Pathology Blog 3 – Irritable Bowel Syndrome

Pathology Blog 3 – Irritable Bowel Syndrome

Simon Marks

Due Date: Monday 14th Oct

Description – Irritable bowel syndrome is a disorder that causes abdominal discomfort or pain that is related to gastrointestinal dysfunction. It is a three part complex that characterizes irritable bowel syndrome, the first being abnormal bowel movements, the second hypersensitivity of the visceral sensory system and thirdly abnormal processing of the central nervous system. It is usually a combination of one or more of these complexes that causes the symptoms in an individual.
(Springerlink, 2007) (E medicine, 2009)

Etiology Although the condition is common, it has no known cause, and is diagnosed through a pattern of symptoms rather than by specific tests. IBS may often follow after an infection or stressful event suffered by the person, and lactose intolerance can increase the likelihood of developing the condition, but often there will be no known trigger. (Wikipedia, 2009)

Incidence -incidence of irritable bowel syndrome in the USA is 1-2% of the population per year. (E medicine, 2009)


Prevalence – The percentage of the population of Western civilisation with IBS symptoms is between 10 and 15% in most studies 2001.
(Digestion, 2001). With an estimated prevalence of 12% in Canada 2009. (CPF, 2009)


Signs and symptoms
Lethargy
Gastroesophageal reflux
Fibromyalgia
Abdominal pain and or discomfort,
Bloating
Abnormal bowel movements constipation or diarrhea sometimes alternating
A feeling of incomplete evacuation of bowels
Can suffer from depression chronic fatigue headaches back pain
Heart burn
Weakness
(Wikipedia, 2009) (K, Premkumar, 2000)

Diagnostic It is recommended that people suffering constipation older than 50 years should undergo a screening colonoscopy, check for parasitic infection, lactose intolerance, and celiac disease as they need to be considered as a causes of the pain and symptoms (CPF, 2009)
There are three main methods of symptom diagnosis; they are the Rome I Criteria, the Rome II Process, Kruis Criteria and the Manning Criteria. The six manning criteria below are the most common. (Wikipedia, 2009)
The Manning Criteria are:
1. Onset of pain linked to more frequent bowel movements
2. Looser stools associated with onset of pain
3. Pain relieved by passage of stool
4. Noticeable abdominal bloating
5. Sensation of incomplete evacuation more than 25% of the time
6. Diarrhea with mucus more than 25% of the time
(Wikipedia, 2009)

Indications and contraindications

• There is no evidence that any drug is effective in alleviating IBS, although individual symptoms may respond to specific agents. Treatment trials are confounded by a placebo effect as high as 71%.
• Ingested peppermint oil relaxes intestinal smooth muscle cells to improve symptoms.
• Herbal formulas ease symptoms with minimal side affects.
• Acupuncture
• Stress relief and management techniques
• Cognitive-behavioural therapy
• Hypnotherapy
• Mind body therapies including- biofeedback therapy, progressive muscle relaxation, relaxation, and stress management.
• Probiotics (living organisms that, when ingested in adequate amounts, can help relieve symptoms
• Fibre intake helps the symptoms of constipation
• Dietary changes

For massage

• Relaxation massage as the condition can be brought on and symptoms increased with high stress levels.
• Progressive muscle relaxation techniques
• Stress relief and management techniques
• Massage to the stomach is advised for constipation, but to be avoided if they have diarrhea symptoms.
• If symptoms are severe consult their physician before treatment

(CPF, 2009) (CMAJ, 1999) (k, Premkumar, 2000)




Reference list
CMAJ. 27 July (1999). Recommendations for the management of irritable bowel syndrome in family practice retrieved 13/09/2009
http://www.cmaj.ca/cgi/content/full/161/2/154

CPF. 2nd February (2009). Complementary and alternative medicine for treatment of irritable bowel syndrome. 14/09.2009
http://www.cfp.ca/cgi/content/full/55/2/143


Dr. Premkumar, K. (2000). Pathology A to Z: A handbook for massage therapists (2nd Ed.). Canada: Van Pub Books

E-medicine. 9th August (2009). Irritable Bowel Syndrome. Retrieved 13/09/2009
http://emedicine.medscape.com/article/180389-overview

Prof. Stefan Müller-Lissner. (2001). Digestion - Epidemiological Aspects of Irritable Bowel Syndrome in Europe and North America. Retrieved 14/09.2009
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ProduktNr=223838&Ausgabe=227607&ArtikelNr=48862


Springer link 23 May, (2007). New concepts of irritable bowel syndrome. Retrieved 14/09.2009
http://www.springerlink.com/content/f612h61560855g5k/

Wikipedia, 9th September (2009). Irritable Bowel Syndrome. Retrieved 14/09.2009
http://en.wikipedia.org/wiki/Irritable_bowel_syndrome