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    Ibs

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    mohamed hany
    The document discusses irritable bowel syndrome (IBS), including its definition, diagnostic criteria, and management. It provides details on the Rome foundation that developed diagnostic standards for IBS and functional GI disorders. It also includes a case study example and questions from an expert panel on diet modification, drug treatment, complementary medicine, and psychiatric evaluation for IBS patients.

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    Ibs

    Uploaded by

    mohamed hany
    10 views49 pages
    The document discusses irritable bowel syndrome (IBS), including its definition, diagnostic criteria, and management. It provides details on the Rome foundation that developed diagnostic standards for IBS and functional GI disorders. It also includes a case study example and questions from an expert panel on diet modification, drug treatment, complementary medicine, and psychiatric evaluation for IBS patients.

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    The document discusses irritable bowel syndrome (IBS), including its definition, diagnostic criteria, and management. It provides details on the Rome foundation that developed diagnostic standards for IBS and functional GI disorders. It also includes a case study example and questions from an expert panel on diet modification, drug treatment, complementary medicine, and psychiatric evaluation for IBS patients.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    10 views49 pages

    Ibs

    Uploaded by

    mohamed hany
    The document discusses irritable bowel syndrome (IBS), including its definition, diagnostic criteria, and management. It provides details on the Rome foundation that developed diagnostic standards for IBS and functional GI disorders. It also includes a case study example and questions from an expert panel on diet modification, drug treatment, complementary medicine, and psychiatric evaluation for IBS patients.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 49

    IBS

    Yasser M Fouad MD, DO, IMACG


    Ass. Prof, Endemic Medicine
    Hepatogastroenterologist
    Why are they crying ?
    Why are they suffering ?
    Diseases with symptoms
    Silent Killers:
    Hypertension
    Diabetes
    Cancer colon

    Disease without symptoms


    symptoms without
    disease
    Functonal disorder
    (symptoms without disease)

    Absence of organic or structural changes:


    Macroscopic
    Microscopic
    Metabolic
    infecton
    Functonal gastrointestnal disorders

    40 % of daily practice of
    gastroenterologists

    Kellow 2010, AJG


    Functional gastrointestinal disorders

    Functional dyspepsia

    Irritable bowel syndrome (IBS)


    IBS
    Manning (1978)
    Kruis (1984)
    Rome I (1992)
    Rome II (1999)
    Rome III (2006) :
    A functional bowel disorder in which abdominal
    pain or discomfort is associated with a change in
    bowel habits, and with features of disordered
    defecation.
    Rome foundation

    -87 participants from18 countries in 14 committees .


    - Members were added from developing countries including China,
    Brazil,Chile, Venezuela, Hungary, and Romania.
    - New workingteams were created for gender, society, patient, and
    socialissues; and pharmacology and pharmacokinetics
    Case 1
    A 32-year-old business woman is referred to a
    gastroenterologist because of recurrent episodes of
    abdominal pain associated with a disordered bowel
    habit.

    The symptoms have been present intermitently for


    about 5 years, but have become more frequent and
    severe over the past 4 months. The pain occurs every
    2 or 3 weeks, and lasts for several days at a tme
    • It is usually situated in the lef iliac fossa or
    periumbilical region, and is ofen brought on by
    eatng and relieved by a bowel movement. She may
    have up to four loose stools within a period of 2 h in
    the morning.
    • At other tmes she may not have a bowel
    movement for 3 or 4 days, and the stool is then
    hard and lumpy.
    .There are no alarm features, with no blood or
    mucus in her stools, no weight loss, nor any
    pain during the night
    -There is no family history of gastrointestinal
    diseases
    • non-smoker and with no known food intolerances.
    • Her only medicatons: oral contraceptve pill and
    infrequent sumatriptan tablets for migraine
    headaches. She has not taken antbiotcs recently.
    • She has tried a number of herbal preparatons for
    her symptoms with no improvement.
    • Physical examinaton is negatve with no pallor or
    abdominal mass. Perianal and rectal examinaton
    are normal .
    • Given her tredness and heavy periods, the
    gastroenterologist arranged a complete blood
    count (CBC); he also suggested checking celiac
    serology . The CBC was normal tssue
    transglutaminase was Negatve .
    queston to the panel

    What is the suggested diagnosis ??


    What is the suggested steps in this case ???
    Recurrent abdominal pain
    and altered bowel habits

    History and examinaton

    Investgatons as
    needed: yes Alarm features no Consider limited tests
    Colonoscopy
    Blood tests, biopsies

    Any abnormality No Yes


    Any abnormality

    Yes
    No
    Celiac disease, IBD, IBS
    etc
    queston to the panel:

    What to do frst with IBS patent ???


    queston to the panel

    Do you think that diet modifcaton is important to


    IBS patent?
    queston to the panel

    When and what drug treatment in IBS patent?


    queston to the panel

    We need to know about complementary medicine in


    IBS patent. Is it of value?
    queston to the panel

    When to send the IBS patent to a psychiatrist ?


    queston to the panel

    IBS : what is new in treatment ?

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