Abstract This paper attempts to define and explain Irritable bowel syndrome (IBS), which affects approximately 20% of the Western population, and accounts for frequent absenteeism from work and impaired quality of life. The paper outlines how it is characterised by altered bowel habits and abdominal pain, in the absence of any other GI problems and diagnosis is based on the Rome criteria. Despite the the heterogenous nature of the disorder, the writer succeeds in giving a general overview of this disease for the reader.
From the Paper "Psychiatric disorders are recorded in 50-80% of patients with IBS in some studies, although a single disorder is not well defined. Anxiety, depression, somatization, and neurosis have all been recorded1. In patients with IBS, acute psychological attacks have been shown to significantly alter their gastrointestinal motility2. Drossman et al found that patients with IBS undergo more suffering from psychosocial distress than non-patients with IBS3. Osterberg et al, on the other hand, found that there were minute differences in psychological distresses between patients with IBS, and non-patients with IBS4. Thus, assorted studies have conclusions that vary from each other. Altered gastrointestinal motility seems to be associated with the aetiology of IBS, but is not diagnostic. Serotonin (5-HT) has been studied for its role in regulating colonic motility in humans, but it is not yet known whether alterations in the colonic 5-HT system are involved in the pathophysiology of irritable bowel syndrome5. Lincoln et al established that the total indoleamine (5-HT plus its metabolite 5-HIAA) concentration in the sigmoid colon in patients undergoing partial or total colectomy for treatment of idiopathic constipation, attributed to IBS, was considerably higher than in normal subjects6. In unstimulated conditions, the colonic myoelectrical and motor activity are normal, whereas under stimulated conditions, IBS patients shown more abnormalities than normal subjects7. Lanng et al, found that all investigations regarding motility disorders showed variation, supporting the general theory of IBS being a broad-spectrum motility disorder."
Abstract This paper presents the case of M.D., a 66-year-old female who was admitted to Fremont Memorial Hospital on September 4, 2007 with bowel obstruction (BO). The paper explains the pathophysiology related to bowel obstruction and then discusses diagnostic studies and medications. The paper also examines the nursing care that was provided to the patient.
From the Paper "Labs on September 4, September 9, and September 10 included: complete blood cell count (CBC), and electrolyte panel. M.D.'s vomiting contributed to her body's compensatory reaction of low and high electrolyte values. Additionally, her chemotherapy affected her white blood cell (WBC) and red blood cell (RBC) count. Each was low relative to received chemotherapy. Consequently the following Hematopoietic disorders have developed: Anemia from decreased production of the protein erythropoietin (EPO), Leucopenia, Thrombocytopenia, and Neutropenia all are side effects from damage to the spongy bone marrow tissue due to chemotherapy."
Abstract A discussion of how Irritable Bowel Syndrome (IBS) is the common intestinal and chronic disorder most frequently reported to and encountered by gastro-enterologists. It discusses when and why this condition occurs and this is often related to stress factors. The paper focuses on a study of how this condition effects working habits of sufferers.
From the Paper "Workers with IBS and who were investigated suggested that doctors give more time and interest in diagnosing their condition. Furthermore, they felt that these doctors should be informed about and made to appreciate their suffering. Health care workers should view the sickness as socially isolating and therefore, sufferers should be provided with a support group by those who are able or are obliged to do so."
This paper is a case presentation of a physical assessment of a 4-day-old child, eventually diagnosed to be vomiting because of a partial small bowel obstruction, secondary to Midgut Volvulus.
Abstract This paper discusses that the differential diagnosis for a vomiting four-day-old child is extensive, including intestinal obstructions, inborn errors of metabolism, sepsis, intracranial bleeding, gastroenteritis, and overfeeding. The author concludes that imaging diagnosis suggests malrotation of the small intestine, resulting in partial obstruction of the small bowel. The paper relates that the prognosis for children who undergo surgery before development of any degree of bowel infarction usually can return to normal function within three days.
Table of Contents
General Information
Chief Complaint
History of the Present Illness
Family History
Review of Systems
Social History
Physical Examination
Clinical Laboratory
Differential Diagnosis
Assessment
Treatment plan
Discussion
From the Paper "Imaging studies were obtained. Abdominal radiographs were essentially unremarkable. An upper GI series was obtained and showed that the duodenal-jejunal junction was abnormally located to the right of the patient's spine. After this point there was a narrowing of the duodenum with a fine thread of contrast extending inferiorly in a "corkscrew" like appearance. Abdominal ultrasound with color Doppler was also obtained and shows the superior mesenteric vein coursing around the superior mesenteric artery in a swirl-like appearance."
Abstract This paper compares and contrasts the pathophysiological mechanisms, symptoms, and general natures of Crohn's disease, ulcerative colitis, diverticulitis and irritable bowel syndrome. Medical journals are researched and cited to support the content of the paper.
Abstract This paper presents a case study of a patient suffering from ulcerative colitis, an inflammatory bowel disease. The paper discusses the epidemiological factors of the disease. The paper evaluates the patient's background and description of symptoms as well as her family history. The physical examination is described and the paper discusses the diagnosis, treatment and results.
Outline
Introduction
Case Study
Presentation and Background
Further History
Physical Examination
Laboratory Examination
Sigmoidoscopy
Diagnosis
Treatment and Management
Results
From the Paper "Both Ulcerative Colitis and Crohn's disease share many epidemiologic features. They can affect individuals in all age groups although they usually affect individuals in the over forty age group. Ulcerative colitis is however more prevalent among females and affects 30 percent more females than males. (Ulcerative Colitis, 2004) While Ulcerative Colitis is also more likely to occur in the middle to older age groups, there are increasing indications of the occurrence of the illness among younger people. "The incidence of ulcerative Colitis peaks in people aged 15-25 years and in people aged 55-65 years, although it can occur in people of any age." (ibid) "
Abstract This paper explores the conventional, alternative and combined treatments for irritable bowel syndrome. This paper discusses the risks and benefits associated with each of the therapies, and with a combination of all three therapies.
From the Paper "Irritable bowel syndrome is a common gastrointestinal disorder which affects up to 20 percent of the North American adult population. The condition is characterized by chronic symptoms of pain and changed bowel habits. Irritable bowel syndrome produces a serious impact on quality of life, and also creates an enormous drain on healthcare resources. The use of alternative medicine either alone or in combination with conventional medicine is effective in resolving these issues."
This paper analyzes a study by Winkelman, W., Leonard, K. and Rossos, P. that explored the perceived usefulness of electronic medical information for patients with chronic inflammatory bowel disease.
Abstract The paper examines Winkelman, Leonard and Rossos' study that investigated the value and usefulness of Internet-based patient access to information for patients with chronic inflammatory bowel disease. The paper evaluates the study design and its rationale, research purpose, target population, participants, ethical issues, data quality methods, findings, limitations and implications. The paper relates that while the study provides an indication of the usefulness of information technology regarding chronic illness, it is limited because it is a qualitative and therefore a subjective study. The paper points out, however, that the qualitative method is the only available means to understand the patient's perspective that should always be of central importance.
Outline:
Introduction
Rationale
Research Purpose
The Target Population
Study Participants and Setting
Ethical Considerations
Data Quality Methods
Findings and Limitations
Implications for Nursing
Summary
From the Paper "The design used was a qualitative, exploratory, and descriptive (grounded theory) study which made use of in-depth interviews. The grounded theory approach does not being with a theoretical framework, but leads to the development of a theory. The rationale for the methodology was that a descriptive, exploratory approach such as grounded theory in conjunction with chronically ill patients' perceptions would enable the language and perceptions of chronically ill patients to emerge (Winkelman, et al., 2005). The design was appropriate because the use of information technology by patients may be beneficial or it can be problematic. What is most lacking in many facilities is the patient's point of view on this technology, and therefore the implementation of technology has been uneven. Patients' own perceptions can clarify its value."
Abstract In this article, the writer explains that Crohn's disease is a debilitating bowel disease that has no known cause and very limited treatment options. The writer then discusses symptoms and the diagnosis of Crohn's disease. The writer maintains that individual and long-term counseling with an individual who is particularly sensitive to the devastating effects of chronic illness, and specifically "invisible" illnesses as one counselor puts it is the key approach to maintenance counseling for Crohn's disease. The writer concludes that just as the disease is variable in individuals so must the approach to resolving the many issues that are faced by individuals who have it.
From the Paper "The disease itself is a clear robber of vitality, as the individual does not get the needed nutritional elements to gain weight, and in women mature sexually and potentially menstruate for the first time. The body is placed in position of shock with regard to physical growth and development and if the disease's onset is early enough this can stunt growth for life or completely destroy one's body image, another potential psychological problem. Thompson points out that the age group of typical onset is particularly vulnerable to impatience and therefore may feel devastated by the length of time it takes to elicit treatment results, and restore the body to its normal state, and appearance."
Abstract This paper gives general information about colon cancer including its signs and symptoms, causes, risk factors, diagnosis, prevention, and treatment. The paper defines colon cancer (also called colorectal or large bowel cancer) as cancerous growths in the colon and the rectum.
Outline:
Signs and Symptoms
Causes/ Risk Factors
Diagnosis
Prevention
Treatment
From the Paper "When colon cancer is suspected, barium enema x-ray or colonoscopy is usually performed to confirm the diagnosis and to find out the exact location of the tumor. For the barium enema x-ray, the patient is given an enema with white chalky liquid containing barium; it helps to outline the large intestine, and the tumors are then detectable as dark shadows on the x-rays. Colonoscopy consists of a procedure in which a long flexible tube is inserted via the rectum for inspecting the inside of the colon. If colon polyps are found, they are removed through the colonoscope and examined in the lab for cancer and for pre-cancerous growth ("Colon Cancer" Mayo Clinic, 2008). "
Abstract The paper explores the risk factors for developing colorectal carcinoma, which include one's diet, hereditary factors and syndromes and having inflammatory bowel disease. The paper discusses the symptoms, findings of a physical examination, prognosis for patients and treatment options.
From the Paper "The gastrointestinal tract is our body's pathway where food travels from the mouth, through the esophagus, stomach, small and large intestine within where the nutrients are extracted for the needs of the body. The first part of the pathway is the esophagus. It is the conduit that guides food from the mouth, where it is prepared by chewing, down to the stomach where it is stored. Then, the stomach, which is both a storage space and a secretory organ that produces the gastric acid necessary for digestion. Then the tract is followed by the duodenum when involuntary muscle contractions (peristalsis) empties the food gradually into it, the first part of the small intestine."
From the Paper "Pneumatosis intestinalis is an uncommon condition in which gas is found in a linear or cystic form in the submucosa or subserosa of the bowel wall (8). This paper will look at the epidemiology, clinical manifestations, pathological findings, pathogenesis, clinical course and management of pneumatosis intestinalis.
Pneumatosis intestinalis is not a disease per se, but a sign, and therefore its relevance should be interpreted within the whole clinical context within which it occurs (8). It has been found in several distinctive clinical settings: in premature infants with necrotizing enterocolitis; in adults with obstructive pulmonary disease; in adults and children with a wide variety of associated conditions, including pyloric stenosis, jejunoileal bypass, progressive ischemic sclerosis..."
Abstract This paper examines a common assumption that children and adolescents with inflammatory bowel disease or functional gastro-intestinal complaints are children who have impaired psycho-social adjustment and how coordinated care for maintenance of optimum functioning is often required. It considers a two-year-old girl with gastro-intestinal problems which include recurrent abdominal pain, diarrhea, constipation and vomiting and how she is obviously not able to communicate well about what is happening in her body.
Outline
Introduction
Case Study
Tests
Possible Diagnoses
Problem Management
From the Paper "Given the results from the MRI, several other diseases were dismissed as likely causes of the child's problem. At this point, the tendency of the team was to identify the child as having one of the functional gastrointestinal disorders. As Hyams (1999) noted, this is often a diagnosis that is seen as pejorative, or as indicating that it is the child's problem, and that it is more psychological than physiological. However, Hyams indicated, this is a negative, and inaccurate, way to look at the problem. There clearly is a disease state existing for most of these children, but technology and testing are not able to pinpoint the exact source of the problem. Thus, we are left with diagnoses like irritable bowel syndrome, chronic nonspecific diarrhea, functional constipation, non-ulcer dyspepsia, and indeterminate colitis."
Abstract This paper discusses how, in Mary Godwin Shelley's 1818 Gothic masterpiece, "Frankenstein", the main protagonist, Victor Frankenstein, a young student of the alchemical arts and sciences, takes the reader on an exploration into the unknown, for his primary goal is to create life from the dead. It looks at how, after much experimentation, he produces a creature of hideous proportions and intellect, bent on nothing but revenge. It also shows how, likewise, Professor Hardwigg, the main protagonist in Jules Verne's "Journey to the Center of the Earth", published in 1864, leads the reader on another "journey" into the unknown, only this time into the bowels of the earth, where Hardwigg and his companions discover another world, much like Victor Frankenstein with his experiments concerning the mysteries of life and death.
From the Paper "The beginning of Frankenstein opens the proverbial door to the strange and horrifying tale related by Victor Frankenstein to Captain Walton, an English explorer surveying the polar regions of the far north. One day, as the ship's company is looking out over the empty ice fields, they are astonished to see a sledge drawn by dogs speeding northward with the sledge driver huge and misshapen. That night, an ice floe carries another sledge with a weakened man to the ship, and once the man (Victor Frankenstein) discovers that the first sledge has been sighted, he turns quite agitated. As Victor convalesces on the ship, he becomes friendly with Walton and after recovering his strength, relates the tale of the creature that he created artificially from the dead."
This paper discusses the symptoms and treatment of fibromyalgia and distinguishes between fibromyalgia and other pain causing diseases such as arthritis.
Abstract This paper explains that, unlike arthritis, which affects the skeleton joints, fibromyalgia affects the muscles and other fibrous tissues, creating sensations, which range from nagging to burning to agonizing pain throughout the body and a syndrome of accompanying related symptoms, such as severe fatigue, disturbed sleep, morning stiffness, headaches and irritable bowel syndrome. The author points out that fibromyalgia is a puzzling disorder; its cause remains unknown and its pain responds poorly to aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin) and even narcotics such as morphine. The paper stresses that, in the United States, too many health provide only "tough love" for this condition; therefore, fibromyalgia patients must be their own advocates and seek a practitioner who knows what fibromyalgia is, believes that it exists and wants to help people with this disorder.
From the Paper "Fibromyalgia is characterized by abnormalities in the central nervous system's processing of sensory input of pain signals. Patients with fibromyalgia hurt when and where they should not. Pain amplification could be the result of the release of neurotransmitters where the sustained release of certain chemicals results in more pain. Some of the possible disruptions in pain circuitry have been reviewed, but we still know relatively little about what really goes on. Since most fibromyalgia patients complain of aching and spasm in their muscles, common sense suggests that there must be something wrong with the muscle. This is easier said than agreed upon. For the last 80 years, researchers have been looking for the key to muscle pathology in fibromyalgia. As of this writing, there are highly respected investigators who feel that there is little if anything wrong with fibromyalgia muscles. However, other equally regarded researchers have presented evidence that abnormal muscle metabolism is the linchpin for what goes awry in the disorder. Our body has 640 different muscles, which constitute as much as 40 percent of our weight. When physicians look at muscles of fibromyalgia patients under a simple microscope, they generally appear normal."
