Talk:Irritable bowel syndrome/Archive 3

Archive 1

Archive 2

Archive 3

Causes of IBS?

Where exactly in that review does it say that "an interaction between the immune system and the intestinal flora are the main cause of IBS". I didn't read the whole thing, so I might have missed it. Also it looks like this review is mostly a study on probiotics.

If you do a general search for reviews on the etiology of IBS, these reviews come up:

http://www.nature.com/pr/journal/v62/n3/abs/pr2007210a.html http://www.nature.com/ajg/journal/v103/n3/abs/ajg200850148a.html

--sciencewatcher (talk) 17:58, 26 January 2014 (UTC)

It is in the last paragraph of the review that I read that. Undoubtedly there are at least several major theories for the causes of irritable bowel syndrome and probably there are several different causes for different people. I guess we need to be careful particularly in the lede section how we present these different viewpoints.--MrADHD | T@1k? 09:32, 28 January 2014 (UTC)

Here is another well-cited review from Nature which says IBS "is thought to be the result of disturbed neural function along the brain–gut axis. The mechanisms behind this disturbance are not clear, but important roles for low-grade inflammation and immunological alterations in the development of symptoms compatible with IBS have become evident" :

http://www.nature.com/nrgastro/journal/v7/n3/full/nrgastro.2010.4.html

So it looks like IBS is still thought to be caused by some combination of a disrupted brain-gut axis, infections and psychological factors/stressors. I was going to update the article a bit, but I can't be bothered (and since you removed that sentence I think it's mostly okay anyway :) --sciencewatcher (talk) 22:06, 30 January 2014 (UTC)

If editors are going to be bothered to edit, they really should be bothered to give their full attention to it. ~ P-123 (talk) 09:25, 4 May 2015 (UTC)

Now, really? Says who? You, the IBS and diarrhea expert? Just assume good faith and go edit. No need to criticize any other editors! 208.123.223.58 (talk) 12:53, 4 May 2015 (UTC)

We're all unpaid volunteers here. Nobody has to give their full attention to it -- the only requirement is to improve the articles and not violate wikipedia policies doing it. If anyone has the time, motivation and skill to make this into a perfect article, please go ahead. --sciencewatcher (talk) 14:11, 4 May 2015 (UTC)

Lost my faith in Wikipedia Science

Yes, an encyclopedia controlled by bigPharma editors. I have no faith on this site as my entry was undone with a citation from an international journal in GI. — Preceding unsigned comment added by NulliusinverbaC4URSelf (talk • contribs) 19:50, 21 December 2015 (UTC)

Well, your comment about bigPharma is pretty dumb. Most of us are just volunteers and have nothing to do with "big pharma".

There are lots of peer-reviewed studies proving that homeopathy works, HIV doesn't cause AIDS, etc. That is why wikipedia relies on reviews rather than individual studies. I would recommend that you read WP:MEDRS, which explains this in detail. I'm happy with your edit as long as it has a proper source (and I'm sure all the other editors would be equally happy). Please take the time to understand how wikipedia works, so that you can contribute. Thanks. --sciencewatcher (talk) 20:58, 21 December 2015 (UTC)

I'm not particularly happy with the edit as it stands, for the reasons you gave when you reverted it (primary source, single study, 13 subjects, no controls, etc.) -- and now that poisoning the well has been tossed in, I'm even less enthusiastic. There is already a reference to low-FODMAP diets, which do have some science behind them; if you're suggesting that we keep this addition, despite its gossamer citation support, I'd recommend inclusion of "in one small study" at the end of the first sentence -- unless NulliusinverbaC4URSelf can come up with other credible references, or a secondary review, neither of which I was able to find on an (admittedly hasty) NLM search just now. I'm aware that WP:BITE applies here -- but so does WP:RS. DoctorJoeE ^{review transgressions}/_{talk to me!} 01:17, 22 December 2015 (UTC)

I agree with Sciencewatcher and DoctorJoeE. Maybe Doc James can give us his opinion.

I apologize if I have bitten ip 190.90.70.129/NulliusinverbaC4URSelf, but thought I was being nice and have properly explained the reasons for my reversions:

• (Undid revision 696066927 by 190.90.70.129 (talk) Citation needed WP:IRS) (undo)
• (Undid revisions by NulliusinverbaC4URSelf (talk) Information only partly backed, and by primary source. Please, see WP:IRS) (undo)

Best regards. --BallenaBlanca (talk) 21:09, 22 December 2015 (UTC)

All comments are honest and civil and I understand all want to give the science a critical review - I am on board with that. I am imagining at least 3 citations are required to be able to post on Wikipedia. I have 3 more citations: https://www.ncbi.nlm.nih.gov/pubmed/24582764, https://www.ncbi.nlm.nih.gov/pubmed/25680668, https://www.ncbi.nlm.nih.gov/pubmed/25785440, I think it warrants even the Swedish Government nutritional advisory is promoting low-carb diet based on their research. Yes, more research is needed in this area, but many GI docs will tell you that carbohydrates feed the gut microflora which is the culprit for many patients with IBS - it makes sense in some cases. I apologize for the bigPharma remark but I worked in medical research and have become a bit cynical over time unfortunately. This IBS Wikipedia entry is surprisingly quite heavy on the medications as treatments so this was where my reasoning for the bigPharma comment originated. Keep up the good work - I am impressed with the quality of contributors on this page. — Preceding unsigned comment added by 190.90.70.129 (talk) 22:38, 22 December 2015 (UTC)

I have removed it again. Filling this article full of primary sources is not the solution. Doc James (talk · contribs · email) 22:47, 22 December 2015 (UTC)

You guys are tough (in a good way though), but since I am a newbie here I am going to embrace the Illegitimi non carborundum and take a deep breath and admit I was check-mated by formidable opponents. Wow, and I used to think primary sources were preferred and used to tell my students you can not use Wikipedia as a source, since it is not a primary source - how things change. The best to everyone.

No, primary sources are *not* preferred on wikipedia. We prefer secondary sources, and that is one of the main reasons why your edit was reverted. Please read WP:MEDRS which explains this. I would urge you to have a look to see if there are any reviews, and decide whether or not it's worth adding. If you need any help, let me know. --sciencewatcher (talk) 00:55, 23 December 2015 (UTC)

I read the link - thanks and I understand. All these great educated editors and Wikipedia is not allowed as a reference in research papers and primary sources are not preferred on Wikipedia - am I the only one to find it a bit ironic? — Preceding unsigned comment added by NulliusinverbaC4URSelf (talk • contribs) 01:31, 23 December 2015 (UTC)

Literature reviews and systematic reviews are generally better representations of the scientific position. Doc James (talk · contribs · email) 04:06, 23 December 2015 (UTC)

Please read WP:PSTS, which explains in detail the difference between primary, secondary, and tertiary sources, and why the absence of conclusions in primary sources is problematic for WP editors. We try not to rely on primary sources because they nearly always force editors to draw their own conclusions, which is a basic WP no-no. Or, to put it another way, by drawing your own conclusions you are doing original research, which is not allowed here. DoctorJoeE ^{review transgressions}/_{talk to me!} 05:48, 23 December 2015 (UTC)

Parasite reviews

References

Seppi333 (Insert 2¢) 18:36, 1 January 2016 (UTC) – Updated 01:23, 4 January 2016 (UTC)

If you're suggesting that some cases of IBD can be explained by parasites -- that's probably true, but the cited article (a primary source) doesn't draw that conclusion. So we can't say it in this article, unless and until a secondary source draws the conclusion for us. DoctorJoeE ^{review transgressions}/_{talk to me!} 20:07, 1 January 2016 (UTC)

Eh... actually all I intended to do by posting this section was add an external link to that article for me to follow/use later when I feel like adding and citing new content in this article. It is indeed a medical review though – follow the link to PMID 26635531 and expand the "Publication Types" tab.

The only reason I think it's worth covering is because parasites (protazoa/helminths) and IBS both have significant associations with mast cells. Intestinal parasites can trigger mast cell degranulation and some intestinal parasites can influence mast cell function and/or proliferation/migration into the GI tract by various mechanisms; on the other hand, IBS is associated with mast cell abnormalities in different parts of the GI tract (abnormalities differ between subtypes). Seppi333 (Insert 2¢) 20:57, 1 January 2016 (UTC)

Syndrome or condition?

Thanks to Doc James for cleaning up the lead section and sourcing much from the NIDDK fact sheet[1]. I think the way they define this is very good: "Irritable bowel syndrome (IBS) is a group of symptoms—including pain or discomfort in your abdomen and changes in your bowel movement patterns—that occur together" and helps to start the article with the idea that IBS is not a single disorder but a symptom cluster (group of symptoms/syndrome). Can we incorporate the words in this source please? Jrfw51 (talk) 12:22, 30 March 2016 (UTC)

Sure added. Doc James (talk · contribs · email) 12:37, 30 March 2016 (UTC)

Management - Diet/FODMAPs diet

Under Management, and further under Diet, we find FODMAPs diet, where the latter two seem to not be aware of each other. Wouldn't it be better to rewrite these, since they deal with the same/overlap? — Preceding unsigned comment added by 195.249.185.2 (talk) 09:06, 18 June 2016 (UTC)

Differential diagnosis/ Bile acid malabsorption

I propose adding this condtion to the list. The same source as in "Bile acid malabsorption" could be used, which is number 12 there. ( Walters, JR (2010). "Defining primary bile acid diarrhea: making the diagnosis and recognizing the disorder". Expert review of gastroenterology & hepatology. 4 (5): 561–7. doi:10.1586/egh.10.54. PMID 20932141. ) 77.252.193.181 (talk)
21:03, 31 January 2017 (UTC)anon, 01/31/2016— Preceding unsigned comment added by 77.252.193.181 (talk) 20:59, 31 January 2017 (UTC)

A minor doubt

About this edit [2], this is a minor issue, but I would like to know what to do in future occasions.

I understood that they are two different links, not duplicates.

I linked to the section on the diet [[FODMAP#Low-FODMAP diet|diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols]] (for those who want to see the diet) and to the page ([[FODMAP]]s) (for those who want to see the definition of FODMAP).

Only the first link (to the diet section) has been maintained. But I think that when most readers click and enter the diet section are not oriented, they do not have to know that navigating up the page they arrive to the definition. --BallenaBlanca 🐳 ♂ (Talk) 06:28, 6 June 2018 (UTC)

Both the links bring the person to the same page so IMO one does not need both. One can scroll up on the first. Doc James (talk · contribs · email) 08:36, 6 June 2018 (UTC)

Doc James, thanks for your answer. Best regards. --BallenaBlanca 🐳 ♂ (Talk) 12:06, 6 June 2018 (UTC)

Tricyclic antidepressants

I'm not sure that I understand the posited conclusion of the sentence "Antidepressants are not effective for IBS in people suffering from depression, possible because lower doses of antidepressants than the doses used to treat depression are required for relief of IBS" and I'm unsure as to whether that is what the source says. It states "TCAs and SSRIs are not effective in IBS patients with depression. However, a smaller dose of antidepressants than that used for depression is required to improve the symptoms of IBS". It's not clear to me whether it is stating that TCAs and SSRIs are not effective for these individuals for IBS or for depression. Whatever the meaning of the former sentence, it is not clear to me that the second sentence is being given as a reason for the first. Any thoughts? Mutt Lunker (talk) 09:41, 4 October 2018 (UTC)

"Rome II Conference" listed at Redirects for discussion

An editor has asked for a discussion to address the redirect Rome II Conference. Please participate in the redirect discussion if you wish to do so. Hog Farm (talk) 05:28, 16 February 2020 (UTC)

"Gut Itch" explanation for IBS

From the medical news: https://www.medicalnewstoday.com/articles/326728.php

Maybe worth adding this in the wiki page? — Preceding unsigned comment added by 95.245.51.49 (talk) 23:29, 20 October 2019 (UTC)

User:95.245.51.49, thanks for sharing. It looks like the article provides a credible source (a medical journal). I think it might be worthwhile to reference to the source instead, although that would require someone to read and be able to summarize the study. I will give it a read sometime soon. Another user is more than welcome to do so before me. To clarify, I am referring to what they (Medical News Today) sourced to here: https://insight.jci.org/articles/view/131712 SchizoidNightmares (talk) 00:55, 5 January 2021 (UTC)

Shortening introductory sentence

I included the referenced former names for the condition in the introductory sentence not too long ago. However, someone may want to find another source, or a few more, to determine, which former names are more commonly referenced, and remove the ones that are not (or move the lesser sourced ones elsewhere). The introductory sentence just seems kind of long. SchizoidNightmares (talk) 01:24, 12 January 2021 (UTC)

I removed "colitis" and "mucous colitis" from the first sentence. These terms are no longer used at all, and I think it's preferable to avoid confusion between IBS and the many causes of true colitis. These are included in the infobox. Thanks! Rytyho usa (talk) — Preceding undated comment added 01:58, 12 January 2021 (UTC)

Template Box / Management

Why is Eluxadoline listed for management of IBS but not Rifaximin which has also been approved by the FDA in recent years? I haven't even heard of Eluxadoline until now so this seems strange. — Preceding unsigned comment added by 79.201.166.79 (talk) 23:12, 13 June 2021 (UTC)

Chronic fatigue syndrome

The chronic fatigue syndrome onset is after 60 years and the IBS onset is before 45. Anyone can reliably reconcile this difference? AXONOV (talk) ⚑ 10:36, 11 August 2021 (UTC)

"ME/CFS is most common in people between 40 and 60 years old."[3], but that doesn't mean ME/CFS does not occur at other ages. Nor have there been rigorous studies to explore what ages persons with ME/CFS exhibit the symptoms of IBS, that I know of anyway. As a further compounding factor, studies have used many different definitions to diagnose the patients, so there are many subgroups lumped in the umbrella term ME/CFS. In other words, the research has a lot of issues that would make it difficult to answer to your question with any certainty. Ward20 (talk) 20:00, 11 August 2021 (UTC)

@Ward20: Well, then I propose to clarify that the overlap is less significant and age should be taken into account. According to cited source (review)[4] CFS is not the only accompanying disease and found only in 51% of IBS cases, so it shouldn't be taken like a major indicator (symptom) or a disease concomitant with IBS.
Btw, one review [5] claims that the age of onset of CFS is between 20 and 45 (38 years old on average per another source, see TABLE 4: [6]) and is prevalent in females (3:1 - female:male ratio). AXONOV (talk) ⚑ 09:41, 12 August 2021 (UTC)

I'm not very familiar with this article, but where does it state ME/CFS is a major indicator of IBS? ME/CFS is not a symptom, it is a diagnosis of an illness, so I'm not sure what needs to be clarified in the article. Would you please be specific what sentence(s) need to be changed?

First, the 2002 Gastroenterology Review[7] uses cites of ME/CFS defintions from 1988 and 1994, mostly studies from the 1990s, and even uses studies of Chronic fatigue in their data about ME/CFS. The premise in the Abstract Conclusions states that, "strong comorbidity suggests a common feature important to their expression, which is most likely psychological." The study basically conculudes IBS and other cormorbid conditions associated with it are psychological. This study is so biased and out of date it shouldn't be used as a reference.

The '40 to 60 year old' data is from the CDC guidance[8] which is based on the diagnostic definition of the 2015 Institute of Medicine report on ME/CFS.[9] The '38 years old' data mentioned in the WP:Primary Source Mayo Prevalence study was published in 2012, but the Fukuda criteria they used for the diagnosic definition is from 1994[10] and quite different from the newer CDC symptom criteria. The 2019 ME/CFS review[11] is good but the definition of ages where it is most common is not necessarily the same as the definition for peak age of onset.

To sum up, the data and citations used here need to be carefully considered before use, and terminology and definitions agreed upon by the involved editors in order to have a good result. Ward20 (talk) 21:18, 12 August 2021 (UTC)

@Ward20: [...] This study is so biased and out of date it shouldn't be used as a reference. [...]
Well even though I tend to agree with you for now I propose to explicitly mention that materials backed up by [12] are old (per WP:MEDDATE) until more WP:RS are provided.

I also propose to remove mentions of CFS from symptoms because it's confusing and certainly shouldn't be listed there.
In the lead and § Comorbidities I'm going to explicitly mention that the source used is old by using H:RTAG. Any objections? AXONOV (talk) ⚑ 12:32, 13 August 2021 (UTC)

@Alexander Davronov: Sounds like a good start to me. Ward20 (talk) 21:47, 13 August 2021 (UTC)

Length of article

In my humble opinion, this article is way too long and because of this is less accessible. I would suggest dramatically reducing some of the sections and/or moving some areas (e.g. dietary management of IBS) to a separate page Y2k3000 (talk) 00:55, 28 October 2022 (UTC)

Blood test

This Wikipedia article says: "Irritable bowel syndrome (IBS) or spastic colon is a symptom-based diagnosis….No specific laboratory or imaging test can be performed to diagnose irritable bowel syndrome."

However, this may need updating. See here.Anythingyouwant (talk) 00:35, 22 May 2015 (UTC)

Well, we would need to wait for this to appear in a review. Looking at the study itself, it doesn't really seem all that impressive. If you look at the results for Anti-vinculin (fig 3) you'll see all the results are overlapping. There would be no way to diagnose IBS from that. The Anti CdtB results are slightly more impressive, although it still doesn't distinguish between IBS and Celiac. As usual, this is another good example of science hyped by press release, and demonstrates precisely why we don't use primary studies (and news articles in particular) for medical claims. --sciencewatcher (talk) 00:45, 22 May 2015 (UTC)

For sure, science hyped press releases are not reliable sources for this Wikipedia article, but still it's worth keeping an eye on them, so that more reliable sources can be consulted later. As for celiac disease, that problem may be solved by testing for celiac disease antibodies alongside the new IBS tests, or at least so says this unreliable source. You may want to consider simply removing the categorical statement that "No specific laboratory or imaging test can be performed to diagnose irritable bowel syndrome" without yet asserting the contrary.Anythingyouwant (talk) 00:52, 22 May 2015 (UTC)

Is there any update to this?

Not to my knowledge -- IBS remains a diagnosis of exclusion.DoctorJoeE ^{review transgressions}/_{talk to me!} 01:46, 14 June 2021 (UTC)

It is still a diagnosis of exclusion; there are no specific blood tests for IBS, other than to rule out other conditions like celiac disease.Rytyho usa (talk) 03:57, 14 June 2021 (UTC)

You're obviously not very familiar with ongoing research in this field. 79.201.168.182 (talk) 17:19, 16 October 2023 (UTC)