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Overview of

Department of Gastroenterology, Hepatology, and Nutrition ... At least 12 weeks or more, which need not be. consecutive, in the preceding 12 months, of ...

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Overview of

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    1. Overview ofIrritable Bowel Syndrome Arnold Wald, MD Professor of MedicineDepartment of Gastroenterology, Hepatology, and NutritionUniversity of Pittsburgh Medical Center Pittsburgh, Pennsylvania

    2. Chronic or recurrent GI symptoms Lower abdominal pain/discomfort Altered bowel habits Bloating Not explained by structural or biochemical abnormalities

    3. IBS Clinical Subgroups Constipation predominant Diarrhea predominant Alternating constipation/diarrhea

    4. IBS Clinical Subgroups Constipation predominant Diarrhea predominant Alternating constipation/diarrhea

    5. Rome II Criteria for IBS At least 12 weeks or more, which need not be consecutive, in the preceding 12 months, of abdominal discomfort or pain that has 2 out of 3 features: Relieved by defecation Onset associated with a change in frequency of stool Onset associated with a change in form (appearance) of stool

    6. Epidemiology of IBS in US(15% to 20% of Population)

    7. Prevalence of Disorders in US IBS: 15% - 20% Dyspepsia: 8% GE reflux: 7% Asthma: 4% Diabetes: 3%

    8. IBS Symptoms Reduce Patient Well Being

    9. Medical Costs Associated With IBS Estimated $8 billion annually in direct costs Increased physician visits for both GI and non-GI complaints IBS patients incur 74% more health care costs than do non-IBS sufferers

    10. Impact of IBS on Work Missed work: 30% (1.7 days) Reduced days: 46% (3 days) Turned down promotion: 16% Changed job, health reasons: 9% Changed work schedule: 8%

    11. Pathophysiology of IBS: A Biopsychosocial Disorder Biological Altered GI motor activity Altered visceral sensation Psychosocial Behavioral Cognitive Emotional

    12. Multiple Medications Are Used to Treat IBS Anticholinergics Tricyclic antidepressants SSRIs Antidiarrheals Bulking agents Laxatives Alosetron*

    13. New Treatment Paradigm for C-IBS

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