Published on February 16, 2014
LOGO Irritable Bowel syndrome: Dr.Mohamed Shekhani
Contents 1 3 Epidemiology 2 Pathophysiology 3 Diagnostic crieteria 4 Management
Epidemiology: A common disorder 7% prevalence. Women * 1.5 >men Most commonly between 20-40 years. Onset after the age of 50 years is uncommon. IBS is costly, with direct& indirect costs at $20 billion. Consume > 50% more in health care resources than matched controls.
Pathogenesis: Not well understood Psychological factors Depression Anxiety H/O sexual abuse, Phobias Somatization Somatic abnormalities Abnormal GIT motility Visceral afferent hypersensitivity Autonomic innervation abnormalities. Altered mucosal immune system activation
Diagnosis: no diagnotic marker Positive diagnosis: Abd pain/or Discomfort For 3/30, 3/12 + 2 0r > Absence of red flags Excess gasses& mucus Rome Criteria Change stool consistency Change stool Frequency
Re Flags: 1 Age >50 years Male Short history of symptoms 2 Documented weight loss Nocturnal symptoms Rectal bleeding Recent antibiotic use Family history of CRC. 3
Diagnosis: Rome criteria 20-50 years > females No red flags
Diagnosis: Rome sensitivity 71% specificity 85%. Infections DD: is wide IBD Drugs Foods intolerance or allergy Gynecological etc
Diagnotic testing: Only if alarm Features present 3.Colonoscopy if Done for screeing Biopsies taken to exclude microcolitis. 2.H breath test For lactasia def If cli suspicion is high & After diet exclusion fails Except 1.celiac serology For IBS-D or IBS-M.
Diagnostic studies: Routine Blood tests Blood Bio If red flags Present TFTs Celaic serology Colonoscopuy imagings IBD Serology Stool exams
Mnagement: no cure,symptoms trts Mild: Education,reassurance,diet Moderate: pharmacotherapy & psychiatric interventions Severe: multidisplinary& referral to pain centers Good doctor-patient relationship
IBD-C: Laxatives Bulking,Stimulants, Osmotic,emolionts. Serotoin modulators Increase fibers Tegaseroid CVD risk Vegetables/fruits
IBD-C: Cl channel activator Lubiprostone For: 1.IBS-C in women 2.Idiopathic C in men/women
IBD-D: AntiDiarrheal Diphenoxylate Loperamide TAD Antibiotics Greater efficacy In IBD-D Rifaximin
IBD-D: 5 HT Antagonists Alosetron For IBS-D Only for women S/Es: constipation& ischemic colitis
IBD-Abd pain/Bloating: Antispasmotics Hyosin,Mebeverin, Specially for PPP. TAD IBS-D Lower doses than for depression SSRIs Improvement in Well being.
Previous research has shown that worsening GSA in IBS patients ... BioPsychoSocial Medicine The official ... onset associated with a change in form ...
Association of IBS with fibromyalgia (FMS), interstitial cystitis (IC), chronic fatigue syndrome (CFS), TMJ and other non-GI functional disorders and symptoms.
Abstract Class with Zend_Form. Skip to content. All gists; ... Clone via HTTPS Clone with Git or checkout with SVN using the repository's web address.
Know More in Less Time. getAbstract is the world’s largest library of business book summaries, read in less than 10 minutes on your PC, smart phone or ...
IgE-mediated food allergy is uncommon in IBS, ... Abstract. Background. Patients ... Subjects were asked to complete questionnaires in paper form.
Fiber and Functional Gastrointestinal Disorders. Shanti Eswaran, MD; ... normalizing stool form ... (IBS). Fiber for Chronic ...
The relationship between occupational stress and GIT diseases is evident in everyday clinical ... (IBS) and functional ... to a specific form of human ...
- Tests for all behaviors of abstract factory - Fixed a number of issues along the way - Form Factory should inject created input filter with input filter ...
abstractform - Abstract From Framework for ... Clone with Git or checkout with SVN using the repository's web ... AbstractForm. Abstract Form Framework for ...