INFECTIONS AND IRRITABLE BOWEL SYNDROME (IBS)

1. INFECTIONSAND IRRITABLE BOWEL SYNDROME(IBS) By Pebbles Miller

2. What Are Intestinal Infections • Viruses, bacteria, parasites, or other pathogens ( microscopic organisms that cause disease) can cause infections in the stomach and small and large intestines, which often lead to gastroenteritis, and diarrhea. • Gastroenteritis is an inflammation of the gastrointestinal tract.

3. Intestinal infections are very common, particularly in developing parts of the world. • The World Health Organization (WHO) estimates that about 2 million children worldwide die each year from diseases that cause diarrhea. • Children, the elderly, and people who have weak immune systems are most likely to contract intestinal infections.

4. What Bacteria Cause Intestinal Infections ? Clostridium difficile infection • can produce fever, watery diarrhea, abdominal pain, and loss of appetite. • Risk factors for infection include taking antibiotics, a hospital stay, gastrointestinal surgery, and having another serious illness. • Health care workers often spread the bacteria when they touch infected feces or contaminated surfaces, then touch patients or give them medicine without first washing their hands.

5. Figure 2. Irregular yellow plaques of necrotic debris (black arrow) with intervening edematous bowel mucosa (white arrow) in an 87-year-old woman. These findings are consistent with pseudomembranes caused by Clostridium difficile infection. • C. difficile will overgrow from a lack of normal flora due to treatment with antibiotics. • This causes an inflammation called antibiotic associated pseudomembranous colitis(AAPMC).

6. Salmonella E.coli 0157:H7 Shigella Campylobacter

7. These bacteria produce toxic substances , and mucosal cells respond by secreting water and electrolytes, causing an imbalance. • The amount of fluid secreted exceeds the ability of the large intestine to reabsorb the fluid into the vascular system. • This causes diarrhea

8. Conditions are treated with antibiotics: clindamycin, ampicillin, & amoxicillin, Flagyl is the drug of choice for AAPMC Pepto-Bismol can effectively ↓intestinal secretoins & diarrhea vol. Electrolyte replacement if necessary. Pt. will complain of diarrhea, rectal urgency, abdominal cramping. They will have a fever higher than 102°F, and vomiting. A stool culture is done, and possibly a blood chemistry to monitor electrolyte ∆’s Important stuff

9. The Nurse should… • Do a thorough assessment: determining onset, severity, and the number of people exposed. • Instruct Pt. to keep track of bowel movements & its characteristics • Teach Pt. and family the importance of handwashing after bowel movements and handling raw meats ( cook meat thoroughly).

10. Prognosis • Good. Especially w/ early treatment. • The body may be able to successfully defend against infection w/o intervention. • In other cases meds. and fluid replacement is needed.

11. Irritable Bowel Syndrome • irritable bowel syndrome (IBS) or spastic colon is a functional bowel disorder characterized by abdominal pain and changes in bowel habits which are not associated with any abnormalities seen on routine clinical testing. • It is fairly common and makes up 20–50% of visits to gastroenterologists. • Lower abdominal pain, and bloating associated with alteration of bowel habits and abdominal discomfort relieved with defecation are the most frequent symptoms.

12. 3 Types Diarrhea, constipation, or both • Diarrhea-predominant: At least 1 of B, D, F and none of A, C, E; or at least 2 of B, D, F and one of A or E. • Constipation-predominant: At least 1 of A, C, E and none of B, D, F; or at least 2 of A, C, E and one of B, D, F A) Fewer than three bowel movements a week B) More than three bowel movements a day C) Hard or lumpy stools D) Loose (mushy) or watery stools E) Straining during a bowel movement F) Urgency (having to rush to have a bowel movement) G) Feeling of incomplete bowel movement H) Passing mucus (white material) during a bowel movement I) Abdominal fullness, bloating, or swelling

13. IBS is not a disease. It's a functional disorder, which means that the bowel doesn't work as it should. • With IBS, the nerves and muscles in the bowel are extra-sensitive. For example, the muscles may contract too much when you eat. These contractions can cause cramping and diarrhea during or shortly after a meal. • Or the nerves can be overly sensitive to the stretching of the bowel (because of gas, for example). Cramping or pain can result.

14. Causes of IBS

15. Medical Tests for IBS • Physical exam • Blood tests • X ray of the bowel: This x-ray test is called a barium enema or lower GI (gastrointestinal) series. Barium is a thick liquid that makes the bowel show up better on the x ray. Before taking the x ray, the doctor will put barium into your bowel through the anus. • Endoscopy: The doctor inserts a thin tube into your bowel. The tube has a camera in it, so the doctor can look at the inside of the bowel to check for problems.

16. What is the treatment? • IBS has no cure, but you can do things to relieve symptoms. Treatment may involve • diet changes • medicine • stress relief • You may have to try a combination of things to see which works best for you.

17. Things that make it better • Here are some examples of foods with fiber: • Fruits,vegetables,breads, cereals, and beans, • ApplesPeaches • Broccoli, rawCabbageCarrots, rawPeas; Kidney beansLima beans • Whole-grain breadWhole-grain cereal

18. Med. Management • Medicine • If necessary, the doctor might give you medicine to help with symptoms: • laxatives: to treat constipation • antispasmodics: to slow contractions in the bowel, which helps with diarrhea and pain • antidepressants: to help those who have severe pain

19. Medicine • If necessary, the doctor might give you medicine to help with symptoms: • laxatives: to treat constipation • antispasmodics: to slow contractions in the bowel, which helps with diarrhea and pain • antidepressants: to help those who have severe pain

20. Medicine • If necessary, the doctor might give you medicine to help with symptoms: • laxatives: to treat constipation • antispasmodics: to slow contractions in the bowel, which helps with diarrhea and pain • antidepressants: to help those who have severe pain