1 / 13

Overview of Irritable Bowel Syndrome

Overview of Irritable Bowel Syndrome. Arnold Wald, MD Professor of Medicine Department of Gastroenterology, Hepatology, and Nutrition University of Pittsburgh Medical Center Pittsburgh, Pennsylvania. Irritable Bowel Syndrome. Chronic or recurrent GI symptoms Lower abdominal pain/discomfort

ferris
Download Presentation

Overview of Irritable Bowel Syndrome

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

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

  2. Irritable Bowel Syndrome • 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 Gut. 1999.

  6. Epidemiology of IBS in US(15% to 20% of Population) Specialists 5% Primary care 15% Nonconsulters 80% 25% to 50% of referrals to GIs are IBS

  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 Abdominal pain Reduced sense of well being Altered bowel habits Cramps Bloating Constipation Diarrhea Urgency

  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 Drossman, et al. Dig Dis Sci. 1993;38(9):1569-1580. Talley, et al. Gastroenterology. 1995;109(6):1736-1741.

  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% Hahn BA, et al. Digestion. 1999;60(1):77-81.

  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* *Data support efficacy for diarrhea-predominant IBS.

  13. IO 13 New Treatment Paradigm for C-IBS 5-HT4 agonists Altered motility Altered sensation

More Related