces a painful ecchymosis, some consider the condition to be an autosensitivity to a component of the erythrocyte membrane; others consider it to be of psychosomatic or factitious origin.

Pancoast's syndrome 

1. neuritic pain and muscle atrophy in the upper limb, and Horner's syndrome, seen with a tumor near the apex of the lung when it involves the brachial plexus.

2. osteolysis in the posterior part of a rib or ribs, sometimes spreading to adjacent vertebrae.

paraneoplastic syndrome  a symptom complex arising in a cancer-bearing patient that cannot be explained by local or distant spread of the tumor.

Parinaud's syndrome  paralysis of conjugate upward movement of the eyes without paralysis of convergence; associated with tumors of the midbrain.

Parinaud's oculoglandular syndrome  a general term applied to conjunctivitis, usually unilateral and of the follicular type, followed by tenderness and enlargement of the preauricular lymph nodes; often due to leptotrichosis but may be associated with other infections.

parkinsonian syndrome  a form of parkinsonism due to idiopathic degeneration of the corpus striatum or substantia nigra; frequently a sequela of lethargic encephalitis.

PEP syndrome  POEMS s.

Pepper syndrome  neuroblastoma with metastases to the liver.

persistent müllerian duct syndrome  a hereditary syndrome in males of persistence of müllerian structures in addition to male genital ducts. There may be cryptorchidism on just one side with a contralateral inguinal hernia that contains a testis, uterus, and uterine tube (hernia uteri inguinalis).

Peutz-Jeghers syndrome  familial gastrointestinal polyposis, especially in the small bowel, associated with mucocutaneous pigmentation.

Pfeiffer syndrome  acrocephalosyndactyly, type V; an autosomal dominant disorder characterized by acrocephalosyndactyly associated with broad short thumbs and big toes.

pickwickian syndrome  obesity-hypoventilation s.

Pierre Robin syndrome  micrognathia with cleft palate, glossoptosis, and absent gag reflex.

plica syndrome  pain, tenderness, swelling, and crepitus of the knee joint, sometimes with weakness or locking of the joint, caused by fibrosis and calcification of the synovial plicae.

Plummer-Vinson syndrome  dysphagia with glossitis, hypochromic anemia, splenomegaly, and atrophy in the mouth, pharynx, and upper end of the esophagus.

POEMS syndrome  p olyneuropathy, o rganomegaly, e ndocrinopathy, M component, and s kin changes, sometimes linked to a dysproteinemia such as the presence of unusual monoclonal proteins and light chains.

polyangiitis overlap syndrome  a form of systemic necrotizing vasculitis resembling polyarteritis nodosa and allergic angiitis but also showing features of hypersensitivity vasculitis.

polycystic ovary syndrome  (PCOS) a clinical symptom complex associated with polycystic ovaries and characterized by oligomenorrhea or amenorrhea, anovulation (hence infertility), and hirsutism; both hyperestrogenism and hyperandrogenism are present.

polysplenia syndrome  a congenital syndrome of multiple splenic masses, abnormal position and development of visceral organs, complex cardiovascular defects, and abnormal, usually bilobate, lungs.

post–cardiac injury syndrome  fever, chest pain, pleuritis, and pericarditis weeks after injury to the heart, including that due to surgery (postpericardiotomy s.) and that due to myocardial infarction (post) .

postcardiotomy syndrome  postpericardiotomy s.

postcardiotomy psychosis syndrome  anxiety, confusion, and perception disturbances occurring three or more days after open heart surgery.

postcommissurotomy syndrome  postpericardiotomy s.

postconcussional syndrome  physical and personality changes that may occur after concussion of the brain, including amnesia, headache, dizziness, tinnitus, irritability, fatigability, sweating, heart palpitations, insomnia, and difficulty concentrating.

postgastrectomy syndrome  dumping s.

post–lumbar puncture syndrome  headache in the erect posture, sometimes with nuchal pain, vomiting, diaphoresis, and malaise, all relieved by recumbency, occurring several hours after lumbar puncture; it is due to lowering of intracranial pressure by leakage of cerebrospinal fluid through the needle tract.

postmaturity syndrome  a syndrome due to placental insufficiency that causes chronic stress and hypoxia, seen in fetuses and neonates in postterm pregnancies, characterized by decreased subcutaneous fat, skin desquamation, and long fingernails, often with yellow meconium staining of the nails, skin, and vernix.

post–myocardial infarction syndrome  post after myocardial infarction.

postpericardiotomy syndrome  post after surgery with opening of the pericardium.

Potter's syndrome  oligohydramnios sequence.

preexcitation syndrome  any syndrome with electrocardiographic signs of preexcitation, such as Wolff-Parkinson-White syndrome; sometimes used synonymously with it.

premenstrual syndrome  some or all of the symptoms of depressed, anxious, angry, or irritable mood, emotional lability, bloating, edema, headache, increased fatigue or lethargy, altered appetite or food cravings, breast swelling and tenderness, constipation, and decreased ability to concentrate occurring in the period between ovulation and the onset of menstruation.

prune-belly syndrome  a congenital syndrome of deficient or absent anterior abdominal wall musculature, urinary tract anomalies, and undescended testicles. The abdomen is protruding and thin-walled, with wrinkled skin.

Putnam-Dana syndrome  subacute combined degeneration of the spinal cord.

Raeder syndrome , Raeder paratrigeminal syndrome unilateral paroxysmal neuralgic pain in the face associated with Horner's syndrome.

Ramsay Hunt syndrome 

1. geniculate neuralgia; facial paralysis with otalgia and a vesicular eruption in the external canal of the ear, sometimes extending to the auricle, due to herpes zoster virus infection of the geniculate ganglion.

2. juvenile paralysis agitans (of Hunt).

3. dyssynergia cerebellaris progressiva.

Reiter syndrome  the triad of nongonococcal urethritis, conjunctivitis, and arthritis, frequently with mucocutaneous lesions.

respiratory distress syndrome of the newborn  a condition seen in infants born prematurely, by cesarean section, or to diabetic mothers, marked by dyspnea and cyanosis; a common, usually fatal subtype is hyaline membrane disease.

Reye's syndrome  a rare often fatal encephalopathy of childhood, marked by acute brain swelling with hypoglycemia, fatty infiltration of the liver, hepatomegaly, and disturbed consciousness and seizures, usually seen as a sequel of varicella or an upper airway viral infection.

Rh-null syndrome  chronic hemolytic anemia affecting individuals who lack all Rh factors (Rhnull); it is marked by spherocytosis, stomatocytosis, and increased osmotic fragility.

Riley-Day syndrome  familial dysautonomia.

Rosenberg-Bergstrom syndrome  an inherited syndrome of hyperuricemia, renal insufficiency, ataxia, and deafness.

Rukavina's syndrome  a type of familial amyloid polyneuropathy.

Rundles-Falls syndrome  hereditary sideroblastic anemia.

Ruvalcaba's syndrome  abnormal shortness of the metacarpal or metatarsal bones, hypoplastic genitalia, and mental and physical retardation of unkown etiology, present from birth in males.

Saethre-Chotzen syndrome  Chotzen's s.

salt-depletion syndrome , salt-losing syndrome vomiting, dehydration, hypotension, and sudden death due to very large sodium losses from the body. It may be seen in abnormal losses of sodium into the urine (as in congenital adrenal hyperplasia, adrenocortical insufficiency, or one of the forms of salt-losing nephritis) or in large extrarenal sodium losses, usually from the gastrointestinal tract.

Sanfilippo's syndrome  four biochemically distinct but clinically indistinguishable forms of mucopolysaccharidosis, characterized by urinary excretion of heparan sulfate, rapid mental deterioration, and mild Hurler-like symptoms, with death usually occurring before 20 years of age.

scalenus syndrome , scalenus anticus syndrome a type of thoracic outlet syndrome due to compression of the nerves and vessels between a cervical rib and the scalenus anticus muscle, with pain over the shoulder, often extending down the arm or radiating up the back.

Schaumann's syndrome  sarcoidosis.

Scheie's syndrome  a mild allelic variant of Hurler's syndrome, marked by corneal clouding, clawhand, aortic valve involvement, wide-mouthed facies, genu valgus, and pes cavus; stature, intelligence, and life span are normal.

second impact syndrome  acute, usually fatal, brain swelling and increased cranial pressure, caused by repeated head trauma in a short space of time, so that a second concussion occurs before recovery from a previous concussion is complete.

Sertoli-cell–only syndrome  congenital absence of the germinal epithelium of the testes, the seminiferous tubules containing only Sertoli cells, marked by testes slightly smaller than normal, azoospermia, and elevated titers of follicle-stimulating hormone and sometimes of luteinizing hormone.

severe acute respiratory syndrome  (SARS) an infectious respiratory illness characterized by fever, dry cough, and breathing difficulties, often accompanied by headache and body aches; believed to be caused by a coronavirus.

Sézary syndrome  a form of cutaneous T-cell lymphoma manifested by exfoliative erythroderma, intense pruritus, peripheral lymphadenopathy, and abnormal hyperchromatic mononuclear cells in the skin, lymph nodes, and peripheral blood.

Sheehan's syndrome  postpartum pituitary necrosis.

short-bowel syndrome , short-gut syndrome any of the malabsorption conditions resulting from massive resection of the small bowel, the degree and kind of malabsorption depending on the site and extent of the resection; it is characterized by diarrhea, steatorrhea, and malnutrition.

shoulder-hand syndrome  reflex sympathetic dystrophy limited to the upper limb.

Shprintzen's syndrome  velocardiofacial s.

Shwachman syndrome , Shwachman-Diamond syndrome primary pancreatic insufficiency and bone marrow failure, characterized by normal sweat chloride values, pancreatic insufficiency, and neutropenia; it may be associated with dwarfism and metaphyseal dysostosis of the hips.

sick sinus syndrome  intermittent bradycardia, sometimes with episodes of atrial tachyarrhythmias or periods of sinus arrest, due to malfunction originating in the supraventricular portion of the cardiac conducting system.

Silver-Russell syndrome  a syndrome of low birth weight despite normal gestation duration, and short stature, lateral asymmetry, and some increase in gonadotropin secretion.

Sipple's syndrome  multiple endocrine neoplasia, type II.

Sjögren's syndrome  a symptom complex usually in middle-aged or older women, marked by keratoconjunctivitis sicca, xerostomia, and enlargement of the parotid glands; it is often associated with rheumatoid arthritis and sometimes with systemic lupus erythematosus, scleroderma, or polymyositis.

sleep apnea syndrome  sleep apnea.

Smith-Lemli-Opitz syndrome  an autosomal recessive syndrome of microcephaly, mental retardation, hypotonia, incomplete development of male genitalia, short nose with anteverted nostrils, and syndactyly of second and third toes.

social breakdown syndrome  deterioration of social and interpersonal skills, work habits, and behavior seen in chronically hospitalized psychiatric patients; due to the effects of long-term institutionalization rather than the primary illness.

stagnant loop syndrome  stasis s.

staphylococcal scalded skin syndrome  an infectious disease, usually affecting infants and young children, following infection with certain strains of Staphylococcus aureus, characterized by localized to widespread bullous eruption and exfoliation of the skin leaving raw, denuded areas that make the skin look scalded.

stasis syndrome  overgrowth of bacteria in the small intestine secondary to various disorders causing stasis; it is characterized by malabsorption of vitamin B12, steatorrhea, and anemia.

Steele-Richardson-Olszewski syndrome  a progressive neurological disorder with onset during the sixth decade, characterized by supranuclear ophthalmoplegia, especially paralysis of the downward gaze, pseudobulbar palsy, dysarthria, dystonic rigidity of the neck and trunk, and dementia.

Stein-Leventhal syndrome  polycystic ovary s.

Stevens-Johnson syndrome  a sometimes fatal form of erythema multiforme presenting with a flulike prodrome and characterized by severe mucocutaneous lesions; pulmonary, gastrointestinal, cardiac, and renal involvement may occur.

Stewart-Treves syndrome  lymphangiosarcoma occurring as a late complication of severe lymphedema of the arm after excision of the lymph nodes, usually in radical mastectomy.

stiff-man syndrome  a condition of unknown etiology marked by progressive fluctuating rigidity of axial and limb muscles in the absence of signs of cerebral and spinal cord disease but with continuous electromyographic activity.

stroke syndrome  stroke; a condition with sudden onset due to acute vascular lesions of the brain (hemorrhage, embolism, thrombosis, rupturing aneurysm), which may be marked by hemiplegia or hemiparesis, vertigo, numbness, aphasia, and dysarthria, and often followed by permanent neurologic damage.

Sturge's syndrome , Sturge-Kalischer-Weber syndrome, Sturge-Weber syndrome a congenital syndrome consisting of a port-wine stain type of nevus flammeus distributed over the trigeminal nerve accompanied by a similar vascular disorder of the underlying meninges and cerebral cortex.

subclavian steal syndrome  cerebral or brain stem ischemia due to vertebrobasilar insufficiency in cases of subclavian steal.

sudden infant death syndrome  sudden and unexpected death of an infant who had previously been apparently well, and which is unexplained by careful postmortem examination.

Swyer-James syndrome  acquired unilateral hyperlucent lung, with severe airway obstruction during exhalation, oligemia, and a small hilum.

tarsal tunnel syndrome  a complex of symptoms resulting from compression of the posterior tibial nerve or of the plantar nerves in the tarsal tunnel, with pain, numbness, and tingling paresthesia of the sole of the foot.

Taussig-Bing syndrome  transposition of the great vessels of the heart and a ventricular septal defect straddled by a large pulmonary artery.

testicular feminization syndrome  complete androgen resistance.

thoracic outlet syndrome  any of several neurovascular syndromes due to compression of the brachial plexus nerve trunks, with pain, paresthesias, vasomotor symptoms, and weakness and small muscle wasting in upper limbs; causes include drooping shoulder girdle, a cervical rib or fibrous band, an abnormal first rib, limb hyperabduction (as during sleep), or compression of the edge of the scalenus anterior muscle.

Tolosa-Hunt syndrome  unilateral ophthalmoplegia associated with pain behind the orbit and in the area supplied by the first division of the trigeminal nerve; it is thought to be due to nonspecific inflammation and granulation tissue in the superior orbital fissure or cavernous sinus.

TORCH syndrome  (t oxoplasmosis, o ther agents, r ubella, c ytomegalovirus, h erpes simplex) any of a group of infections seen in neonates as a result of the infectious agent having crossed the placental barrier.

Tourette's syndrome  Gilles de la Tourette's s.

Townes' syndrome  an inherited disorder of auricular anomalies, anal defects, limb and digit anomalies, and renal deficiencies, occasionally including cardiac disease, deafness, or cystic ovary.

toxic shock syndrome  a severe illness with sudden high fever, vomiting, diarrhea, and myalgia, followed by hypotension and, in severe cases, shock; a sunburn-like rash with skin peeling, especially on palms and soles, occurs during the acute phase. It primarily affects menstruating women using tampons, although a few women not using tampons and a few males have been affected. It is thought to be caused by infection with Staphylococcus aureus.

Treacher Collins syndrome  the incomplete form of mandibulofacial dysostosis.

trisomy 8 syndrome  a syndrome due to an extra chromosome 8, usually mosaic (trisomy 8/normal), with mild to severe mental retardation, prominent forehead, deep-set eyes, thick lips, prominent ears, and camptodactyly.

trisomy 11q syndrome  a variable syndrome due to an extra long arm of chromosome 11, possibly including preauricular fistulas, hypoplasia of the gallbladder, micropenis, bicornuate uterus, microphthalmos, malformations of the heart, lungs, and brain, seizures, and recurrent infection.

trisomy 13 syndrome  holoprosencephaly due to an extra chromosome 13, in which central nervous system defects are associated with mental retardation, along with cleft lip and palate, polydactyly, and dermal pattern anomalies, and abnormalities of the heart, viscera, and genitalia.

trisomy 18 syndrome  neonatal hepatitis, mental retardation, scaphocephaly or other skull abnormality, micrognathia, blepharoptosis, low-set ears, corneal opacities, deafness, webbed neck, short digits, ventricular septal defects, Meckel's diverticulum, and other deformities. It is due to an extra chromosome 18.

trisomy 21 syndrome  Down s.

Trousseau's syndrome  spontaneous venous thrombosis of upper and lower limbs associated with visceral carcinoma.

tumor lysis syndrome  severe hyperphosphatemia, hyperkalemia, hyperuricemia, and hypocalcemia after effective induction chemotherapy of rapidly growing malignant neoplasms.

Turcot's syndrome  familial polyposis of the colon associated with gliomas of the central nervous sytem.

Turner's syndrome  gonadal dysgenesis with short stature, undifferentiated (streak) gonads, and variable abnormalities such as webbing of neck, low posterior hair line, increased carrying angle of elbow, cubitus valgus, and cardiac defects. The genotype is XO (45, X) or X/XX or X/XXX mosaic. The phenotype is female.

twiddler's syndrome  dislodgement, breakdown, or other malfunction of an implanted diagnostic device as a result of unconscious or habitual manipulation by the patient.

twin transfusion syndrome , twin–twin transfusion syndrome one caused by twin-to-twin transfusion (q.v.); the donor twin is small, pale, and anemic, while the recipient is large and polycythemic, with an overloaded cardiovascular system.

Twin transfusion syndrome characterized by arteriovenous shunt at a shared placental cotyledon in diamniotic monochorionic twins.

urethral syndrome  symptoms associated with a urethral problem other than infection, including suprapubic aching and cramping, urinary frequency, and bladder complaints such as dysuria, tenesmus, and low back pain.

Usher's syndrome  an inherited syndrome of congenital deafness with retinitis pigmentosa, often ending in blindness; mental retardation and gait disturbances may also occur.

velocardiofacial syndrome  an inherited syndrome of cardiac defects and craniofacial anomalies, often with abnormalities of chromosome 22; learning disabilities often occur, and less often other abnormalities.

Vernet's syndrome  paralysis of the glossopharyngeal, vagus, and spinal accessory nerves due to a lesion in the region of the jugular foramen.

Vogt-Koyanagi-Harada syndrome  bilateral uveitis with iridocyclitis, exudative choroiditis, meningism, and retinal detachment, accompanied by alopecia, vitiligo, poliosis, loss of visual acuity, headache, vomiting, and deafness; possibly an inflammatory autoimmune disorder.

Waardenburg's syndrome  a hereditary, autosomal dominant disorder characterized by wide bridge of the nose due to lateral displacement of the inner canthi and puncta, pigmentary disturbances, including white forelock, heterochromia iridis, white eyelashes, leukoderma, and sometimes cochlear hearing loss.

WAGR syndrome  a syndrome of W ilms' tumor, a niridia, g enitourinary abnormalities or g onadoblastoma, and mental r etardation, due to a deletion in chromosome 11.

Walker-Warburg syndrome , Warburg's syndrome a usually fatal congenital syndrome of hydrocephalus, agyria, various ocular anomalies, and sometimes encephalocele.

Waterhouse-Friderichsen syndrome  the malignant or fulminating form of epidemic cerebrospinal meningitis, with sudden onset, short course, fever, collapse, coma, cyanosis, petechiae on the skin and mucous membranes, and bilateral adrenal hemorrhage.

Weber's syndrome  paralysis of the oculomotor nerve on the same side as the lesion, causing ptosis, strabismus, and loss of light reflex and accommodation; also spastic hemiplegia on the side opposite the lesion with increased reflexes and loss of superficial reflexes.

Weil's syndrome  a severe form of leptospirosis, marked by jaundice usually accompanied by azotemia, hemorrhage, anemia, disturbances of consciousness, and continued fever.

Werner's syndrome  premature aging of an adult, with early graying and some hair loss, cataracts, hyperkeratinization, muscular atrophy, scleroderma-like changes in the skin of the limbs, and a high incidence of neoplasm.

Wernicke-Korsakoff syndrome  a neuropsychiatric disorder caused by thiamine deficiency, most often due to alcohol abuse, combining the features of Wernicke's encephalopathy and Korsakoff's syndrome.

whiplash shake syndrome  subdural hematomas, retinal hemorrhage, and sometimes cerebral contusions caused by the stretching and tearing of cerebral vessels and brain substance, sometimes seen when a very young child is shaken vigorously by the limbs or trunk with the head unsupported; paralysis, visual disturbances, blindness, convulsions, and death may result.

Wilson-Mikity syndrome  a rare form of pulmonary insufficiency in low-birth-weight infants, with hyperpnea and cyanosis during the first month of life, sometimes ending in death; there are also radiologic abnormalities.

Wiskott-Aldrich syndrome  chronic eczema with chronic suppurative otitis media, anemia, and thrombocytopenic purpura, an immunodeficiency syndrome transmitted as an X-linked recessive trait, with poor antibody response to polysaccharide antigens and dysfunction of cell-mediated immunity.

withdrawal syndrome  substance withdrawal.

Wolf-Hirschhorn syndrome  a syndrome due to partial deletion of the short arm of chromosome 4, with microcephaly, ocular hypertelorism, epicanthus, cleft palate, micrognathia, low-set ears simplified in form, cryptorchidism, and hypospadias.

Wolff-Parkinson-White (WPW) syndrome  the association of paroxysmal tachycardia (or atrial fibrillation) and preexcitation, in which the electrocardiogram displays a short P–R interval and a wide QRS complex which characteristically shows an early QRS vector (delta wave).

Wyburn-Mason's syndrome  arteriovenous aneurysms on one or both sides of the brain, with ocular anomalies, facial nevi, and sometimes mental retardation.

syndrome X  angina pectoris or angina-like chest pain associated with normal arteriographic appearance of the coronary arteries.

Zollinger-Ellison syndrome  the association of atypical, intractable, sometimes fulminating, peptic ulcers with extreme gastric hyperacidity and benign or malignant gastrinomas in the pancreas.

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irritable bowel syndrome

n.

A chronic disorder characterized by motor abnormalities of the small and large intestines, causing variable symptoms including cramping, abdominal pain, constipation, and diarrhea. Also called irritable colon, spastic colon.

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irritable bowel syndrome (IBS)

Etymology: L, irritare, to tease; OFr, boel + Gk, syn, together, dromos, course

abnormally increased motility of the small and large intestines, of unknown origins. Most of those affected are young adults who complain of diarrhea and, occasionally, pain in the lower abdomen. The pain is usually relieved by passing flatus or stool. In diagnosing irritable bowel syndrome, other more serious conditions, such as dysentery, lactose intolerance, and the inflammatory bowel diseases, must be ruled out. Because there is no organic disease present in irritable bowel syndrome, no specific treatment is necessary. Many persons benefit from the use of bulk-producing agents in the diet because bulk tends to stabilize the water content of the stool. Antidiarrheal drugs are helpful in decreasing the frequency of stool. Although this is a functional disorder, patients experience pain and discomfort and need emotional support. Mild tranquilizers or antidepressants are sometimes given to relieve anxiety or depression. Also called functional bowel syndrome, mucous colitis, spastic colon.

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irritable [ir´ĭ-tah-b'l]

1. capable of reacting to a stimulus.

2. abnormally sensitive to stimuli.

irritable bowel syndrome the most common disorder presented by patients with gastrointestinal complaints, consisting of (1) altered bowel habits with diarrhea, constipation, or alternating diarrhea and constipation; (2) abdominal pain and intolerance to flatus; and (3) absence of detectable organic disease. Many inappropriate terms have been used to describe this disorder, including mucous colitis, nervous colon, spastic colon, and irritable colon. This syndrome should not be confused with colitis or other inflammatory diseases of the intestinal tract; in irritable bowel syndrome there is no inflammation, and it is not necessarily limited to the colon.

Patient Care. Because of psychological factors that usually contribute to the disorder and its tendency to be chronic in nature, treatment should be holistic and individualized to meet the needs of each patient. In most cases, treatment is needed for an extended period of time. Patients should be assured that there is no relationship between their disorder and malignancy of the bowel. Modes of therapy include psychotherapy, biofeedback training, medications such as antidepressants, antispasmodics, and analgesics, and a diet that is high in bran and fiber.

Nursing care for the patient with irritable bowel syndrome is essentially the same as that for someone with diarrhea or constipation. Patient teaching should include information about gas-forming foods such as legumes and those in the cabbage family. Milk and milk products are restricted in those patients who have shown an intolerance to milk.

Anxiety can often be mitigated by teaching the patient about the nature of the illness and reassurance that it is not related to malignancy of the bowel and can be managed by relatively simple, noninvasive measures. Ineffective coping patterns are not uncommon in these patients. When there is evidence that the patient is either unable to cope or is using harmful coping mechanisms such as smoking, drinking, or drug abuse, health teaching concerning relaxation techniques, wholesome diet, exercise, and recreation is appropriate.

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irritable

1. capable of reacting to a stimulus.

2. abnormally sensitive to stimuli.

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irritable bowel syndrome

see irritable colon syndrome.

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irritable bowel syndrome

Irritable colon GI disease A condition characterized by chronic abdominal pain, bloating, mucus in stools, irregular bowel habits, alternating diarrhea and constipation; IBS may accompany anxiety and panic disorders; Sx tend to wax and wane over yrs; the primary defect appears to be abnormal GI tract contractions–motility, which does not lead to any serious organ problems; it is a diagnosis of exclusion Management Symptomatic–high fiber diet, exercise, relaxation techniques, avoid caffeine, milk products, sweeteners, medications

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Patient discussion about irritable bowel syndrome.

Q. What percentages of fibromyalgia patients have IBS. My cousin with fibromyalgia aka FMS have also been diagnosed with IBS. Is it a usual happening? What percentages of fibromyalgia patients have IBS?

A. Irritable bowel syndrome seems to go hand in hand with FMS, similar to the way in which people with fibromyalgia are also found to have depression. A fairly high percentage of individuals with fibromyalgia aka FMS have also been diagnosed with IBS, or irritable bowel syndrome. So how high is the percentage? It is believed that up to 70 to 80 percent of fibromyalgia patients also suffer from IBS, a form of inflammatory bowel disease. Irritable bowel syndrome seems to go hand in hand with FMS, similar to the way in which people with fibromyalgia are also found to have depression. Statistically, of course, those who have both IBS and FMS are overwhelmingly female, just as patients who are diagnosed with depression, fibromyalgia, or irritable bowel syndrome separately, tend more often to be female versus male.