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Peter Whorwell

Helen Pilcher
No abstract text is available yet for this article.
May 19, 2016: Nature
Olafur S Palsson, William E Whitehead, Miranda A L van Tilburg, Lin Chang, William Chey, Michael D Crowell, Laurie Keefer, Anthony J Lembo, Henry P Parkman, Satish Sc Rao, Ami Sperber, Brennan Spiegel, Jan Tack, Stephen Vanner, Lynn S Walker, Peter Whorwell, Yunsheng Yang
The Rome IV Diagnostic Questionnaires were developed to screen for functional gastrointestinal disorders (FGIDs), serve as inclusion criteria in clinical trials, and support epidemiological surveys. Separate questionnaires were developed for adults, children/adolescents, and infants/toddlers. For the adult questionnaire, we first surveyed 1,162 adults without gastrointestinal disorders, and recommended the 90(th) percentile symptom frequency as the threshold for defining what is abnormal. Diagnostic questions were formulated and verified with clinical experts using a recursive process...
February 13, 2016: Gastroenterology
Laurie Keefer, Douglas A Drossman, Elspeth Guthrie, Magnus Simrén, Kirsten Tillisch, Kevin Olden, Peter J Whorwell
Centrally Mediated Abdominal Pain Syndrome (CAPS), formerly known as Functional Abdominal Pain Syndrome, can be distinguished from other functional GI disorders by its strong central component and relative independence from motility disturbances. CAPS is a result of central sensitization with disinhibition of pain signals rather than increased peripheral afferent excitability. A newly described condition, Narcotic Bowel Syndrome (NBS)/Opioid-Induced GI Hyperalgesia, is characterized by the paradoxical development of or increases in abdominal pain associated with continuous or increasing dosages of opioids...
February 19, 2016: Gastroenterology
Maura Corsetti, Peter Whorwell
Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder, which represents a major cost to healthcare services. Current pharmacological treatment includes fibre supplements, antispasmodics, laxatives, loperamide and antidepressants. This article reviews the novel pharmacological treatments already or recently approved for patients with IBS-C (lubiprostone, linaclotide) and IBS-D (alosetron, ramosetron, rifaximin, eluxadoline). Furthermore, results for drugs in development (plecanatide, ibudutant and ebastine) or used in chronic constipation or for other indications, with potential application in IBS (prucalopride, elobixibat, mesalazine, ondansetron and colesevelam) are also reviewed...
July 2016: Expert Review of Gastroenterology & Hepatology
Yi Qun Yu, Peter James Whorwell, Lin Heng Wang, Jun Xiang Li, Qing Chang, Jie Meng
Cronkhite-Canada syndrome (CCS) is a rare nongenetic polyposis syndrome first reported by Cronkhite and Canada in 1955. Up to the present time, the literature consists of ∼400 cases of CCS with the majority being reported from Japan although 49 cases have been described in China.CCS is characterized by diffuse polyposis of the digestive tract in association with ectodermal changes, such as onychomadesis, alopecia, and cutaneous hyperpigmentation. The principal symptoms of CCS are diarrhea, weight loss, abdominal pain, and other gastrointestinal complications, such as protein-losing enteropathy and malnutrition...
December 2015: Medicine (Baltimore)
Sima Atarodi, Shahram Rafieian, Peter J Whorwell
OBJECTIVE: Faecal incontinence (FI) is a devastating condition which is well recognised in the elderly and those with certain conditions such as inflammatory bowel disease. However, there is surprisingly little information on its prevalence in irritable bowel syndrome (IBS), especially in relation to bowel habit subtype, and this study aimed to answer this question. DESIGN: 500 consecutive new and follow-up secondary care IBS outpatients (399 female, 101 male, age range 15-87, mean age 46) fulfilling Rome III criteria without any significant concomitant disease were studied...
2014: BMJ Open Gastroenterology
Maura Corsetti, Peter J Whorwell
The classic symptoms of irritable bowel syndrome (IBS) are abdominal pain, bloating and some form of bowel dysfunction. The pain is typically colicky in nature and can occur at any site although most commonly it is on the left side. The abdomen feels flat in the morning and then gradually becomes more bloated as the day progresses reaching a peak by late afternoon or evening. It then subsides again over night. Traditionally IBS is divided into diarrhoea, constipation or alternating subtypes. IBS patients frequently complain of one or more non-colonic symptoms, these include constant lethargy, low backache, nausea, bladder symptoms suggestive of an irritable bladder, chest pain and dyspareunia in women...
June 2015: Practitioner
Kenneth Finlayson, Soo Downe, Susan Hinder, Helen Carr, Helen Spiby, Peter Whorwell
BACKGROUND: Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women's views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth...
September 25, 2015: BMC Pregnancy and Childbirth
Dorte Eskesen, Lillian Jespersen, Birgit Michelsen, Peter J Whorwell, Stefan Müller-Lissner, Cathrine M Morberg
The aim of the present study was to investigate the effect of Bifidobacterium animalis subsp. lactis, BB-12®, on two primary end points - defecation frequency and gastrointestinal (GI) well-being - in healthy adults with low defecation frequency and abdominal discomfort. A total of 1248 subjects were included in a randomised, double-blind, placebo-controlled trial. After a 2-week run-in period, subjects were randomised to 1 or 10 billion colony-forming units/d of the probiotic strain BB-12® or a matching placebo capsule once daily for 4 weeks...
November 28, 2015: British Journal of Nutrition
James S Pearson, Robert M Niven, Jie Meng, Sima Atarodi, Peter J Whorwell
Irritable bowel syndrome (IBS) is notoriously difficult to treat and this situation is unlikely to change until the pathophysiology is better understood. There is no doubt that IBS is a multifactorial condition but it is likely that the relative contribution of the various factors involved varies from patient to patient. Consequently, in some individuals one mechanism may have such a strong effect that its elimination may lead to a substantial improvement in symptoms. This paper describes a patient with severe asthma and IBS where the administration of an anti-Immunoglobulin E (IgE) monoclonal antibody not only improved her asthma but also resulted in an almost complete resolution of her IBS symptoms...
September 2015: Therapeutic Advances in Gastroenterology
Peter J Whorwell
No abstract text is available yet for this article.
May 2015: Therapeutic Advances in Gastroenterology
Tarig Algladi, Mary Harris, Peter J Whorwell, Peter Paine, Shaheen Hamdy
Visceral pain is a particularly difficult symptom to manage in patients with irritable bowel syndrome (IBS). Our aim was to examine whether noninvasive neurostimulation applied to the motor cortex or lumbosacral region can modulate human visceral sensation. Sixteen healthy adult volunteers and 10 patients with IBS were evaluated. Single-pulse lumbosacral magnetic stimulation (LSMS) or transcranial magnetic stimulation (TMS) was used to assess spinal root and cortical excitability as well as the effect of neurostimulation on anorectal sensation and pain, which were provoked by a local electrical stimulus...
July 2015: Pain
Ching Lam, Wei Tan, Matthew Leighton, Margaret Hastings, Melanie Lingaya, Yirga Falcone, Xiaoying Zhou, Luting Xu, Peter Whorwell, Andrew F Walls, Abed Zaitoun, Alan Montgomery, Robin Spiller
INTRODUCTION: Immune activation has been reported in the mucosa of IBS patients with diarrhoea (IBS-D), and some small studies have suggested that mesalazine may reduce symptoms. We performed a double-blind, randomised placebo-controlled trial of 2 g mesalazine twice daily versus placebo for 3 months in patients with Rome III criteria IBS-D. Primary outcome was daily average stool frequency during weeks 11-12; secondary outcomes were abdominal pain, stool consistency, urgency and satisfactory relief of IBS symptoms...
January 2016: Gut
Viola Andresen, Peter Whorwell, Josep Fortea, Sébastien Auzière
BACKGROUND: The diagnostic processes for chronic abdominal conditions are challenging. Despite their tendency for diagnostic tests in patients with irritable bowel syndrome (IBS) symptoms, clinicians are encouraged to make a positive diagnosis based on symptom criteria without alarm signs. We explored how European physicians diagnose and manage patients suffering from IBS. METHODS: We conducted a vignette-based survey to evaluate the diagnostic approaches in four standardized patients with IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), inflammatory bowel disease (IBD) and chronic constipation (CC)...
February 2015: United European Gastroenterology Journal
Peter J Whorwell
No abstract text is available yet for this article.
February 2015: Nature Reviews. Gastroenterology & Hepatology
James S Pearson, Christine Pollard, Peter J Whorwell
OBJECTIVES: In patients with severe irritable bowel syndrome (IBS), abdominal pain can be the predominant symptom impacting on all aspects of their lives and resulting in excessive healthcare utilization. Furthermore, the use of analgesics can become excessive in this group of patients, sometimes leading to opiate dependency. Typically, the pain is often described as spastic in nature and we have speculated that parenteral anticholinergics might provide effective relief when all other measures have failed...
November 2014: Therapeutic Advances in Gastroenterology
Patrick Veiga, Nicolas Pons, Anurag Agrawal, Raish Oozeer, Denis Guyonnet, Rémi Brazeilles, Jean-Michel Faurie, Johan E T van Hylckama Vlieg, Lesley A Houghton, Peter J Whorwell, S Dusko Ehrlich, Sean P Kennedy
The gut microbiota (GM) consists of resident commensals and transient microbes conveyed by the diet but little is known about the role of the latter on GM homeostasis. Here we show, by a conjunction of quantitative metagenomics, in silico genome reconstruction and metabolic modeling, that consumption of a fermented milk product containing dairy starters and Bifidobacterium animalis potentiates colonic short chain fatty acids production and decreases abundance of a pathobiont Bilophila wadsworthia compared to a milk product in subjects with irritable bowel syndrome (IBS, n = 28)...
2014: Scientific Reports
Nicolas G Rey de Castro, Vivien Miller, Helen R Carruthers, Peter J Whorwell
BACKGROUND AND AIM: Irritable bowel syndrome (IBS) is traditionally divided into subtypes depending on the bowel habit abnormality, but there is little clarity in the literature about whether these subtypes differ symptomatically or psychologically. Furthermore, there are conflicting reports on the relationship between symptom severity and psychological status. The aim of this study was to address these issues in a large cohort of patients defined by bowel habit. METHODS: One thousand IBS patients were divided into diarrhea (IBS-D), constipation (IBS-C), and mixed (IBS-M) bowel habit subtypes and completed a series of validated questionnaires capturing symptom severity, non-colonic symptomatology (somatization), quality of life, and anxiety or depression levels...
February 2015: Journal of Gastroenterology and Hepatology
Richard Hunt, Eamonn Quigley, Zaigham Abbas, Abraham Eliakim, Anton Emmanuel, Khean-Lee Goh, Francisco Guarner, Peter Katelaris, Andre Smout, Mohammad Umar, Peter Whorwell, John Johanson, Roque Saenz, Luc Besançon, Edith Ndjeuda, John Horn, Pali Hungin, Roger Jones, Justus Krabshuis, Anton LeMair
No abstract text is available yet for this article.
August 2014: Journal of Clinical Gastroenterology
Klara Garsed, Julia Chernova, Margaret Hastings, Ching Lam, Luca Marciani, Gulzar Singh, Amanda Henry, Ian Hall, Peter Whorwell, Robin Spiller
BACKGROUND: Irritable bowel syndrome with diarrhoea (IBS-D) is particularly debilitating due to urgency and episodic incontinence. Some 5-hydroxytryptamine 3 (5-HT3) receptor antagonists (5-HT3RAs) have proven effective but have serious side effects. Ondansetron, also a 5-HT3RA, has been widely used as an antiemetic with an excellent safety record for over two decades. Our aim was to assess its effectiveness in IBS-D. METHODS: 120 patients meeting Rome III criteria for IBS-D entered a randomised, double-blind, placebo-controlled crossover study of 5 weeks of ondansetron 4 mg versus placebo with dose titration allowed, up to two tablets three times daily in the first 3 weeks...
October 2014: Gut
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