Fact Sheet: Colonoscopy and Sigmoidoscopy: What to Expect114
Your doctor has suggested that you have a colonoscopy, or perhaps a shorter version called a sigmoidoscopy. For that purpose you are referred to a specialist, usually a gastroenterologist who is specially trained to do the procedure. This article describes what to expect. Reviewed and updated 2009.Topics: Tests, lower GI tract
Fact Sheet: Doctor - Patient Communication116
Functional GI disorders present a special challenge to the doctor-patient interaction for several reasons. First, functional GI disorders are characterized, in most cases, by vague symptoms of variable intensity. Many times, these symptoms involve the most intimate anatomic areas of the body. The sensitivity of these issues can complicate the task for the patient who needs to express them in terms that the physician can interpret to formulate a diagnosis. Secondly, the physician is hampered by the absence of obvious structural lesions that often lessens the likelihood of devising a specific medical intervention that is successful. In some cases, the physician’s own anxiety can be increased by the lack of a symptom complex that leads to well-understood disease entity, such as parasites or lactose intolerance. This deficiency, in turn, often leads both physician and patient to over-investigate the symptoms. So what are the ingredients that comprise successful doctor-patient communication about the functional GI disorders?
Fact Sheet: Evaluation and Treatment of Constipation118
Constipation is one of the most common gastrointestinal complaints in the United States. It afflicts approximately 1 in 6 individuals and is responsible for approximately 2.5 million physician visits each year. More than $400 million is spent annually on over-the-counter laxatives; at least 120 of these products are available. The management of constipation includes patient education about bowel function and diet, behavior modification, drug therapy, and infrequently, surgery. Revised 1/2012
Fact Sheet: Malabsorption119
The gastrointestinal tract and liver play key roles in the digestion, absorption and metabolism of nutrients. Diseases of the gastrointestinal tract and liver may profoundly disturb normal nutrition. Malabsorption refers to decreased intestinal absorption of carbohydrate, protein, fat, minerals or vitamins. There are many symptoms associated with malabsorption. Weight loss, diarrhea, greasy stools (due to high fat content), abdominal bloating and gas are suggestive of malabsorption.Topics: Food intolerance, Malabsorption
What are normal movements (motility) of the digestive tract? How may altered motility lead to symptoms? Disorders affecting the motility of the digestive tract may be self-limiting, occurring only for a brief period as in acute infection of the digestive tract causing diarrhea. They can also be more longstanding and persistent as in irritable bowel syndrome (IBS). IBS is associated with a variety of symptoms, particularly abdominal pain and an irregular bowel habit.
The term lactose intolerance refers to the development of gastrointestinal symptoms following the ingestion of milk or dairy products. Lactose intolerance is caused by a shortage of a digestive enzyme called lactase, which is produced within the lining of the small intestine, although not all people with lactase deficiency develop symptoms. Lactose intolerance is an extremely common disorder and may have a prevalence of up to 100% in some populations. The following brief review of lactose intolerance will provide a summary of the populations most affected, symptoms, diagnosis, and treatment. Revised 2007.Topics: Food intolerance, Malabsorption
Over a decade ago, investigators noted that approximately half of the women attending a gynecology clinic had symptoms (e.g., abdominal pain, change in bowel pattern) compatible with a diagnosis of irritable bowel syndrome (IBS). Since that study, a number of other studies have demonstrated a higher prevalence of gynecologic disorders, such as pain associated with menstruation (dysmenorrhea) and premenstrual distress syndrome in women with IBS as compared to those without IBS.
Several investigators as well as an NIH consensus conference on the "irritable bowel syndrome" (IBS) have stressed the importance of the biopsychosocial model in the etiopathogenesis (origin and development) of this syndrome. In this short article, the pathophysiologic (disease process) links between big brain, little brain, motility and sensation are explored based on currently available data. These data suggest that investigators and clinicians need to be dissuaded from approaching IBS as though it was a single disorder in all patients, or as though only one mechanism is responsible for development of symptoms. In essence, this is a plea for the importance of integrated rather than reductionist approaches to research, diagnosis, and management of IBS. Revised and updated 2009.
There is a growing understanding of the multi-faceted nature of functional gastrointestinal disorders. Symptoms, behaviors, and treatment outcomes for individuals with these disorders relate to disturbances in gastrointestinal motility and sensation that is effected by interactions that take place via the brain-gut axis. To understand and study these conditions, physicians and researchers must become familiar with evolving knowledge that integrates basic science, physiology, clinical medicine, psychology, and psychiatry. Indicated below are some of the highlights of the presentations at the 4th International Symposium for Functional Gastrointestinal Disorders, which we believe truly reflect the developing areas of research in irritable bowel syndrome (IBS) and the functional gastrointestinal (GI) disorders.
Nearly two million people are affected with IBD [e.g., Crohn's disease and ulcerative colitis] in the U.S. These inflammatory conditions are a group of several distinct disorders which probably explains the diversity of extent and activity of inflammation within the gastrointestinal (GI) tract. The age of onset is usually in the 20s and 30s, although there is a slight second peak in incidence in the 50s to 60s. Men and women are equally affected in IBD as opposed to IBS, which is female predominant. Revised and updated 2009.
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