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Anatomical marker and a surgical option in the irritable bowel syndrome treatment

PURPOSE: Based on the observation that the mobile cecum syndrome (MCS) includes symptoms which overlap symptoms of the IBS, our purposes were: to demonstrate the relationship of cause and effect between the mobile cecum and IBS; to evaluate the result of the cecopexia, as method of patients' treatment with irritable bowel syndrome (IBS) or with abdominal discomfort of ignored etiology; and to show that the mobile cecum can be considered as the first anatomical marker for IBS. PATIENTS AND METHODS: From 1994 to 2006, 123 patients (109 women and 14 men - median age, 37,7 - ranged 3 to 82) seen in private office had clinical diagnosis of mobile cecum; 103 patients (83,7%) had been seen as having irritable bowel syndrome. All patients of this series were programmed for cecopexy. Thirty refused the surgical treatment and 29 are waiting for suitable surgery; both are on clinical follow-up in private office RESULTS: All operated patients (64/52%) with fixed cecum followed from 1 to 139 months (median, 21) are well and asymptomatic Among the 58 operated women, 48 (82,7%) answered the inquiry about dispareunia; 44(92%) had dispareunia. After surgical treatment 89,7% have participated of the inquiry; 52 (96%) were without symptoms. The non-operated patients (59/48%) followed from 1 to 72 months (median, 16) are with the same complain. CONCLUSION: Based on the results, we conclude that: the topographical investigation of the cecum-ascendent should be made for all the patients with diagnosis of IBS or with functional obscure abdominal symptoms; the patients of that serie with IBS had mobile cecum and they were cured with cecopexy; there is a relationship of cause and effect between mobile cecum and IBS; the mobile cecum can be pointed as the first anatomical marker for SCI; the mobile cecum can be considered as cause of deep dispareunia.

Mobile cecum syndrome; irritable bowel syndrome; intermittent abdominal complains; abdominal pain; colic; diarrhea; constipation; cecal volvulus


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