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Book Details
Abstract
Irritable bowel syndrome is a part of the family of gastrointestinal motility disorders and is characterized by abdominal pain and altered bowel habits. It is highly prevalent throughout the world with the reported prevalence rates lying between 9% and 25%. The incidence of IBS varies between different ethnic groups and the incidence has also been reported to be different in males and females. The incidence also varies between various clinical subgroups (diarrhea-predominant/constipation-predominant) of the disorder.
This is a chronic condition and is the most frequent symptom complex in patients who visit gastroenterologists throughout the world. However, this is one of the least understood GI disorders as it is not a disease but a complex of symptoms. The symptoms are often severe and quite bothersome, and thus have a negative effect on the patient’s quality of life and activity level, often leading to psychiatric complications. Besides this, a substantial economic burden of the disease and its impact in terms of man hours lost per annum make it one of the most troublesome symptom complexes in medicine, which need to be solved.
This book has been designed to update the readers on the extensive research done over these years and on the many new potential mechanisms of pathogenesis of this troublesome condition. The reader will also be updated on the changing epidemiology of the condition. Diagnostic approach and management of IBS have also been thoroughly reviewed with an emphasis on the recent updates in the field. Typical supportive case scenarios have been included to exemplify and highlight various points discussed. Thus, it provides an excellent opportunity to widen one’s perspective in this area.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Front Cover | ||
Front Matter | ia | ||
Elsevier Clinical Advisory Board:Gastroenterology/Hepatology | ic | ||
Copyright | ie | ||
About the Authors | if | ||
Contents | ih | ||
ECAB Clinical Update Information | i | ||
Foreword | v | ||
Irritable Bowel Syndrome: Epidemiology and Pathogenesis | 1 | ||
Introduction | 2 | ||
Epidemiology | 2 | ||
Etiology | 4 | ||
Postinfectious IBS | 4 | ||
Pathophysiology of IBS | 6 | ||
Genetic Factors | 7 | ||
Psychological Factors | 8 | ||
Visceral Hypersensitivity | 9 | ||
Effect of Nutrients | 10 | ||
Role of Serine Protease | 10 | ||
Stress and Visceral Sensitivity | 10 | ||
GI Motility | 11 | ||
Dysregulation of Brain-Gut Axis | 11 | ||
Neuropeptides and Hormones | 12 | ||
Altered Serotonin Signaling | 13 | ||
Inflammatory Changes | 13 | ||
Defective Mucosal Barrier | 14 | ||
Food Hypersensitivity | 14 | ||
Evolution of Diagnostic Criteria for IBS | 14 | ||
Rome I Criteria | 15 | ||
Rome II Criteria | 15 | ||
Rome III Criteria | 17 | ||
Irritable Bowel Syndrome: Diagnosis | 27 | ||
Diagnosis | 28 | ||
Clinical Manifestations | 28 | ||
Chronic Abdominal Pain | 28 | ||
Altered Bowel Habits | 29 | ||
Other Symptoms | 29 | ||
Diagnosis Criteria | 30 | ||
Manning Criteria (presence of any four of the six symptoms) | 30 | ||
Rome Criteria | 30 | ||
Red Flag Symptoms which Are Not Typical of IBS | 32 | ||
Subtypes of IBS | 32 | ||
Validity of Different Criteria | 33 | ||
Diagnostic Evaluation | 35 | ||
Blood Biochemistry and Endoscopy | 35 | ||
Imaging in Suspected IBS | 37 | ||
Investigation for Celiac Disease | 37 | ||
Investigation for Lactose Intolerance | 38 | ||
Other Diagnostic Studies | 40 | ||
Diagnostic Approach | 40 | ||
Indian Data | 41 | ||
Summary | 43 | ||
Case Studies Irritable Bowel Syndrome: Diagnosis | 47 | ||
Case I | 47 | ||
History | 47 | ||
Examination and Management | 47 | ||
Discussion | 48 | ||
Case II | 49 | ||
History | 49 | ||
Examination and Management | 49 | ||
Discussion | 49 | ||
Management of Irritable Bowel Syndrome | 50 | ||
Natural History and Subtype Durability | 51 | ||
Diagnosis in a Clinical Setting | 51 | ||
Primarily Symptomatic Diagnosis | 53 | ||
Treatment | 56 | ||
Dietary Management | 56 | ||
Supplements and Preparations | 57 | ||
Conventional Pharmacological Management | 57 | ||
Antidiarrheal Agents | 58 | ||
Antispasmodics | 58 | ||
Prokinetics | 59 | ||
Laxatives | 59 | ||
Serotonergic Drugs | 59 | ||
Psychological Therapies | 60 | ||
Antidepressants | 61 | ||
Recent Advances in Management of IBS | 62 | ||
Developmental Drugs | 62 | ||
Discussion | 62 | ||
Prognosis | 64 | ||
Personal Clinical Experience and Management | 64 | ||
Conclusion | 66 | ||
Case Studies Management of Irritable Bowel Syndrome | 73 | ||
Case Study I | 73 | ||
History | 73 | ||
Physical Examination | 73 | ||
Management | 73 | ||
Case Study II | 74 | ||
History | 74 | ||
Physical Examination | 74 | ||
Management | 74 | ||
Irritable Bowel Syndrome: Could a Subset of this Syndrome Have Organic Basis? | 75 | ||
Evidences that Organic Diseases can be Misdiagnosed as IBS | 76 | ||
Celiac Disease and other Causes of Malabsorption Syndrome | 76 | ||
SIBO Syndrome | 78 | ||
Fecal Evacuation Disorders | 80 | ||
Evidences Suggesting that IBS may have Organic Basis | 81 | ||
Postinfectious IBS | 81 | ||
Small Intestinal Permeability in IBS | 82 | ||
Could IBS have Genetic Basis? | 82 | ||
Available Data on Role of Genetic Polymorphism in IBS | 83 | ||
Genes of Serotonergic System | 83 | ||
Genes of Adrenergic System | 84 | ||
Polymorphism in Cholecystokinin Genes | 85 | ||
Polymorphism in Cytokine Genes | 85 | ||
Conclusions and Future Directions | 86 | ||
Case Study Irritable Bowel Syndrome: Could a Subset of this Syndrome Have Organic Basis? | 93 | ||
Case Study | 93 | ||
History | 93 | ||
Management | 94 | ||
Discussion | 94 | ||
Editor’s Summary | 95 | ||
Forthcoming Books | 97 |