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  1. Fact Sheet: Disorders Related to Excessive Pelvic Floor Muscle Tension

    109

    By: Jeanette Tries, PhD, OTR

    Disorders which have excessive pelvic floor muscle activity as their primary feature are often not recognized and diagnosed by physicians. However, millions of people suffer from such disorders and associated symptoms of disabling pain and disruptions in bowel and bladder control. Unfortunately, individuals with these disorders frequently seek help for many years before receiving any explanation for, or relief from their disturbing symptoms. The purpose of this article is to briefly explain the role of the pelvic floor muscles and some symptoms related to the presence of elevated tension in these muscles, and to describe various treatment options available.

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  2. Fact Sheet: Biofeedback & Bowel Disorders: Teaching Yourself to Live without the Problem

    112

    By: Mary K. Plummer, OTR, BCIA-PMBD; Jeanette Tries, PhD, OTR

    Biofeedback is a neuromuscular reeducation tool we can use to tell if certain processes in our bodies are working correctly. It is a painless process that uses a computer and a video monitor to display bodily functions that we usually are not aware of. Special sensors measure these functions, which are displayed as sounds we can hear, or as linegraphs we can see on a computer screen. A therapist helps us use this displayed information to modify or change abnormal responses to more normal patterns such as increasing a response, decreasing a response, or learning to coordinate two responses more effectively.

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  3. Fact Sheet: Colonoscopy and Sigmoidoscopy: What to Expect

    114

    By: W. Grant Thompson, MD, FRCPC

    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.

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  4. Fact Sheet: Doctor - Patient Communication

    116

    By: Kevin W. Olden, MD

    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?

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  5. Fact Sheet: Evaluation and Treatment of Constipation

    118

    By: M. Scott Harris, MD

    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

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  6. Fact Sheet: Malabsorption

    119

    By: Nimish Vakil, MD, FACP, FACG; Carol Jorgensen-Vakil, MS, RD, CNSD, Registered Dietician

    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.

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  7. Fact Sheet: Gut Motility: In Health and Irritable Bowel Syndrome

    121

    By: John E. Kellow, MD

    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.

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  8. Fact Sheet: Lactose Intolerance: Definition, Symptoms and Treatment

    122

    By: Eli D. Ehrenpreis, MD; Benjamin Z. Ehrenpreis

    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.

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  9. Fact Sheet: Gynecological Aspects of Irritable Bowel Syndrome

    123

    By: Margaret M. Heitkemper, RN, PhD; Monica Jarett

    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.

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  10. Fact Sheet: Irritable Bowel Syndrome: The Pathophysiologic Links to More Effective Future Therapy

    124

    By: Michael Camilleri, MD

    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.

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