Irritable Bowel Syndrome Case Study

Medication: Different types of medications are effective treatments for IBS. Taking antidepressants can help treat depression but can also treat abdominal pain. Antispasmodic medicines can be used to reduce abdominal pain. Laxatives are helpful treatments for constipation.

Many people take the efficiency of their digestive system for granted. Imagine having a bowel disorder that impacts your everyday life, by affecting your weight and hygiene, impacting the foods you are able to eat, decreasing your energy levels, causing severe colicky pain, at times making you feel awkward around others, and suddenly sending you to the bathroom in the middle of important events. Not only does it uncomfortably affect those aspects of a person’s life, but frequently becomes a serious health issue that if uncontrolled may land you in the hospital. Imagine having to take expensive medications everyday that are supposed to keep you from having your disorder flare up, but then those medications cause uncomfortable

Ordinarily recommended cholinesterase inhibitors incorporate donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon). The primary symptoms of these medications incorporate loose bowels,

Based on 2014 hepatic encephalopathy guideline, NA’s hepatic encephalopathy is classified as type C and recurrent due to the cirrhosis and 2 episodes of HE occur with a time interval of 6 months or less. Typical signs and symptoms consistent with his HE includes confusion, forgetfulness, and anxiety. According to the guideline, the goals for the treatment are maintaining two to three bowel movements per day, decreasing elevated ammonia level, prevention of recurrent episodes of HE, and improvement of daily functioning. Lactulose is the first choice for treatment of overt HE. Currently, patient is on lactulose only once a day because of his noncompliance. The dose frequency is incorrect since he does not have at two to three bowel movements per day. Increasing frequency back to three times a day is recommended for the patient. Moreover, rifaximin is an effective add-on therapy to lactulose for prevention of OHE recurrence. Also, counseling the effects of lactulose and rifaximin, importance of adherence, early signs of recurring HE, and actions to be taken if recurrence are also beneficial for the patient.

Crohn 's disease is a debilitating inflammatory bowel condition that has the potential to affect any part of the gastrointestinal tract. The disease due to its relapsing and remitting nature decreases a persons quality of life and can lead to complications such as abscesses and fistulae formation, which then require recurrent surgical interventions. The therapeutic endpoint in Crohns disease management is to induce and sustain remission, decrease complications, hospitalisations and surgeries. Therefore, therapeutic management aims to change the natural course of Crohns disease so that people with the condition are not disabled by its relapsing nature. This review whilst establishing the clinical features of Crohns disease aims to investigate the efficacy of these standard therapies. It also attempts to explore alternative approaches to managing Crohns disease that focus on minimising flare-ups and complications. Conventional therapies include antibiotics, glucocorticosteroids, 5-aminosalicylic acids, and to a lesser extent, immunosuppression with azathioprine /6-mercaptopurine or methotrexate. Whilst, these therapies have helped control symptoms the review finds they have made no attempt to modify the disease course. Recently, there have been advancements in treatment, with the introduction of biological agents aiming to combat the ineffectiveness of standard therapy by inducing and maintaining mucosal healing. This review will outline the extend advancements, such as these

Irritable bowel syndrome is a very common condition that effects a lot of people throughout the world. While it isn’t a particularly dangerous condition, it is generally very long term, requiring treatment for many years, sometimes even for the duration of the patients life. It isn’t widely known what causes irritable bowel syndrome, but there are several factors that seem to make the symptoms worse for those that suffer from this condition; diet, stress and exercise. While there are medication that help manage the symptoms of irritable bowel syndrome, most people with this condition find that managing their diet, keeping stress under control and getting a reasonable amount of exercise is a good way to keep their large intestine happier than

Acute severe ulcerative colitis (ASUC) is now primarily a colon threatening condition with intensive medical management reducing the mortality to 1-2 % in specialist centres.1 The colectomy rate has remained high at 20-40 % over the last 30 years despite significant advances in medical therapy.2 ASUC occurs in 19 % of patients with ulcerative colitis (UC) during their disease course but accounts for 75 % of hospitalizations. 3 In these patients 55 % are on treatment with oral corticosteroids or an immunomodulator at the time of admission. 3 Oral corticosteroid although effective for induction of remission in mild-moderate UC is poor at maintaining that remission and comes with significant side effects in both the short and long term.4 Although these medications are widely used in inflammatory bowel disease little data is available on the effect of treatment prior to hospitalization on colectomy rate and this was the primary focus of this study.

Describe the pathopysiology of the disease you have chosen – What is the spectrum of disease/pathology the disease? Is the disease characterized by inflammation, etc? Is it an infectious and/or chronic disease? If so what is the agent, its reservoir, mode of transmission etc.

Metformin is the therapy of choice based on its glycemic efficacy without causing weight gain and reduced risk of hypoglycemia (McCulloch, 2017). However, the side effect of gastrointestinal upset is one that can be troublesome to patients, and patients with vomiting and diarrhea need close safety monitoring (Gold Standard, 2016). Studies suggest that patients should begin with 500 mg once daily, then if tolerated add a second 500mg dose, and then finally increase by one tablet every week or two to goal of 2000 mg daily (McCulloch, 2017). Based on Mr. Cumberbatch’s reaction to metformin dosage increase to 1000mg twice daily, this was too fast of a dosage increase. While it may not necessarily be indicated to completely stop this medication, a good plan for this patient is to decreasing his dosage back to 500 mg one or twice daily until gastrointestinal symptoms resolve. This patient could continue on a smaller dose of metformin at night with meals, and then titration of dosage can be made slower to achieve the goal of 500 or 1000 mg twice daily. This patient may tolerate a slower increase, such as adding one extra 500mg pill per week to achieve goal over a long period of time (McCulloch, 2017). These changes to the metformin should help reduce Mr. Cumberbatch’s diarrhea, thus a pharmacotherapy for diarrhea is not indicated. With reduction of his dose and ensuring

Pancreatitis is the most common and feared complication of ERCP. The pathology of acute pancreatitis relates to inappropriate activation of trypsinogen to trypsin and a lack of prompt removal of active trypsinogen inside the pancreas. The clinical diagnosis of acute pancreatitis is based on characteristic abdominal pain and nausea, combined with elevated serum levels of pancreatic enzymes (Cheng, et al., 2006). When caring for a patient suffering from acute pancreatitis it is important to monitor fluid balance and pulse oximetry (Whitcomb, 2006). This is especially true when a patient’s pain is being treated with narcotic analgesics. The respiratory depression affects of the narcotics coupled with the pain of breathing due

In oncological patients, diarrhea can occur in several different situations. Possible etiologies could be chemotherapeutic agents, radiation, decreased physical performance, graft vs. host disease and infections. “Of clinical importance is chemotherapy-induced diarrhea, which has been reported as a grade 3–4 serious adverse event with a frequency of 5–47% in randomized clinical trials” (Andreyev, 2014). Diarrhea is divided into different grading and these are Grade 1: increase to two to three bowel movements per day additional to number before treatment or mild increase in stoma output. Grade 2: increase to four to six bowel movements per day additional to number before treatment, moderate increase in stoma output, as well as moderate cramping

Medications that can cause interactions include anticoagulants, probenecid, bisphosphonates, angiotensin-converting enzyme (ACE) inhibitors, anticoagulants (Warfarin), antiplatelet medicines (Clopidogrel), aspirin, corticosteroids (Prednisone), heparin, other NSAIDs (Ibuprofen), Rivaroxaban, or Selective Serotonin Reuptake Inhibitors (SSRIs) (Fluoxetine) due to the risk of stomach bleeding may be increased. Bisphosphonates (Alendronate), Cyclosporine, Hydantoins (Phenytoin), Lithium, Methotrexate, Quinolones (Ciprofloxacin), Sulfonamides (Sulfamethoxazole), and Sulfonylureas (Glipizide) side effects may be increased by Naproxen. The effectiveness of Angiotensin-converting enzyme (ACE) inhibitors (Enalapril), Beta-blockers (Propranolol), or diuretics (Furosemide, Hydrochlorothiazide) may be decreased by Naproxen (Lexi-Comp,

Celecoxib is a selective COX-2 inhibitor, is potential applied for the aggravated treatment of colonic diseases such as colorectal cancer and colitis [7, 8]. The possible mechanism of action of celecoxib is COX-2 specific inhibiting agent that inhibits the conversion of arachidonic acid to the prostaglandins that mediate normal homeostasis in the gastrointestinal tract, kidneys, and platelets and that are formed under control of COX-1[9]. Human clinical studies performed to evaluate the safe of celecoxib in inflammatory bowel disease (IBD) patients have no conclusion result yet. Thus, the controversy regarding risks and benefits of celecoxib for treatments of IBD is still going on [10]. Therefore the great caution should be used in treating

In practice, dexamethasone is less widely used for control of PONV by anesthetists in gastrointestinal patients, perhaps because of a lack of proven efficacy in these patients. However, its use is advocated in some enhanced recovery programs (ERAS) to improve recovery after colorectal surgery. Its precise mechanism of action is unknown but it has been proposed that the antiemetic properties arise due to activation of glucocorticoid receptors in the medulla, or by inhibiting central production of prostaglandins or inhibiting the release of endogenous opioids. It is also known to improve appetite, and in combination with reduced nausea and vomiting, aids early recovery. Glucocorticoids can also reduce pain by suppression of bradykinin and neuropeptides from nerve

Enteric coating is made up of many tightly bound cellulose fibres. This coating is designed to be pH dependant and prevents dissolution or release of the drug. This is to prevent it interacting with the body at those regions especially the stomach. Aspirin is particularly harmful to the stomach because of the impact it has on prostaglandin production. Prostaglandins have numerous functions one of which is a process called cytoprotection. (10) Cytoprotection reduces HCL production from the parietal cells and stimulate alkaline mucus production needed for neutralisation, which are necessary to protect the mucosa from damage caused by gastric juices and acids. Furthermore, prostaglandin help dilates vessels to increase the volume of blood flow to the stomach, in turn increasing rate of repair and renewal of cells and as importantly carrying away acids from the stomach which can damage the mucosa lining (11). Therefore, by preventing prostaglandin production, the gastric acids can continue to attack the mucosa lining and this can lead to excessive bleeding enhanced by the anti-platelet properties of aspirin which further prevent clotting or even form ulcers. Problems with a bleeding